A Cohort Analysis of Clinical and Ultrasound Variables Predicting Cancer Risk in 20,001 Consecutive Thyroid Nodules

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Assessing thyroid nodules for malignancy is challenging.
• The influence of patient and nodule characteristics on cancer risk is not fully understood.

Purpose of the Study:

• To precisely estimate cancer risk based on clinical and sonographic variables during thyroid nodule assessment.
• To identify key factors influencing malignancy risk in thyroid nodules.

Main Methods:

• Analysis of 20,001 thyroid nodules from 9,967 adult patients undergoing ultrasound-guided fine-needle aspiration (1995-2017).
• Mixed-effect logistic regression used to calculate malignancy risk for patient and sonographic variables.

Main Results:

• Thyroid cancer was confirmed in 9.9% of nodules.
• Factors increasing malignancy risk include younger age (<52 years), male sex, larger nodule size (≥40 mm), and predominantly solid composition.
• Factors decreasing risk include cystic content and the presence of multiple nodules (≥4).

Conclusions:

• Patient and nodule characteristics provide a more accurate assessment of thyroid nodule malignancy risk.
• These findings enhance individualized patient care and risk stratification during routine evaluations.