PURPOSE: To assess the incidence of thyroid malignancy in an adult population screened by high-resolution ultrasonography at a medical screening center and to compare the clinical and pathological features of screen-detected thyroid carcinomas to symptomatic overt thyroid carcinomas. MATERIALS AND METHODS: We calculated the prevalence of screen-detected thyroid cancer at a medical screening center using high- resolution ultrasonography and fine needle aspiration. We then compared the clinical and pathological features of screen-detected thyroid cancers (n = 46) to clinical symptomatic thyroid cancers (n = 157). We evaluated age, gender, size, perithyroidal extension, lymphovascular extension, stage, histological lymph node metastasis, and the type of cancer. We also compared the above findings of micropapillary carcinomas to papillary thyroid carcinomas that were larger than 1cm in diameter. RESULTS: Screen-detected thyroid nodule patients were 2,747 (37%) of 7,491 patients. Nodules selected for fine needle aspiration were 658 and cytology confirmed malignancy were 79 (12%) nodules. When screen-detected thyroid cancers (n = 46) were compared to symptomatic overt thyroid cancers (n = 157), only statistically significant factor was size (p = 0.002). Papillary thyroid carcinomas that were larger than 1 cm had more frequent capsular invasion (p = 0.000) and a higher stage (p = 0.027), and a higher prevalence of lymph node metastases (p = 0.002). CONCLUSION: Screen-detected thyroid cancers should be managed as same as symptomatic thyroid cancers in respect to size, and an assessment should strictly be based on the ultrasound features and fine needle aspiration biopsy findings.
Adult ; Age Factors ; Biopsy, Fine-Needle ; Carcinoma, Papillary/*epidemiology/pathology/ultrasonography ; Female ; Humans ; Korea/epidemiology ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Sex Factors ; Thyroid Neoplasms/*epidemiology/pathology/ultrasonography

INTRODUCTIONNodular goitres occur commonly in the population and this paper aims to determine the incidence of thyroid cancer found in these goitres.

MATERIALS AND METHODSThis is a retrospective, consecutive analysis of the histology of 268 nodular goitres that had been operated on, from 2002 to 2004, in a single tertiary hospital in Singapore.

RESULTSFifty-seven goitres (21.2%) with multiple nodules were found to contain a malignancy. Forty-four thyroid cancers (77%) were of the papillary type. The mean age of presentation for benign nodular goitres was 47.9 years. The mean age of presentation for malignant thyroid tumours was 49.25 years.

CONCLUSIONThe incidence of cancer is significant in nodular goitres and these malignant tumours are usually of the papillary type.

Biopsy, Fine-Needle ; Female ; Goiter, Nodular ; diagnostic imaging ; pathology ; surgery ; Humans ; Incidence ; Male ; Middle Aged ; Pathology, Clinical ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Singapore ; epidemiology ; Thyroid Neoplasms ; diagnosis ; epidemiology ; pathology ; Ultrasonography