Epidemiology of thyroid nodules.

Thyroid nodules are common and are commonly benign. The reported prevalence of nodular thyroid disease depends on the population studied and the methods used to detect nodules. Nodule incidence increases with age, and is increased in women, in people with iodine deficiency, and after radiation exposure. Numerous studies suggest a prevalence of 2-6% with palpation, 19-35% with ultrasound, and 8-65% in autopsy data. With widespread use of sensitive imaging in clinical practice, incidental thyroid nodules are being discovered with increasing frequency. Ultrasonography is the most accurate and cost-effective method for evaluating and observing thyroid nodules. Current ultrasonography machines are relatively inexpensive, sensitive, and easy to operate. Most endocrinologists are now using ultrasound examination in the initial evaluation of a patient with known or suspected thyroid nodule. The management of thyroid incidentalomas is a matter of controversy.

[1]  H. Gharib,et al.  Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. , 1993, Clinics in laboratory medicine.

[2]  G. Blair,et al.  The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices. , 2008, Journal of pediatric surgery.

[3]  L. Crapo,et al.  The epidemiology of thyroid disease and implications for screening. , 1997, Endocrinology and metabolism clinics of North America.

[4]  A. Auvinen,et al.  Thyroid nodularity and cancer among Chernobyl cleanup workers from Estonia. , 1997, Radiation research.

[5]  H. Gharib,et al.  Solitary thyroid nodule. Comparison between palpation and ultrasonography. , 1995, Archives of internal medicine.

[6]  C. Minder,et al.  Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency. , 1995, European journal of endocrinology.

[7]  T. Jørgensen,et al.  The impact of smoking on thyroid volume and function in relation to a shift towards iodine sufficiency , 2008, European Journal of Epidemiology.

[8]  M. Erdoğan,et al.  Endemic goiter, thiocyanate overload, and selenium status in school-age children , 2001, Biological Trace Element Research.

[9]  N. Agnantis,et al.  Occult thyroid carcinoma. A study of 160 autopsy cases. The first report for the region of Epirus-Greece. , 2002, Anticancer research.

[10]  G. Brabant,et al.  Association between serum insulin-like growth factor-I levels and thyroid disorders in a population-based study. , 2007, The Journal of clinical endocrinology and metabolism.

[11]  P. Marcy,et al.  Very high frequency (13 MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules. , 1994, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[12]  E. A. Gaston,et al.  The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. , 1968, Annals of internal medicine.

[13]  P. Trerotoli,et al.  Prevalence of thyroid nodules in an occupationally radiation exposed group: a cross sectional study in an area with mild iodine deficiency , 2005, BMC public health.

[14]  R. Kane,et al.  Thyroid nodules: sonographic-pathologic correlation. , 1984, Radiology.

[15]  U. John,et al.  Smoking as a risk factor for thyroid volume progression and incident goiter in a region with improved iodine supply. , 2008, European journal of endocrinology.

[16]  M. Erdoğan Thiocyanate overload and thyroid disease. , 2003, BioFactors.

[17]  L. Woolner,et al.  Gross and microscopic findings in clinically normal thyroid glands. , 1955, The Journal of clinical endocrinology and metabolism.

[18]  H. Gharib,et al.  Nodular thyroid disease. Evaluation and management. , 1985, The New England journal of medicine.

[19]  M. Niedziela,et al.  Pathogenesis, diagnosis and management of thyroid nodules in children. , 2006, Endocrine-related cancer.

[20]  Jeong Hyun Lee,et al.  Focal uptake of 18F‐fluorodeoxyglucose by thyroid in patients with nonthyroidal head and neck cancers , 2007 .

[21]  K. Sullivan,et al.  Randomized clinical trial comparing different iodine interventions in school children , 1999, Public Health Nutrition.

[22]  C. Ruchti,et al.  Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients , 1993, Histopathology.

[23]  T. Jørgensen,et al.  Risk factors for goiter and thyroid nodules. , 2002, Thyroid : official journal of the American Thyroid Association.

[24]  D. Sarti,et al.  Thyroid Incidentalomas: Prevalence by Palpation and Ultrasonography , 1994 .

[25]  C. O. Rice INCIDENCE OF NODULES IN THE THYROID: A COMPARATIVE STUDY OF SYMPTOMLESS THYROID GLANDS REMOVED AT AUTOPSY AND HYPERFUNCTIONING GOITERS OPERATIVELY REMOVED , 1932 .

[26]  R J Telepak,et al.  Thyroid palpation versus high‐resolution thyroid ultrasonography in the detection of nodules. , 1998, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[27]  Katsumi Eguchi,et al.  Radiation dose-response relationships for thyroid nodules and autoimmune thyroid diseases in Hiroshima and Nagasaki atomic bomb survivors 55-58 years after radiation exposure. , 2006, JAMA.

[28]  T. Jørgensen,et al.  The Danish investigation on iodine intake and thyroid disease, DanThyr: status and perspectives. , 2006, European journal of endocrinology.

[29]  A. Pinchera,et al.  The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. , 1999, The Journal of clinical endocrinology and metabolism.

[30]  M. Schoemaker,et al.  The Relationship of Thyroid Cancer with Radiation Exposure from Nuclear Weapon Testing in the Marshall Islands , 2003, Journal of epidemiology.

[31]  L. Hegedüs,et al.  HIGH FREQUENCY OF GOITRE IN CIGARETTE SMOKERS , 1985, Clinical endocrinology.

[32]  J. Leech,et al.  Aberrant Thyroid Glands. , 1928, The American journal of pathology.

[33]  M. Zimmermann,et al.  Thyroid size and goiter prevalence after introduction of iodized salt: a 5-y prospective study in schoolchildren in Côte d'Ivoire. , 2003, The American journal of clinical nutrition.

[34]  Henry Völzke,et al.  The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area. , 2003, Thyroid : official journal of the American Thyroid Association.

[35]  Oertel Je,et al.  STRUCTURAL CHANGES IN THE THYROID GLANDS OF HEALTHY YOUNG MEN. , 1965 .

[36]  M. Zimmermann,et al.  Rapid relapse of thyroid dysfunction and goiter in school-age children after discontinuation of salt iodization. , 2004, The American journal of clinical nutrition.

[37]  S. Krishnamurthi,et al.  Evaluation and management of incidental thyroid nodules in patients with another primary malignancy. , 2007, Surgery.

[38]  R. Paschke,et al.  The role of thiocyanate in the etiology of goiter in an industrial metropolitan area. , 2006, European journal of endocrinology.

[39]  T. Jørgensen,et al.  Alcohol consumption is associated with reduced prevalence of goitre and solitary thyroid nodules , 2001, Clinical endocrinology.

[40]  M. Nichaman,et al.  Iodine and goiter in children. , 1975, Pediatrics.

[41]  K. Sworczak,et al.  [The prevalence of incidentaloma--asymptomatic thyroid nodules in the Tricity (Gdansk, Sopot, Gdynia) population]. , 2006, Endokrynologia Polska.

[42]  P. Laurberg,et al.  Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. , 1998, The Journal of clinical endocrinology and metabolism.

[43]  M. Fey,et al.  Polyclonal and monoclonal thyroid nodules coexist within human multinodular goiters. , 1994, The Journal of clinical endocrinology and metabolism.

[44]  Jen-Der Lin,et al.  Thyroid cancer in the thyroid nodules evaluated by ultrasonography and fine-needle aspiration cytology. , 2005, Thyroid : official journal of the American Thyroid Association.

[45]  F. H. Tyler,et al.  Thyroid nodularity in children. , 1975, JAMA.

[46]  D. Seehofer,et al.  Prevalence of Thyroid Nodules and Carcinomas in Patients Operated on for Renal Hyperparathyroidism: Experience with 339 Consecutive Patients and Review of the Literature , 2005, World Journal of Surgery.

[47]  P. Singer,et al.  Evaluation and management of the solitary thyroid nodule. , 1996, Otolaryngologic clinics of North America.

[48]  H. Oh,et al.  Critical analysis of two hundred twenty-one thyroid glands; study of thyroid glands obtained at necropsy in Colorado. , 1955 .

[49]  M. F. Lesses,et al.  The treatment of nodular goiter. , 1952, The Journal of clinical endocrinology and metabolism.

[50]  W. Lang,et al.  Occult carcinomas of the thyroid. Evaluation of 1,020 sequential autopsies. , 1988, American journal of clinical pathology.

[51]  M. Schoemaker,et al.  An investigation into the prevalence of thyroid disease on Kwajalein Atoll, Marshall Islands. , 1997, Health physics.

[52]  M. Galia,et al.  Incidentally discovered thyroid nodules: incidence, and greyscale and colour Doppler pattern in an adult population screened by real-time compound spatial sonography , 2006, La radiologia medica.

[53]  T. Jørgensen,et al.  Association of tobacco smoking with goiter in a low-iodine-intake area. , 2002, Archives of internal medicine.

[54]  W C Black,et al.  Advances in diagnostic imaging and overestimations of disease prevalence and the benefits of therapy. , 1993, The New England journal of medicine.

[55]  R. Görges,et al.  Impact of disease activity on thyroid diseases in patients with acromegaly: basal evaluation and follow-up. , 2004, Experimental and clinical endocrinology & diabetes.

[56]  M. J. Schlesinger,et al.  STUDIES IN NODULAR GOITER: I. INCIDENCE OF THYROID.NODULES IN ROUTINE NECROPSIES IN A NONGOITROUS REGION , 1938 .

[57]  L. Janzon,et al.  The prevalence of thyroid disorders in a middle-aged female population, with special reference to the solitary thyroid nodule. , 1984, Acta chirurgica Scandinavica.

[58]  Lamberg Ba Endemic goitre in Finland and changes during 30 years of iodine prophylaxis. , 1986 .

[59]  G. Leopold,et al.  High-resolution real-time ultrasonography of thyroid nodules. , 1979, Radiology.

[60]  H. Gharib,et al.  Thyroid incidentalomas. Prevalence, diagnosis, significance, and management. , 2000, Endocrinology and metabolism clinics of North America.

[61]  Q. Duh,et al.  Does the presence of additional thyroid nodules on ultrasound alter the risk of malignancy in patients with a follicular neoplasm of the thyroid? , 2007, Surgery.

[62]  Seung-Yong Jeong,et al.  Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. , 2003, The Journal of clinical endocrinology and metabolism.

[63]  T. Desser,et al.  Ultrasound of thyroid nodules. , 2008, Neuroimaging clinics of North America.

[64]  A. Maes,et al.  Clinical relevance of thyroid fluorodeoxyglucose-whole body positron emission tomography incidentaloma. , 2002, The Journal of clinical endocrinology and metabolism.

[65]  H. Gharib,et al.  Changing concepts in the diagnosis and management of thyroid nodules. , 1997, Endocrinology and metabolism clinics of North America.

[66]  M. Richards,et al.  Total thyroidectomy is the preferred treatment for patients with Graves' disease and a thyroid nodule , 2007, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[67]  U. John,et al.  The spectrum of thyroid disorders in adult type 1 diabetes mellitus , 2007, Diabetes/metabolism research and reviews.

[68]  A. Meikle,et al.  Natural history of thyroid abnormalities: prevalence, incidence, and regression of thyroid diseases in adolescents and young adults. , 1991, The American journal of medicine.

[69]  D. Appleton,et al.  THE SPECTRUM OF THYROID DISEASE IN A COMMUNITY: THE WHICKHAM SURVEY , 1977, Clinical endocrinology.

[70]  Z. Baloch,et al.  Is fine-needle aspiration (FNA) of multiple thyroid nodules justified? , 2006, Endocrine pathology.

[71]  A. Vermeulen,et al.  Demonstration of nodules in the normal thyroid by echography. , 1985, The British journal of radiology.

[72]  F. Bianchi,et al.  Risk of thyroid nodules in subjects occupationally exposed to radiation: a cross sectional study. , 1995, Occupational and environmental medicine.

[73]  J Nickels,et al.  Thyroid gland: US screening in a random adult population. , 1991, Radiology.

[74]  P. Larsen,et al.  Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. , 2006, The Journal of clinical endocrinology and metabolism.

[75]  F. Epstein,et al.  GOITER AND OTHER THYROID DISEASES IN TECUMSEH, MICHIGAN; STUDIES IN A TOTAL COMMUNITY. , 1965, JAMA.