Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Feb;96(2):246-254.
doi: 10.1111/cen.14575. Epub 2021 Aug 11.

The influence of incidental detection of thyroid nodule on thyroid cancer risk and prognosis-A systematic review

Je Ern Chooi  1   2 , Abiramie Ravindiran  1 , Saba P Balasubramanian  2   3
Affiliations
Meta-Analysis

The influence of incidental detection of thyroid nodule on thyroid cancer risk and prognosis-A systematic review

Je Ern Chooi et al. Clin Endocrinol (Oxf). 2022 Feb.

Abstract

Background: Clinically inapparent thyroid nodules discovered serendipitously on imaging for nonthyroid indications are termed as thyroid incidentalomas. It is unclear whether these incidentalomas have a lower prevalence of malignancy or slower tumour progression compared to symptomatic nodules. The aims of this systematic review were to determine the impact of incidental detection of thyroid nodules on both the risk of malignancy and on prognosis in patients with thyroid cancer.

Method: PubMed and MEDLINE® on Web of Science databases were searched from inception to March 2020 for English language articles reporting on human studies of thyroid cancer risk and/or prognosis in incidental and nonincidental nodules.

Results: Eighteen observational studies published between 1998 and 2020 were eligible for analysis; four studies reported on risk, nine on prognosis and five studies reported on both risk and prognosis. When comparing the incidental and nonincidental groups in the risk study, the odds of incidental detection in the cancer and benign groups ranged from 0.16 to 0.5 and 0.06 to 0.38, respectively (odds ratio [OR] = 0.64-2.86) in case-control studies (n = 6); the risk of malignancy for thyroid nodules ranged from 4% to 23.5% in the incidental and 3.8% to 28.7% in the nonincidental groups (relative risk = 0.13-6.27) in the cohort studies (n = 3). A meta-analysis of the eligible case-control studies (n = 3) showed a nonsignificant summated OR of 1.04 (95% confidence interval = 0.63-1.70; p = .88). In the prognosis study, five direct and thirteen indirect markers of prognosis were compared between the incidental and nonincidental groups. A meta-analysis was not possible but incidentally detected thyroid cancer had better progression-free and overall survival.

Conclusion: Current evidence suggests that investigation and management of thyroid nodules should not be influenced by the mode of detection.

Keywords: incidental detection; incidentaloma; prognosis; risk; thyroid cancer; thyroid nodule.

PubMed Disclaimer

References

REFERENCES

    1. Surveillance, Epidemiology, and End Results Program. SEER Cancer Statistics Review, 1975-2017. 2020. https://seer.cancer.gov/csr/1975_2017/. Accessed June 13, 2020.
    1. Russ G, Leboulleux S, Leenhardt L, Hegedüs L. Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup. Eur Thyroid J. 2014;3(3):154-163. https://doi.org/10.1159/000365289
    1. Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab. 1955;15(10):1270-1280. https://doi.org/10.1210/jcem-15-10-1270
    1. Martinez-Tello FJ, Martinez-Cabruja R, Fernandez-Martin J, Lasso-Oria C, Ballestin-Carcavilla C. Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods. Cancer. 1993;71(12):4022-4029. https://doi.org/10.1002/1097-0142(19930615)71:12%3C4022::aid-cncr2820711...
    1. Furmanchuk AW, Roussak N, Ruchti C. Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients. Histopathology. 1993;23(4):319-325. https://doi.org/10.1111/j.1365-2559.1993.tb01214.x

LinkOut - more resources