Very High Prevalence of Ultrasound Thyroid Scan Abnormalities in Healthy Volunteers in Modena, Italy

Overview

Journal J Endocrinol Invest

Publisher Springer

Specialty Endocrinology

Date 2013 Apr 13

PMID 23579962

Citations 9

Authors

V L Gnarini

G Brigante

E Della Valle

C Diazzi

B Madeo

C Carani

V Rochira

M Simoni

Affiliations

Soon will be listed here.

Abstract

Background: Italy is characterized by high prevalence of goiter. To date, only limited data about the prevalence of goiter in the Italian adult population are available.

Aim: To investigate the prevalence of thyroid ultrasound abnormalities in adults unaware of any thyroid disease and evaluate the rate of differentiated thyroid cancer (DTC) obtained by this intervention.

Methods: Ultrasound (US) thyroid scan was performed in adult volunteers recruited by advertisement in Modena, Italy. One hundred and thirty-five women and 66 men (no.= 201), unaware of any thyroid disease (mean age of 46 ± 10.7 yr) underwent their first thyroid US scan.

Results: US thyroid abnormalities were found in 101 subjects (50.3%): 91 nodular goiters (45.2%) and 13 US-thyroiditis (6.5%) associated with positive auto-antibodies in 11 of them. Seventeen subjects (18%) with nodules underwent US-fine needle aspiration biopsy with the following cytological class (C) outcome: 14 patients C2 (82%), 1 patient C3 (6%), 2 patients had C4 (12%), the latter received histological confirmation.

Conclusions: The prevalence of thyroid abnormalities is very high in subjects unaware of any thyroid disease. DTC was found in 1% of subjects and in 2% of those affected by nodular goiter. Compared to the detection rate of the well-established screening programs for breast (0.45%) and colorectal (0.27%) cancer, the prevalence of DTC seems to be much higher. Thyroid US screening could allow the detection of DTC in asymptomatic subjects and this diagnosis often includes DTC at an advanced stage. Thus, US screening not necessarily results in the over-diagnosis of clinically not relevant thyroid diseases.

Citing Articles

An Interobserver Comparison of the Ultrasound Lexicon Classification of Thyroid Nodules: A Single-Center Prospective Validation Study.

Uysal E, Yangoz B, Sagan M, Duman I, Alparslan A J Clin Med. 2025; 14(4).

PMID: 40004763 PMC: 11856384. DOI: 10.3390/jcm14041222.

Standardized Imaging and Reporting for Thyroid Ultrasound: Korean Society of Thyroid Radiology Consensus Statement and Recommendation.

Lee M, Na D, Joo L, Lee J, Ha E, Kim J Korean J Radiol. 2023; 24(1):22-30.

PMID: 36606617 PMC: 9830140. DOI: 10.3348/kjr.2022.0894.

The influence of nodule size on clinical efficacy of ethanol ablation and microwave ablation on cystic or predominantly cystic thyroid nodules.

Zhang Y, Chu X, Liu Y, Zhao Y, Han X, Hu X Endocr Connect. 2022; 11(11).

PMID: 36136956 PMC: 9641769. DOI: 10.1530/EC-22-0248.

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations.

Ha E, Chung S, Na D, Ahn H, Chung J, Lee J Korean J Radiol. 2021; 22(12):2094-2123.

PMID: 34719893 PMC: 8628155. DOI: 10.3348/kjr.2021.0713.

Combining radiomics with ultrasound-based risk stratification systems for thyroid nodules: an approach for improving performance.

Park V, Lee E, Lee H, Kim H, Yoon J, Son J Eur Radiol. 2020; 31(4):2405-2413.

PMID: 33034748 DOI: 10.1007/s00330-020-07365-9.

References

Park J, Oh K, Kim E, Chang H, Hong S . Sonographic screening for thyroid cancer in females undergoing breast sonography. AJR Am J Roentgenol. 2006; 186(4):1025-8. DOI: 10.2214/AJR.04.1659. View

Saggiorato E, Arecco F, Mussa A, Sacerdote C, Rossetto R, Origlia C . Goiter prevalence and urinary iodine status in urban and rural/mountain areas of Piedmont region. J Endocrinol Invest. 2006; 29(1):67-73. DOI: 10.1007/BF03349179. View

Frates M, Benson C, Doubilet P, Kunreuther E, Contreras M, Cibas E . Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006; 91(9):3411-7. DOI: 10.1210/jc.2006-0690. View

Miki H, Inoue H, Komaki K, Uyama T, Morimoto T, Monden Y . Value of mass screening for thyroid cancer. World J Surg. 1998; 22(1):99-102. DOI: 10.1007/s002689900356. View

Brander A, Viikinkoski P, Nickels J, Kivisaari L . Thyroid gland: US screening in middle-aged women with no previous thyroid disease. Radiology. 1989; 173(2):507-10. DOI: 10.1148/radiology.173.2.2678263. View

Delange F, Benker G, Caron P, EBER O, Ott W, Peter F . Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol. 1997; 136(2):180-7. DOI: 10.1530/eje.0.1360180. View

Zorzi M, Baracco S, Fedato C, Grazzini G, Naldoni C, Sassoli de Bianchi P . Screening for colorectal cancer in Italy: 2008 survey. Epidemiol Prev. 2011; 34(5-6 Suppl 4):53-72. View

Ito Y, Hirokawa M, Fukushima M, Inoue H, Yabuta T, Uruno T . Occult papillary thyroid carcinoma: diagnostic and clinical implications in the era of routine ultrasonography. World J Surg. 2008; 32(9):1955-60. DOI: 10.1007/s00268-008-9614-9. View

Choi Y, Park Y, Koh J . Prevalence of thyroid cancer at a medical screening center: pathological features of screen-detected thyroid carcinomas. Yonsei Med J. 2008; 49(5):748-56. PMC: 2615358. DOI: 10.3349/ymj.2008.49.5.748. View

10.

Aghini-Lombardi F, Antonangeli L, Vitti P . [Epidemiology of endemic goiter in Italy]. Ann Ist Super Sanita. 1999; 34(3):311-4. View

11.

Yoon D, Chang S, Choi C, Yun E, Seo Y, Nam E . The prevalence and significance of incidental thyroid nodules identified on computed tomography. J Comput Assist Tomogr. 2008; 32(5):810-5. DOI: 10.1097/RCT.0b013e318157fd38. View

12.

Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Bulow Pedersen I, Rasmussen L . The association between hypoechogenicity or irregular echo pattern at thyroid ultrasonography and thyroid function in the general population. Eur J Endocrinol. 2006; 155(4):547-52. DOI: 10.1530/eje.1.02255. View

13.

Cramer J, Fu P, Harth K, Margevicius S, Wilhelm S . Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry. Surgery. 2010; 148(6):1147-52. DOI: 10.1016/j.surg.2010.10.016. View

14.

Shetty S, Maher M, Hahn P, Halpern E, Aquino S . Significance of incidental thyroid lesions detected on CT: correlation among CT, sonography, and pathology. AJR Am J Roentgenol. 2006; 187(5):1349-56. DOI: 10.2214/AJR.05.0468. View

15.

Hegedus L, Perrild H, Poulsen L, Andersen J, Holm B, Schnohr P . The determination of thyroid volume by ultrasound and its relationship to body weight, age, and sex in normal subjects. J Clin Endocrinol Metab. 1983; 56(2):260-3. DOI: 10.1210/jcem-56-2-260. View

16.

Davies L, Welch H . Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006; 295(18):2164-7. DOI: 10.1001/jama.295.18.2164. View

17.

Solares C, Penalonzo M, Xu M, Orellana E . Occult papillary thyroid carcinoma in postmortem species: prevalence at autopsy. Am J Otolaryngol. 2005; 26(2):87-90. DOI: 10.1016/j.amjoto.2004.08.003. View

18.

. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995; 854:1-452. View

19.

Rago T, Vitti P, Chiovato L, Mazzeo S, De Liperi A, Miccoli P . Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in 'cold' thyroid nodules. Eur J Endocrinol. 1998; 138(1):41-6. DOI: 10.1530/eje.0.1380041. View

20.

Ronco G, Giubilato P, Naldoni C, Zorzi M, Anghinoni E, Scalisi A . Extension of organised cervical cancer screening programmes in Italy and their process indicators: 2008 activity. Epidemiol Prev. 2011; 34(5-6 Suppl 4):35-51. View