Thyroid nodule epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Epidemiology and Demographics
Incidence
- The incidence of thyroid cancer is estimated to be 48,288 cases annually in United states.
- Worldwide, the incidence of thyroid cancer ranges from a low of 40,000 per 100,000 persons to a high of 71,000 per 100,000 persons with an average incidence of 50,000 per 100,000 persons.
- There is a large increase worldwide in the incidence of thyroid cancers. It is likely to be due to:24557566 27532827
- The use of head and neck external beam radiation, commonly used to treat benign childhood conditions between 1910 and 1960
- The increased detection of small papillary cancers secondary to more widespread use of neck ultrasonography and fine-needle aspiration (FNA) of very small thyroid nodules
- In developed countries, the prevalence of papillary thyroid cancer ranges from a low of 4.8 per 100,000 persons to a high of 14.9 per 100,000 persons with an average prevalence of 10 per 100,000 persons.
Race
There is a large increase worldwide in the incidence of thyroid cancers. The largest increase in thyroid cancer incidence has been observed in South Korea:
In 1993-1997, the incidence of thyroid cancer was estimated to be 12.2 cases per 100,000 individuals, while in 2003-2007, the incidence of thyroid cancer increased and was estimated to be 59.9 cases per 100,000 individuals.
Thyroid cancer is recognized as the most common cancer among women in South Korea. The impact of diagnostic changes on the rise in thyroid cancer incidence: a population-based study in selected high-resource countries. Thyroid2015;25:1127-1136
Prevalence
Thyroid nodules, are extremely common in young adults and children almost 50% of people have had one, but they are usually only detected by a GP during the course of a health examination, or through a different affliction. Thyroid nodules are common, their prevalence being largely dependent on the identification method.8885814 The estimated prevalence by palpation alone ranges from 4% to 7%,3,4 whereas US detects nodules in 20% to 76% of the adult population,4–6 particularly with the current use of high-resolution US techniques.8426623 The reported frequencies detected by US correlate with the prevalence reported at surgery and autopsy with ranges between 50% and 65%.25041951
Epidemiologic studies have shown the prevalence of palpable thyroid nodules to be approximately 5% in women and 1% in men living in iodine-sufficient parts of the world (1,2). In contrast, high-resolution ultrasound (US) can detect thyroid nodules in 19%–68% of randomly selected individuals, with higher frequencies in women and the elderly.
In the United States, 4 to 7 percent of the adult population have a palpable thyroid nodule
Age
- 27532827 Thyroid nodules occur less frequently in children than in adults.
- Some studies have shown the frequency of malignancy to be higher in children than adults, in the range of 15–20% (98–100), whereas other data have suggested that the frequency of thyroid cancer in childhood thyroid nodules is similar to that of adults
- Raab SS, Silverman JF, Elsheikh TM, Thomas PA, Wakely PE 1995 Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy. Pediatrics 95:46–49. 99.
- Corrias A, Einaudi S, Chiorboli E, Weber G, Crino A, Andreo M, Cesaretti G, de Sanctis L, Messina MF, Segni M, Cicchetti M, Vigone M, Pasquino AM, Spera S, de Luca F, Mussa GC, Bona G 2001 Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: comparison with conventional clinical, laboratory, and imaging approaches.
- J Clin Endocrinol Metab 86:4644–4648. 100. Hung W 1999 Solitary thyroid nodules in 93 children and adolescents, a 35-years experience.
- Horm Res 52:15–18. 101. Gharib H, Zimmerman D, Goellner JR, Bridley SM, LeBlanc SM 1995 Fine-needle aspiration biopsy: Use in diagnosis and management of pediatric thyroid diseases. Endo Pract 1:9–13.
Sex
Nodules are more common in women and increase in frequency with age and with decreasing iodine intake. The prevalence is much greater with the inclusion of nodules that are detected by ultrasonography or at autopsy. By the latter assessment, approximately 50 percent of 60-year-old persons have thyroid nodules.
While nodules are more common in women, thyroid malignancies are more frequent in men
Follicular thyroid lesions occurs most often in women
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Developed countries
Developing countries
- The majority of thyroid nodule cases are reported in iodine deficient regions.
- Thyroid cancer is a are disease that tends to affect patients with previous thyroid nodule history and iodine deficient population.
- The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
- [Cancer name] is the [number] most common cancer worldwide.
- Additional Sentence 1: The case-mortality rate of [disease name] is approximately [number range] worldwide.
- Additional Sentence 2: The majority of [disease name] cases are reported in [geographical region].
- Additional Sentence 3: Patients of all age groups may develop [disease name]
- Additional Sentence 4: [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
- Additional Sentence 5: [Gender 1] are more commonly affected with [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
- Additional Sentence 6: [Disease name] affects men and women equally.
- Additional Sentence 7: There is no racial predilection to [disease name].
- Additional Sentence 8: [Disease name] usually affects individuals of the [ethnicity 1] race. [Ethnicity 2] individuals are less likely to develop [disease name].
- Additional Sentence 9: The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
- Additional Sentence 10: [Chronic disease name] is usually first diagnosed among [age group].
- Additional Sentence 11: [Acute disease name] commonly affects [age group].
- Additional Sentence 12: [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
- Worldwide, the prevalence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average prevalence of _____ per 100,000 persons.
- Worldwide, the prevalence of (insert disease state here) is _____ per 100,000 persons.
- In developed countries, the prevalence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average prevalence of _____ per 100,000 persons.
- In developed countries, the prevalence of (insert disease state here) is _____ per 100,000 persons.
- In developing countries/ Africa, the prevalence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average prevalence of _____ per 100,000 persons.
- In developing countries/ Africa, the prevalence of (insert disease state here) is _____ per 100,000 persons.
- In ____ (insert year), the prevalence of _______ (insert disease name) was estimated to be _______ (insert number) cases per 100,000 individuals worldwide.
- Worldwide, the incidence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average incidence of _____ per 100,000 persons.
- Worldwide, the incidence of (insert disease state here) is _____ per 100,000 persons.
- In developed countries, the incidence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average incidence of _____ per 100,000 persons.
- In developed countries, the incidence of (insert disease state here) is _____ per 100,000 persons.
- In developing countries/ Africa, the incidence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average incidence of _____ per 100,000 persons.
- In developing countries/ Africa, the incidence of (insert disease state here) is _____ per 100,000 persons.
- In ____ (insert year), the incidence of _______ (insert disease name) was estimated to be _______ (insert number) cases per 100,000 individuals worldwide. ===Case Fatality Rate===
- The case fatality rate is defined the number of deaths (fatality) among patients with the disease (case). Case fatality rate should be distinguished from "Mortality Rate" (defined as the number of deaths among the at-risk population).
- The case fatality rate is usually described as a function of time (e.g. In 2015 / annually etc...).
- When using numbers with decimal points, avoid reporting more than 1 number after the decimal point. For example, report the case fatality rate as 10.1% instead of 10.09322%. Many numbers after the decimal point may suggest a false sense of accuracy.
- You can pick the template sentence below for this section:
- In ____ (year), the case fatality rate of ____ (disease name) is ____ (case fatality rate in %).
- The annual case fatality rate of ____ (disease name) is approximately ____ (case fatality rate in %). ===Age===
- This section can describe the impact of the disease depending on the persons age, and the age-specific prevalence and incidence.
- The prevalence of ____ (insert disease state here) increases/decreases with age.
- _____ (insert acute disease) commonly affects _____ (insert age group).
- _____ (insert chronic disease) is usually first diagnosed among _____ (insert age group). ===Gender=== This section describe how prevalence of the disease varies by gender. When describing male to female ratios with decimal points, avoid reporting more than 1 number after the decimal point. For example, report a ratio as as 1.5 to 1 instead of 1.48294 to 1. Many numbers after the decimal point may suggest a false sense of accuracy. You can use either of the following template sentences:
- ______ (insert gender 1) are more commonly affected with ______ (insert disease name) than _____ (insert gender 2). The _____ (insert gender ratio e.g. male to female) ratio is approximately _____ (insert number > 1) to 1.
- The prevalence and incidence of (insert disease state here) does not vary by gender.
- Men and women are affected equally by (insert disease name here).
- (Insert disease state here) is more prevalent in men women.
- The prevalence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.
- The incidence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women. ===Race=== This section describes how the disease differs based upon race. You can use the following template sentence for this section:
- The prevalence of _____ (insert disease) does not vary by race.
- (Insert disease state here) is more prevalent in the ____ (inser race) race and ____ (insert other race) races.
- There is no racial predilection for ____ (insert disease name)
- _____ (insert disease) usually affects individuals of the _____ (inser race) race. _____ (insert other race) individuals are less likely to develop ______ (disease name). ===Developed Countries===
- In this section you should describe the impact of the disease in developed countries.
- Incidence, prevalence, and geographical distribution or areas of interest can be mentioned, as well as the relevant impact the disease has on society. ===Developing Countries===
- In this section you should describe the impact of the disease in developing countries.
- Incidence, prevalence, and geographical distribution or areas of interest can be mentioned, as well as the relevant impact the disease has on society. ==Preferred Template Statements== IF the incidence/prevalence of the disease is known:
- The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
- In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
- The prevalence of [disease/malignancy] is estimated to be [number] cases annually. IF the case-fatality rate is also known, you may use either of the following template statements:
- In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
- The case-fatality rate of [disease name] is approximately [number range]. IF details about prevalence according to age/race/sex are known:
- Age:
- Patients of all age groups may develop [disease name].
- The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
- [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
- Race:
- There is no racial predilection to [disease name].
- [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
- Sex:
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1. IF details about prevalence by region are known:
- [Chronic disease name] is usually first diagnosed among [age group].
- [Acute disease name] commonly affects [age group].
, , , et al. Treatment guidelines for patients with thyroid nodules and well-differentiated thyroid cancer. Arch Intern Med 1996;156:2165-2172
2 to 4 per 100,000 people per year, constituting only 1 percent of all cancers and 0.5 percent of all cancer deaths., . Thyroid nodules: rational management. World J Surg2000;24:934-941
, , . Management of simple nodular goiter: current status and future perspectives. Endocr Rev2003;24:102-132