Thyroid nodule risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Prevalence of thyroid incidentalomas estimated from autopsy studies ranges from 30% to 60%. Studies comparing clinical palpation with thyroid imaging show a prevalence of 13% to 50%. Prospective studies of randomly selected patients have reported a prevalence of 19% to 67%. The risk for malignancy in asymptomatic nodules found in nonirradiated glands is 0.45% to 13% (mean +/- SD, 3.9% +/- 4.1%).

Risk Factors

Other factors associated with an increased risk of thyroid nodules and goiter include:

• Hard nodule
• Nodule that is stuck to nearby structures
• Family history of thyroid cancer
• Younger than 20 or older than 70 1415299
  • Thyroid nodularity increases with age . The presence of a thyroid nodule in a child is twice more likely to be a cancer than if it was in an adult.13263417 2773619
• History of radiation exposure to the head or neck

  • A history of radiation treatment to the head and neck region to treat acne, inflammation of the tonsils or adenoids, or thymic enlargement is associated with an increased incidence of thyroid nodularity and cancer . 3965855

• Male gender
  • the rate of cancer is twice as high in men than women (8 versus 4 percent)
• Smoking 11863477
• Alcohol consumption 18031329
• Insulin-like growth factor 1 (IGF-1) levels
• Increased parity and late age at first pregnancy 10965973
• Hepatitis C-related chronic hepatitis (odds ratio [OR] 12.2 in one report) 17542674

thyroid nodules in men and decreased serum TSH levels in women 17666480

• Uterine fibroids 17988198

Factors associated with a possible decreased risk include:

• Oral contraceptive use 12100072
• Use of statins (associated with a reduced risk of nodules on ultrasound)
  • reduced prevalence, number and volume of thyroid nodules 17666091

• A history of papillary thyroid cancer in at least one first-degree family member is associated with an increased risk of a nodule being malignant

  10030330

  1415299

• Hematopoietic stem cell transplantation increases the relative risk (RR) for thyroid cancer to 3.26; if transplantation occurred prior to age 10, the RR was 24.6.

17557958