Thyroid cancer

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Thyroid cancer
Thyroid papillary carcinoma histopathology (4).jpg
Micrograph of a papillary thyroid carcinoma demonstrating diagnostic features (nuclear clearing and overlapping nuclei).
Specialty Oncology
Symptoms Swelling or lump in the neck [1]
Risk factors Radiation exposure, enlarged thyroid, family history, [1] [2] obesity [3]
Diagnostic method Ultrasound, fine needle aspiration [1]
Differential diagnosis Thyroid nodule, metastatic disease [1] [4]
TreatmentSurgery, radiation therapy, chemotherapy, thyroid hormone, targeted therapy, watchful waiting [1]
Prognosis Five year survival rates 98% (US) [5]
Frequency3.2 million (2015) [6]
Deaths31,900 (2015) [7]

Thyroid cancer is cancer that develops from the tissues of the thyroid gland. [1] It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. [8] [9] Symptoms can include swelling or a lump in the neck, difficulty swallowing or voice changes including hoarseness, or a feeling of something being in the throat due to mass effect from the tumor. However, most cases are asymptomatic. [1] [10] Cancer can also occur in the thyroid after spread from other locations, in which case it is not classified as thyroid cancer. [4]

Contents

Risk factors include radiation exposure at a young age, having an enlarged thyroid, family history and obesity. [1] [2] [3] The four main types are papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and anaplastic thyroid cancer. [4] Diagnosis is often based on ultrasound and fine needle aspiration. [1] Screening people without symptoms and at normal risk for the disease is not recommended. [10] [11]

Treatment options may include surgery, radiation therapy including radioactive iodine, chemotherapy, thyroid hormone, targeted therapy, and watchful waiting. [1] Surgery may involve removing part or all of the thyroid. [4] Five-year survival rates are 98% in the United States. [5]

Globally as of 2015, 3.2 million people have thyroid cancer. [6] In 2012, 298,000 new cases occurred. [12] It most commonly is diagnosed between the ages of 35 and 65. [5] Women are affected more often than men. [5] Those of Asian descent are more commonly affected; [4] with a higher rate of mortality among Filipino females. [13] Rates have increased in the last few decades, which is believed to be due to better detection. [12] In 2015, it resulted in 31,900 deaths. [7]

Signs and symptoms

Most people with thyroid cancer do not have symptoms at the time of diagnosis and thyroid nodules and thyroid cancer is usually found incidentally on imaging of the neck. [10] [14] Up to 65% of adults have small nodules in their thyroids, but typically under 10% of these nodules are found to be cancerous. [15] Sometimes, the first sign is an enlarged lymph node. Later symptoms that can be present are pain in the anterior region of the neck and changes in voice due to an involvement of the recurrent laryngeal nerve. [16]

Thyroid cancer is usually found in a euthyroid patient, but symptoms of hyperthyroidism or hypothyroidism may be associated with a large or metastatic, well-differentiated tumor. Thyroid nodules are of particular concern when they are found in those under the age of 20. The presentation of benign nodules at this age is less likely, thus the potential for malignancy is far greater. [17]

Causes

Thyroid cancers are thought to be related to a number of environmental and genetic predisposing factors, but significant uncertainty remains regarding their causes. [18]

Environmental exposure to ionizing radiation from both natural background sources and artificial sources is suspected to play a significant role, and significantly increased rates of thyroid cancer occur in those exposed to mantlefield radiation for lymphoma, and those exposed to iodine-131 following the Chernobyl, [19] Fukushima, Kyshtym, and Windscale [20] nuclear disasters. [21] Thyroiditis and other thyroid diseases also predispose to thyroid cancer. [20] [22]

Genetic causes include multiple endocrine neoplasia type 2, which markedly increases rates, particularly of the rarer medullary form of the disease. [23] Mutations in the genes for MenA and Men2B in multiple endocrine neoplasia is responsible for 25% of medullary thyroid cancers. [10]

Diagnosis

Micrograph of a lymph node with papillary thyroid carcinoma Lymph node with papillary thyroid carcinoma.jpg
Micrograph of a lymph node with papillary thyroid carcinoma

After a thyroid nodule is found during a physical examination or incidentially on imaging, a referral to an endocrinologist or a thyroidologist may occur. Most commonly, an ultrasound is performed to confirm the presence of a nodule and assess the status of the whole gland. Various radiological clinical criteria, including the thyroid imaging reporting and data system (TIRADs) score, are used to characterize the risk of malignancy. [24] On ultrasound, nodules that are hypoechogenic (solid consistency), having irregular borders, increased vascularity, calcifications, or being taller than wide on transverse views are associated with malignancy. [10] Biopsy or cytology are required if the ultrasound characteristics suggest malignancy. If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10] Ultrasound has a sensitivity of 64-77% and a specificity of 82-90% for the detection of thyroid cancer. [10] Measurement of thyroid stimulating hormone, free and/or total triiodothyronine (T3) and thyroxine (T4) levels, and antithyroid antibodies will help decide if a functional thyroid disease such as Hashimoto's thyroiditis is present, a known cause of a benign nodular goiter. [25] A thyroid scan, performed often in conjunction with a radioactive iodine uptake test may be used to determine whether a nodule is hyperactive [26] which may help to make a decision whether to perform a biopsy of the nodule. [27] Measurement of calcitonin is necessary to exclude the presence of medullary thyroid cancer. To achieve a definitive diagnosis, a fine needle aspiration cytology test may be performed and reported according to the Bethesda system. [28]

After diagnosis, to understand potential for spread of disease, or for follow up monitoring after surgery, a whole body I-131 or I-123 radioactive iodine scan may be performed. [29]

In adults without symptoms, screening for thyroid cancer is not recommended. [30]

Classification

Pie chart of thyroid cancer types by incidence. Pie chart of relative incidences of thyroid cancers.png
Pie chart of thyroid cancer types by incidence.

Thyroid cancers can be classified according to their histopathological characteristics. [32] [33] These variants can be distinguished (distribution over various subtypes may show regional variation):

The follicular and papillary types together can be classified as "differentiated thyroid cancer". [39] These types have a more favorable prognosis than the medullary and undifferentiated types. [40]

Staging

Cancer staging is the process of determining the extent of the development of a cancer. The TNM staging system is usually used to classify stages of cancers, but not of the brain. [45]

Metastases

Detection of differentiated thyroid cancer metastases may be detected by performing a full-body scintigraphy using iodine-131. [46] [47]

Spread

Thyroid cancer can spread directly, via lymphatics or blood. Direct spread occurs through infiltration of the surrounding tissues. The tumor infiltrates into infrahyoid muscles, trachea, oesophagus, recurrent laryngeal nerve, carotid sheath, etc. The tumor then becomes fixed. Anaplastic carcinoma spreads mostly by direct spread, while papillary carcinoma spreads so the least. Lymphatic spread is most common in papillary carcinoma. Cervical lymph nodes become palpable in papillary carcinoma even when the primary tumor is unpalpable. Deep cervical nodes, pretracheal, prelaryngeal, and paratracheal groups of lymph nodes are often affected. The lymph node affected is usually the same side as that of the location of the tumor. Blood spread is also possible in thyroid cancers, especially in follicular and anaplastic carcinoma. The tumor emboli do angioinvasion of lungs; end of long bones, skull, and vertebrae are affected. Pulsating metastases occur because of their increased vascularity. [48]

Treatment

Thyroidectomy and dissection of central neck compartment is the initial step in treatment of thyroid cancer in the majority of cases. [14] Thyroid-preserving operations may be applied in cases, when thyroid cancer exhibits low biological aggressiveness (e.g. well-differentiated cancer, no evidence of lymph-node metastases, low MIB-1 index, no major genetic alterations like BRAF mutations, RET/PTC rearrangements, p53 mutations etc.) in patients younger than 45 years. [49] If the diagnosis of well-differentiated thyroid cancer (e.g. papillary thyroid cancer) is established or suspected by FNA, then surgery is indicated. [49] [50] Surgical resection is the preferred treatment for all biopsy confirmed thyroid cancers. In those with very low risk tumors (such as small papillary tumors without evidence of local or metastatic spread or concerning cytologic findings), patients at high surgical risk due to medical problems, those with short expected lifespans or patients with serious medical issues precluding surgery, an active surveillance approach, in which the tumor is monitored over time (such as with serial imaging) may be pursued. [51]

Post surgical monitoring for recurrence or metastasis may include routine ultrasound, CT scans, FDG-PET/CT, radioactive iodine whole body scans, and routine laboratory blood tests for changes in thyroglobulin, thyroglobulin antibodies, or calcitonin, depending on the subtype of thyroid cancer. [52] [53] [54]

Radioactive iodine-131 is used in people with papillary or follicular thyroid cancer for ablation of residual thyroid tissue after surgery and for the treatment of thyroid cancer. [55] Post-surgical radioactive iodine is recommended for those with high risk of cancer recurrence. Post-surgery radioactive iodine does not reduce recurrence in those with low risk thyroid cancer. [10] Patients with medullary, anaplastic, and most Hurthle-cell cancers do not benefit from this therapy. [14] External irradiation may be used when the cancer is unresectable, when it recurs after resection, or to relieve pain from bone metastasis. [14]

Sorafenib and lenvatinib are approved for advanced metastatic thyroid cancer. [56] Numerous agents are in phase II and III clinical trials. [56]

Prognosis

The prognosis of thyroid cancer is related to the type of cancer and the stage at the time of diagnosis. For the most common form of thyroid cancer, papillary, the overall prognosis is excellent with 97%, 95%, and 90% 10, 15 and 20 year overall survival respectively. [57] The 5 year survival of all thyroid cancers, with treatment, is 98%. [10]

Many small thyroid cancers (mostly papillary type) rarely grow or metastasize. Some have stated that thyroid cances are overdiagnosed and will rarely cause symptoms, illness, or death, even without treatment. [58] Low grade thyroid cancer is very commonly seen during autopsy studies, with the person dying from other causes. [58] Increasingly, small thyroid nodules are discovered as incidental findings on imaging (CT scan, MRI, ultrasound) performed for another purpose. Few of these people with incidentally discovered, subclinical thyroid cancers will ever have any symptoms, and overtreatment may be present. [58]

Thyroid cancer is three times more common in women than in men. [59] The overall relative 5-year survival rate for thyroid cancer is 85% for females and 74% for males. [60]

The identification of some molecular or DNA abnormalities has led to the development of therapies that target these molecular defects. The first of these agents to negotiate the approval process is vandetanib, a tyrosine kinase inhibitor that targets the RET proto-oncogene , two subtypes of the vascular endothelial growth factor receptor, and the epidermal growth factor receptor. [61] For differentiated thyroid carcinoma, strategies are evolving to use selected types of targeted therapy to increase radioactive iodine uptake in papillary thyroid carcinomas that have lost the ability to concentrate iodide. This strategy would make possible the use of radioactive iodine therapy to treat "resistant" thyroid cancers.

Mitogen-activated protein kinase (MAPK) variants are the most common genetic variants seen in thyroid cancer. [10] The BRAF 600E genetic variant is seen in 60% of papillary thyroid cancers. It is associated with increased risks of cervical lymph node metastasis, blunted response to radioactive iodine, and increased rates of local recurrence. [10] RasGTPase mutations are seen in 13% of papillary and 25-50% of follicular cancers and are associated with increased risk of vascular invasion and higher response to radioactive iodine. [10]

Prognosis is better in younger people than older ones. [60]

Prognosis depends mainly on the type of cancer and cancer stage. [10]

 
Thyroid cancer type		 5-year survival 10-year survival
Stage IStage IIStage IIIStage IVOverallOverall
Papillary 100% [62] 100% [62] 93% [62] 51%51% [62] 96% [63] or 97% [64] 93% [63]
Follicular 100% [62] 100% [62] 71% [62] 50% [62] 91% [63] 85% [63]
Medullary 100% [62] 98% [62] 81% [62] 28% [62] 80%, [63] 83% [65] or 86% [66] 75% [63]
Anaplastic (always stage IV) [62] 7% [62] 7% [62] or 14% [63] (no data)

Epidemiology

Thyroid cancer, in 2010, resulted in 36,000 deaths globally up from 24,000 in 1990. [67] Obesity may be associated with a higher incidence of thyroid cancer, but this relationship remains the subject of much debate. [68]

Thyroid cancer accounts for less than 1% of cancer cases and deaths in the UK. Around 2,700 people were diagnosed with thyroid cancer in the UK in 2011, and around 370 people died from the disease in 2012. [69]

However, in South Korea, thyroid cancer was the 5th most prevalent cancer, which accounted for 7.7% of new cancer cases in 2020. [70]

The incidence of thyroid cancer in the United States increased by 313% from a 1974-1977 incidence of 4.6 cases per 100,000 people to 14.4 cases per 100,000 people in 2010-13. [71] This increase is thought to be due to more widespread use of head and neck imaging (which may incidentally detect thyroid masses) as well as increased use of fine needle aspiration biopsies. [10]

Notable cases

Related Research Articles

<span class="mw-page-title-main">Hyperthyroidism</span> Clinical syndrome caused by excessive thyroid hormone

Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidism. Some, however, use the terms interchangeably. Signs and symptoms vary between people and may include irritability, muscle weakness, sleeping problems, a fast heartbeat, heat intolerance, diarrhea, enlargement of the thyroid, hand tremor, and weight loss. Symptoms are typically less severe in the elderly and during pregnancy. An uncommon but life-threatening complication is thyroid storm in which an event such as an infection results in worsening symptoms such as confusion and a high temperature; this often results in death. The opposite is hypothyroidism, when the thyroid gland does not make enough thyroid hormone.

<span class="mw-page-title-main">Thyroid</span> Endocrine gland in the neck; secretes hormones that influence metabolism

The thyroid, or thyroid gland, is an endocrine gland in vertebrates. In humans, it is a butterfly-shaped gland located in the neck below the Adam's apple. It consists of two connected lobes. The lower two thirds of the lobes are connected by a thin band of tissue called the isthmus. Microscopically, the functional unit of the thyroid gland is the spherical thyroid follicle, lined with follicular cells (thyrocytes), and occasional parafollicular cells that surround a lumen containing colloid.

<span class="mw-page-title-main">Thyroid neoplasm</span> Tumor of the thyroid gland

Thyroid neoplasm is a neoplasm or tumor of the thyroid. It can be a benign tumor such as thyroid adenoma, or it can be a malignant neoplasm, such as papillary, follicular, medullary or anaplastic thyroid cancer. Most patients are 25 to 65 years of age when first diagnosed; women are more affected than men. The estimated number of new cases of thyroid cancer in the United States in 2023 is 43,720 compared to only 2,120 deaths. Of all thyroid nodules discovered, only about 5 percent are cancerous, and under 3 percent of those result in fatalities.

<span class="mw-page-title-main">Thyroglobulin</span> Protein produced and used by the thyroid

Thyroglobulin (Tg) is a 660 kDa, dimeric glycoprotein produced by the follicular cells of the thyroid and used entirely within the thyroid gland. Tg is secreted and accumulated at hundreds of grams per litre in the extracellular compartment of the thyroid follicles, accounting for approximately half of the protein content of the thyroid gland. Human TG (hTG) is a homodimer of subunits each containing 2768 amino acids as synthesized.

In medical or research imaging, an incidental imaging finding is an unanticipated finding which is not related to the original diagnostic inquiry. As with other types of incidental medical findings, they may represent a diagnostic, ethical, and philosophical dilemma because their significance is unclear. While some coincidental findings may lead to beneficial diagnoses, others may lead to overdiagnosis that results in unnecessary testing and treatment, sometimes called the "cascade effect".

<span class="mw-page-title-main">Thyroid disease</span> Medical condition

Thyroid disease is a medical condition that affects the function of the thyroid gland. The thyroid gland is located at the front of the neck and produces thyroid hormones that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development.

<span class="mw-page-title-main">Hürthle cell</span> Cell in the thyroid gland associated with cancer

A Hürthle cell is a cell in the thyroid that is often associated with Hashimoto's thyroiditis as well as benign and malignant tumors. This version is a relatively rare form of differentiated thyroid cancer, accounting for only 3-10% of all differentiated thyroid cancers. Oncocytes in the thyroid are often called Hürthle cells. Although the terms oncocyte, oxyphilic cell, and Hürthle cell are used interchangeably, Hürthle cell is used only to indicate cells of thyroid follicular origin.

<span class="mw-page-title-main">Toxic multinodular goitre</span> Enlarged thyroid gland, causing symptoms of hyperthyroidism

Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism.

<span class="mw-page-title-main">Hürthle cell neoplasm</span> Medical condition

Hürthle cell neoplasm is a rare tumor of the thyroid, typically seen in women between the ages of 70 and 80 years old. When benign, it is called a Hürthle cell adenoma, and when malignant it is called a Hürthle cell carcinoma. Hürthle cell adenoma is characterized by a mass of benign Hürthle cells. Typically such a mass is removed because it is not easy to predict whether it will transform into the malignant counterpart of Hürthle cell carcinoma, which is a subtype of follicular thyroid cancer.

<span class="mw-page-title-main">Anaplastic thyroid cancer</span> Most aggressive form of thyroid cancer

Anaplastic thyroid cancer (ATC), also known as anaplastic thyroid carcinoma, is an aggressive form of thyroid cancer characterized by uncontrolled growth of cells in the thyroid gland. This form of cancer generally carries a very poor prognosis due to its aggressive behavior and resistance to cancer treatments. The cells of anaplastic thyroid cancer are highly abnormal and usually no longer resemble the original thyroid cells and have poor differentiation.

<span class="mw-page-title-main">Papillary thyroid cancer</span> Medical condition

Papillary thyroid cancer is the most common type of thyroid cancer, representing 75 percent to 85 percent of all thyroid cancer cases. It occurs more frequently in women and presents in the 20–55 year age group. It is also the predominant cancer type in children with thyroid cancer, and in patients with thyroid cancer who have had previous radiation to the head and neck. It is often well-differentiated, slow-growing, and localized, although it can metastasize.

<span class="mw-page-title-main">Sodium/iodide cotransporter</span> Mammalian protein found in Homo sapiens

The sodium/iodide cotransporter, also known as the sodium/iodide symporter (NIS), is a protein that in humans is encoded by the SLC5A5 gene. It is a transmembrane glycoprotein with a molecular weight of 87 kDa and 13 transmembrane domains, which transports two sodium cations (Na+) for each iodide anion (I−) into the cell. NIS mediated uptake of iodide into follicular cells of the thyroid gland is the first step in the synthesis of thyroid hormone.

<span class="mw-page-title-main">Thyroid adenoma</span> Benign tumor of the thyroid gland

A thyroid adenoma is a benign tumor of the thyroid gland, that may be inactive or active as a toxic adenoma.

<span class="mw-page-title-main">Thyroid nodule</span> Lump of tissue or fluid in the thyroid gland

Thyroid nodules are nodules which commonly arise within an otherwise normal thyroid gland. They may be hyperplastic or tumorous, but only a small percentage of thyroid tumors are malignant. Small, asymptomatic nodules are common, and often go unnoticed. Nodules that grow larger or produce symptoms may eventually need medical care. A goitre may have one nodule – uninodular, multiple nodules – multinodular, or be diffuse.

<span class="mw-page-title-main">Follicular thyroid cancer</span> Malignant tumor made of hormone-producing cells in the thyroid gland

Follicular thyroid cancer accounts for 15% of thyroid cancer and occurs more commonly in women over 50 years of age. Thyroglobulin (Tg) can be used as a tumor marker for well-differentiated follicular thyroid cancer. Thyroid follicular cells are the thyroid cells responsible for the production and secretion of thyroid hormones.

<span class="mw-page-title-main">Medullary thyroid cancer</span> Malignant thyroid neoplasm originating from C-cells

Medullary thyroid cancer is a form of thyroid carcinoma which originates from the parafollicular cells, which produce the hormone calcitonin. Medullary tumors are the third most common of all thyroid cancers and together make up about 3% of all thyroid cancer cases. MTC was first characterized in 1959.

<span class="mw-page-title-main">Noninvasive follicular thyroid neoplasm with papillary-like nuclear features</span>

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an indolent thyroid tumor that was previously classified as an encapsulated follicular variant of papillary thyroid carcinoma, necessitating a new classification as it was recognized that encapsulated tumors without invasion have an indolent behavior, and may be over-treated if classified as a type of cancer.

In CT scan of the thyroid, focal and diffuse thyroid abnormalities are commonly encountered. These findings can often lead to a diagnostic dilemma, as the CT reflects nonspecific appearances. Ultrasound (US) examination has a superior spatial resolution and is considered the modality of choice for thyroid evaluation. Nevertheless, CT detects incidental thyroid nodules (ITNs) and plays an important role in the evaluation of thyroid cancer.

Dr. Yuri Nikiforov is an American scientist who revolutionized the understanding of thyroid cancer, most recently winning a two-year battle in which the World Health Organization agreed in 2017 to reclassify non-invasive thyroid tumors to non-cancerogenic liaisons. Those tumors typically have some, but not all, characteristics of cancer. The WHO has agreed to change the term for the tumors from Encapsulated Follicular Variant of Papillary Thyroid Carcinoma to Noninvasive Follicular Thyroid Neoplasm With Papillary-like Nuclear Features, or NIFTP. About 45,000 people a year are diagnosed with NIFTP in the world. The decision led to a change in the protocol of medical treatment, which no longer required removal of the whole thyroid gland from such patients as well as ended the use of radioactive iodine, extending their life expectancy and quality of life. The patients still undergo surgery, in which their thyroid tumors are removed, typically with half, but not all, of the thyroid gland.

Active surveillance is an observational management being increasingly accepted as an alternative over immediate surgery due to low-risk papillary thyroid microcarcinoma with no evidence of extension or metastatic spread. Patients on active surveillance are observed with periodical ultrasound examinations and thyroid function tests. If disease progression is detected, patients are treated with surgery. The chances of thyroid cancer increased during the past 3 decades in many countries, mostly due to increased detection of small papillary thyroid carcinoma, without associated increase in mortality from thyroid cancer.

References

  1. 1 2 3 4 5 6 7 8 9 10 "Thyroid Cancer Treatment". National Cancer Institute. 27 April 2017. Archived from the original on 15 July 2017. Retrieved 18 July 2017.
  2. 1 2 Carling T, Udelsman R (2014). "Thyroid cancer". Annual Review of Medicine. 65: 125–137. doi: 10.1146/annurev-med-061512-105739 . PMID   24274180.
  3. 1 2 Shin A, et al. (2022). "Body Mass Index and Thyroid Cancer Risk: A Pooled Analysis of Half a Million Men and Women in the Asia Cohort Consortium". Thyroid. 32 (3): 306–314. doi: 10.1089/thy.2021.0445 . PMC   8971972 . PMID   34915752.
  4. 1 2 3 4 5 6 "Thyroid Cancer Treatment". National Cancer Institute. 12 May 2017. Archived from the original on 16 July 2017. Retrieved 18 July 2017.
  5. 1 2 3 4 "Cancer of the Thyroid - Cancer Stat Facts". seer.cancer.gov. Archived from the original on 15 July 2017. Retrieved 18 July 2017.
  6. 1 2 Vos, Theo; et al. (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC   5055577 . PMID   27733282.
  7. 1 2 Wang, Haidong; et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC   5388903 . PMID   27733281.
  8. ↑ "Cancer Fact sheet N°297". World Health Organization. February 2014. Archived from the original on 29 December 2010. Retrieved 10 June 2014.
  9. ↑ "Defining Cancer". National Cancer Institute. 17 September 2007. Archived from the original on 25 June 2014. Retrieved 10 June 2014.
  10. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Boucai, Laura; Zafereo, Mark; Cabanillas, Maria E. (6 February 2024). "Thyroid Cancer: A Review". JAMA. 331 (5): 425. doi:10.1001/jama.2023.26348.
  11. ↑ Bibbins-Domingo K, Grossman DC, Curry SJ, Barry MJ, Davidson KW, Doubeni CA, et al. (May 2017). "Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement". JAMA. 317 (18): 1882–1887. doi:10.1001/jama.2017.4011. PMID   28492905. S2CID   205091526.
  12. 1 2 World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.15. ISBN   978-9283204299.
  13. ↑ Paz-Pacheco, Elizabeth; Juan, Mari Des San (2 March 2023). "Incidence, Recurrence and Mortality Among Filipinos With Differentiated Thyroid Cancer: A Systematic Review". Journal of the ASEAN Federation of Endocrine Societies. 38 (1): 100–107. doi:10.15605/jafes.038.01.14. PMC   10213166 . PMID   37252408.
    Nguyen, Michelle Linh T.; Hu, Jiaqi; Hastings, Kattherine G.; Daza, Eric J; Cullen, Mark R.; Orloff, Lisa A.; Palaniappan, Latha P. (7 September 2017). "Thyroid cancer mortality higher in Filipinos in United States: an analysis using national mortality records from 2003–2012". Cancer. 123 (24): 4860–4867. doi:10.1002/cncr.30958. PMC   5716919 . PMID   28881423.
    Lee, Alice W.; Mendoza, Roy A.; Aman, Shehla; Jsu, Robert; Liu, Lihua (February 2022). "Thyroid cancer incidence disparities among ethnic Asian American populations, 1990–2014". Annals of Epidemiology. 66: 28–36. doi: 10.1016/j.annepidem.2021.11.002 . PMID   34774744. S2CID   244033542.
  14. 1 2 3 4 Hu MI, Vassilopoulou-Sellin R, Lustig R, Lamont JP, eds. (2008). "Thyroid and Parathyroid Cancers". Cancer Management: A Multidisciplinary Approach (11th ed.). Lawrence, Kansas: CMP Media. ISBN   978-1-891483-62-2. Archived from the original on 28 February 2010.
  15. ↑ Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS (March 2018). "The Diagnosis and Management of Thyroid Nodules: A Review". JAMA. 319 (9): 914–924. doi:10.1001/jama.2018.0898. PMID   29509871. S2CID   5042725.
  16. ↑ "Thyroid Cancer". Herbert Irving Comprehensive Cancer Center (HICCC) - New York. 1 February 2021. Archived from the original on 5 February 2023. Retrieved 5 February 2023.
  17. ↑ Grani, Giorgio; Sponziello, Marialuisa; Filetti, Sebastiano; Durante, Cosimo (16 August 2024). "Thyroid nodules: diagnosis and management". Nature Reviews Endocrinology. 20 (12): 715–728. doi:10.1038/s41574-024-01025-4. ISSN   1759-5029.
  18. ↑ "Thyroid Cancer Overview - Signaling Pathway. Diagnosis. Targeted Therapy - Creative Biolabs". www.creativebiolabs.net. Archived from the original on 5 February 2023. Retrieved 5 February 2023.
  19. ↑ "Radioactive I-131 from Fallout". National Cancer Institute. Archived from the original on 19 May 2014. Retrieved 9 June 2014.
  20. 1 2 dos Santos Silva I, Swerdlow AJ (February 1993). "Thyroid cancer epidemiology in England and Wales: time trends and geographical distribution". British Journal of Cancer. 67 (2): 330–340. doi:10.1038/bjc.1993.61. PMC   1968194 . PMID   8431362.
  21. ↑ "Experts link higher incidence of children's cancer to Fukushima radiation". ScienceAlert. 12 October 2015. Archived from the original on 19 January 2016. Retrieved 15 January 2016.
  22. ↑ Pacini F, Castagna MG, Brilli L, Pentheroudakis G (May 2010). "Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Annals of Oncology. 21 (Suppl 5): v214–v219. doi: 10.1093/annonc/mdq190 . PMID   20555084.
  23. ↑ "Genetics of Endocrine and Neuroendocrine Neoplasias". National Cancer Institute. 1 January 1980. Archived from the original on 4 July 2014. Retrieved 9 June 2014.
  24. ↑ Floridi C, Cellina M, Buccimazza G, Arrichiello A, Sacrini A, Arrigoni F, et al. (September 2019). "Ultrasound imaging classifications of thyroid nodules for malignancy risk stratification and clinical management: state of the art". Gland Surgery. 8 (Suppl 3): S233–S244. doi: 10.21037/gs.2019.07.01 . PMC   6755949 . PMID   31559190.
  25. ↑ Bennedbaek FN, Perrild H, Hegedüs L (March 1999). "Diagnosis and treatment of the solitary thyroid nodule. Results of a European survey". Clinical Endocrinology. 50 (3): 357–363. doi: 10.1046/j.1365-2265.1999.00663.x . PMID   10435062. S2CID   21514672.
  26. ↑ "Thyroid scan: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 27 January 2021. Retrieved 5 February 2021.
  27. ↑ "Vol 7 Issue 6 p.3-4". American Thyroid Association. Archived from the original on 4 December 2020. Retrieved 5 February 2021.
  28. ↑ Renuka IV, Saila Bala G, Aparna C, Kumari R, Sumalatha K (December 2012). "The bethesda system for reporting thyroid cytopathology: interpretation and guidelines in surgical treatment". Indian Journal of Otolaryngology and Head and Neck Surgery. 64 (4): 305–311. doi:10.1007/s12070-011-0289-4. PMC   3477437 . PMID   24294568.
  29. ↑ Gerard SK, Cavalieri RR (January 2002). "I-123 diagnostic thyroid tumor whole-body scanning with imaging at 6, 24, and 48 hours". Clinical Nuclear Medicine. 27 (1): 1–8. doi:10.1097/00003072-200201000-00001. PMID   11805475. S2CID   22871325.
  30. ↑ Bibbins-Domingo K, Grossman DC, Curry SJ, Barry MJ, Davidson KW, Doubeni CA, et al. (May 2017). "Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement". JAMA. 317 (18): 1882–1887. doi:10.1001/jama.2017.4011. PMID   28492905. S2CID   205091526.
  31. ↑ Malith V, Bombil I, Harran N, Luvhengo TE (September 2018). "Demographic and histological subtypes of Hurthle cell tumours of the thyroid in a South African setting". South African Journal of Surgery. Suid-Afrikaanse Tydskrif vir Chirurgie. 56 (3): 20–23. doi: 10.17159/2078-5151/2018/v56n3a2557 (inactive 1 November 2024). PMID   30264938.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  32. ↑ "Thyroid Cancer Treatment". National Cancer Institute. 1 January 1980. Archived from the original on 21 April 2008. Retrieved 22 December 2007.
  33. ↑ "Thyroid cancer". National Cancer Institute. Archived from the original on 20 December 2007. Retrieved 22 December 2007.
  34. 1 2 3 Chapter 20 in: Mitchell RS, Kumar V, Abbas AK, Fausto N (2007). Robbins Basic Pathology. Philadelphia: Saunders. ISBN   978-1-4160-2973-1. 8th edition.
  35. ↑ Yu XM, Schneider DF, Leverson G, Chen H, Sippel RS (October 2013). "Follicular variant of papillary thyroid carcinoma is a unique clinical entity: a population-based study of 10,740 cases". Thyroid. 23 (10): 1263–1268. doi:10.1089/thy.2012.0453. PMC   3787730 . PMID   23477346.
  36. ↑ Grani G, Lamartina L, Durante C, Filetti S, Cooper DS (June 2018). "Follicular thyroid cancer and Hürthle cell carcinoma: challenges in diagnosis, treatment, and clinical management". The Lancet. Diabetes & Endocrinology. 6 (6): 500–514. doi:10.1016/S2213-8587(17)30325-X. PMID   29102432. S2CID   24129533.
  37. ↑ Schlumberger M, Carlomagno F, Baudin E, Bidart JM, Santoro M (January 2008). "New therapeutic approaches to treat medullary thyroid carcinoma". Nature Clinical Practice. Endocrinology & Metabolism. 4 (1): 22–32. doi:10.1038/ncpendmet0717. PMID   18084343. S2CID   25818628.
  38. ↑ "Anaplastic Thyroid Cancer". Columbia Thyroid Center. Archived from the original on 23 December 2019. Retrieved 30 March 2020.
  39. ↑ Nix P, Nicolaides A, Coatesworth AP (December 2005). "Thyroid cancer review 2: management of differentiated thyroid cancers". International Journal of Clinical Practice. 59 (12): 1459–1463. doi: 10.1111/j.1368-5031.2005.00672.x . PMID   16351679. S2CID   7912705. Archived from the original on 20 May 2013.
  40. ↑ Nix PA, Nicolaides A, Coatesworth AP (January 2006). "Thyroid cancer review 3: management of medullary and undifferentiated thyroid cancer". International Journal of Clinical Practice. 60 (1): 80–84. doi:10.1111/j.1742-1241.2005.00673.x. PMID   16409432. S2CID   11825588.
  41. ↑ Shaha AR (May 2007). "TNM classification of thyroid carcinoma". World Journal of Surgery. 31 (5): 879–887. doi:10.1007/s00268-006-0864-0. PMID   17308849. S2CID   23121159.
  42. ↑ Dideban S, Abdollahi A, Meysamie A, Sedghi S, Shahriari M (2016). "Thyroid Papillary Microcarcinoma: Etiology, Clinical Manifestations, Diagnosis, Follow-up, Histopathology and Prognosis". Iranian Journal of Pathology. 11 (1): 1–19. PMC   4749190 . PMID   26870138.
  43. ↑ Hughes DT, Haymart MR, Miller BS, Gauger PG, Doherty GM (March 2011). "The most commonly occurring papillary thyroid cancer in the United States is now a microcarcinoma in a patient older than 45 years". Thyroid. 21 (3): 231–236. doi:10.1089/thy.2010.0137. hdl: 2027.42/90466 . PMID   21268762.
  44. ↑ Woolner LB, Lemmon ML, Beahrs OH, Black BM, Keating FR (January 1960). "Occult papillary carcinoma of the thyroid gland: a study of 140 cases observed in a 30-year period". The Journal of Clinical Endocrinology and Metabolism. 20: 89–105. doi:10.1210/jcem-20-1-89. PMID   13845950.
  45. ↑ "Cancer Staging - NCI". www.cancer.gov. 9 March 2015. Archived from the original on 19 March 2015. Retrieved 5 February 2023.
  46. ↑ Hindié E, Zanotti-Fregonara P, Keller I, Duron F, Devaux JY, Calzada-Nocaudie M, et al. (September 2007). "Bone metastases of differentiated thyroid cancer: impact of early 131I-based detection on outcome". Endocrine-Related Cancer. 14 (3): 799–807. doi: 10.1677/ERC-07-0120 . PMID   17914109.
  47. ↑ Schlumberger M, Arcangioli O, Piekarski JD, Tubiana M, Parmentier C (November 1988). "Detection and treatment of lung metastases of differentiated thyroid carcinoma in patients with normal chest X-rays". Journal of Nuclear Medicine. 29 (11): 1790–1794. PMID   3183748.
  48. ↑ Das S (2008). A concise textbook of surgery (5th ed.). Calcutta: Dr S. Das. ISBN   978-8190568128.
  49. 1 2 Cooper DS, Doherty GM, Haugen BR, Hauger BR, Kloos RT, Lee SL, et al. (November 2009). "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer". Thyroid. 19 (11): 1167–1214. doi:10.1089/thy.2009.0110. hdl: 2027.42/78131 . PMID   19860577.
  50. ↑ British Thyroid Association, Royal College of Physicians, Perros P (2007). Guidelines for the management of thyroid cancer. 2nd edition. Report of the Thyroid Cancer Guidelines Update Group (PDF). Royal College of Physicians. p. 16. ISBN   9781860163098. Archived from the original (PDF) on 26 December 2011. Retrieved 12 July 2013.
  51. ↑ Haugen, Bryan R.; Alexander, Erik K.; Bible, Keith C.; Doherty, Gerard M.; Mandel, Susan J.; Nikiforov, Yuri E.; Pacini, Furio; Randolph, Gregory W.; Sawka, Anna M.; Schlumberger, Martin; Schuff, Kathryn G.; Sherman, Steven I.; Sosa, Julie Ann; Steward, David L.; Tuttle, R. Michael; Wartofsky, Leonard (January 2016). "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer". Thyroid. 26 (1): 1–133. doi:10.1089/thy.2015.0020. hdl: 11365/1011394 .
  52. ↑ Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. (January 2016). "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer". Thyroid. 26 (1): 1–133. doi:10.1089/thy.2015.0020. PMC   4739132 . PMID   26462967.
  53. ↑ Wells SA, Asa SL, Dralle H, Elisei R, Evans DB, Gagel RF, et al. (American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma) (June 2015). "Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma". Thyroid. 25 (6): 567–610. doi:10.1089/thy.2014.0335. PMC   4490627 . PMID   25810047.
  54. ↑ Smallridge RC, Ain KB, Asa SL, Bible KC, Brierley JD, Burman KD, et al. (November 2012). "American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer". Thyroid. 22 (11): 1104–1139. doi:10.1089/thy.2012.0302. PMID   23130564.
  55. ↑ Perros P, Boelaert K, Colley S, Evans C, Evans RM, Gerrard Ba G, et al. (July 2014). "Guidelines for the management of thyroid cancer". Clinical Endocrinology. 81 (Suppl 1): 1–122. doi: 10.1111/cen.12515 . PMID   24989897.
  56. 1 2 Lamartina L, Grani G, Durante C, Filetti S (18 January 2018). "Recent advances in managing differentiated thyroid cancer". F1000Research. 7: 86. doi: 10.12688/f1000research.12811.1 . PMC   5773927 . PMID   29399330.
  57. ↑ Ito, Yasuhiro; Miyauchi, Akira; Kihara, Minoru; Fukushima, Mitsuhiro; Higashiyama, Takuya; Miya, Akihiro (March 2018). "Overall Survival of Papillary Thyroid Carcinoma Patients: A Single-Institution Long-Term Follow-Up of 5897 Patients". World Journal of Surgery. 42 (3): 615–622. doi:10.1007/s00268-018-4479-z. PMC   5801380 .
  58. 1 2 3 Welch HG, Schwartz L, Woloshin S (2011). Overdiagnosed: Making People Sick in the Pursuit of Health. [Malaysia?]: Beacon Press. pp. 61–34. ISBN   978-0-8070-2200-9.
  59. ↑ "Thyroid Cancer". MedicineNet.com. Archived from the original on 20 October 2011. Retrieved 26 October 2011.
  60. 1 2 Numbers from EUROCARE, from Page 10 Archived 13 May 2016 at the Wayback Machine in: Grünwald F, Biersack HJ (2005). Thyroid cancer. Berlin: Springer. ISBN   978-3-540-22309-2.
  61. ↑ "FDA approves new treatment for rare form of thyroid cancer" (Press release). U.S. Food and Drug Administration. 6 April 2011. Archived from the original on 10 April 2011. Retrieved 7 April 2011.
  62. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 cancer.org Thyroid Cancer Archived 18 October 2013 at the Wayback Machine By the American Cancer Society. In turn citing: AJCC Cancer Staging Manual (7th ed).
  63. 1 2 3 4 5 6 7 Numbers from National Cancer Database in the US, from Page 10 Archived 13 May 2016 at the Wayback Machine in: Grünwald F, Biersack HJ (2005). Thyroid cancer. Berlin: Springer. ISBN   978-3-540-22309-2. (Note:Book also states that the 14% 10-year survival for anaplastic thyroid cancer was overestimated)
  64. ↑ Rounded up to nearest natural number from 96.7% as given by Santacroce L, Gagliardi S, Kennedy AS (28 September 2010). "Thyroid, Papillary Carcinoma". eMedicine. Archived from the original on 28 July 2010.
  65. ↑ By 100% minus cause-specific mortality of 17% at 5 yr, as given by Barbet J, Campion L, Kraeber-Bodéré F, Chatal JF (November 2005). "Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling-times in patients with medullary thyroid carcinoma". The Journal of Clinical Endocrinology and Metabolism. 90 (11): 6077–6084. doi: 10.1210/jc.2005-0044 . PMID   16091497.
  66. ↑ "Medullary Thyroid Cancer". National Cancer Institute. 4 February 2016. Archived from the original on 30 May 2016. Retrieved 11 May 2016.
  67. ↑ Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. (December 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–2128. doi:10.1016/S0140-6736(12)61728-0. hdl: 10536/DRO/DU:30050819 . PMC   10790329 . PMID   23245604. S2CID   1541253.
  68. ↑ Santini F, Marzullo P, Rotondi M, Ceccarini G, Pagano L, Ippolito S, et al. (October 2014). "Mechanisms in endocrinology: the crosstalk between thyroid gland and adipose tissue: signal integration in health and disease". European Journal of Endocrinology. 171 (4): R137–R152. doi: 10.1530/eje-14-0067 . PMID   25214234. Archived from the original on 11 November 2014.
  69. ↑ "Thyroid cancer statistics". Cancer Research UK. Archived from the original on 17 October 2014. Retrieved 28 October 2014.
  70. ↑ "Republic of Korea Cancer Rates" (PDF). Global Cancer Observatory (GCO). World Health Organization. 2020. Archived (PDF) from the original on 11 November 2022. Retrieved 5 February 2022.
  71. ↑ Lim, Hyeyeun; Devesa, Susan S.; Sosa, Julie A.; Check, David; Kitahara, Cari M. (4 April 2017). "Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013". JAMA. 317 (13): 1338. doi:10.1001/jama.2017.2719. PMC   8216772 .
  72. ↑ "Callum Ainley: Grimsby Town midfielder diagnosed with thyroid cancer". BBC Sport. 16 January 2024. Retrieved 17 January 2024.
  73. ↑ Hunsley, James (27 January 2023). "'I am so grateful' - ex-Liverpool midfielder Emre Can opens up on battle with cancer". Goal.com. Archived from the original on 28 January 2023. Retrieved 29 January 2023.
  74. ↑ Bamberger, Michael (27 May 2002). "Survivors". Sports Illustrated. Archived from the original on 1 March 2014. Retrieved 11 August 2013.
  75. ↑ "Uhm Jung-hwa had Thyroid cancer op". The Korean Herald. 20 October 2010. Archived from the original on 5 February 2022. Retrieved 5 February 2022.
  76. ↑ "Lee Moon-se risks cancer relapse to keep singing". The Korean Herald. 31 March 2015.
  77. ↑ Jacobs E (3 April 2022). "Putin under care of cancer doctor, bathing in deer antler blood: Report". Washington Examiner. Archived from the original on 3 April 2022. Retrieved 3 April 2022.
  78. ↑ Lane C (8 September 2005). "Rehnquist Eulogies Look Beyond Bench". The Washington Post. Archived from the original on 4 March 2016. Retrieved 11 May 2016.
  79. ↑ "Celebrities with Thyroid problems". Alexander Shifrin. Archived from the original on 26 August 2013. Retrieved 11 August 2013.
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