Epidemiology of Thyroid Nodules

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Palpable thyroid nodules increase in frequency throughout life:
    • Reaching a prevalence of about 5% in the U.S. population for individuals ≥50 years having palpable thyroid nodules
  • Nodules are even more prevalent when the thyroid gland is examined at autopsy or surgery, or when using ultrasonography:
    • 50% of the thyroids studied have nodules:
      • Which are almost always benign
  • New nodules develop at a rate of about 0.1% per year:
    • Beginning in early life
  • They develop at a much higher rate (approximately 2% per year):
    • After exposure to head and neck irradiation
  • Thyroid nodules are approximately four times more common in individuals assigned female at birth (AFAB) than in individuals assigned male at birth (AMAB)
  • By contrast, thyroid carcinoma is uncommon:
    • For the U.S. population:
      • The lifetime risk of being diagnosed with thyroid carcinoma is:
        • 1.2%
      • It is estimated that approximately 43,720 new cases of thyroid carcinoma will be diagnosed in the United States in 2023
      • As with thyroid nodules:
        • Thyroid carcinoma occurs two to three times more often in individuals AFAB than in individuals AMAB
      • Thyroid carcinoma is currently the seventh most common malignancy diagnosed in individuals AFAB
      • The disease is also diagnosed more often in white North Americans than in African Americans
    • The main histologic types of thyroid carcinoma are:
      • Differentiated (including papillary, follicular, and oncocytic)
      • Medullary
      • Anaplastic:
        • Which is an aggressive undifferentiated tumor
    • Of 63,324 patients diagnosed with thyroid carcinoma from 2011 to 2015:
      • 89.8% had papillary carcinoma
      • 4.5% had follicular carcinoma
      • 1.8% had oncocytic carcinoma
      • 1.6% had medullary carcinoma
      • 0.8% had anaplastic carcinoma
  • A population-based study of data collected by the International Agency for Research on Cancer from 1998 to 2012:
  • Showed that the global incidence of papillary thyroid carcinoma (PTC) increased during this time
  • Mortality rates for thyroid carcinoma are, in general, very low
  • Differentiated thyroid carcinomas usually have an excellent prognosis:
    • With 10-year survival rates exceeding 90% to 95%
  • In contrast, anaplastic thyroid carcinoma (ATC) is almost uniformly lethal
  • However, since differentiated thyroid carcinomas represent more than 95% of all cases:
    • Most thyroid carcinoma deaths are from:
      • Papillary, follicular, and oncocytic carcinomas
  • In 2023, it is estimated that approximately 2120 cancer deaths will occur among persons with thyroid carcinoma in the United States
  • Though thyroid carcinoma occurs more often in individuals AFAB:
    • Mortality rates are lower for younger individuals AFAB
  • Although the estimated incidence of thyroid carcinoma previously increased by an average of ~5% annually between 2004 and 2013:
    • The incidence rate has more recently stabilized:
      • Likely due to more conservative indications for thyroid biopsy and the reclassification of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)
    • Because overall mortality has not dramatically increased since 1975 (1150 vs. 2060 deaths):
      • The previous increase in incidence may reflect, at least in part, earlier detection of subclinical disease (ie, small papillary carcinomas):
        • However, data show the incidence has increased by varying degrees across all tumor sizes and age groups
          • The stable age- and gender-adjusted mortality rate for thyroid carcinoma contrasts distinctly with the declining rates for other solid tumors in adults
  • A cohort study of 2000 to 2016 data from U.S. cancer registries:
    • Showed an increase in incidence of aggressive PTC
  • In addition, an analysis of 1992 to 2018 SEER data showed that there is no evidence of an improvement in disease-specific survival (DSS) in patients with distantly metastatic differentiated thyroid cancer
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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