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Updated: May 22, 2026

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Predictors of thyroid cancer in paediatric patients with thyroid nodules: A systematic review and meta-analysis

Savan Shah1, Ben Walters2, Saba Prakash Balasubramanian3

  • 1ENT Department, Barking Havering Redbridge NHS Trust, London, RM7 0AG, UK. savan.shah2@nhs.net.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|May 20, 2026
PubMed

Insights

Predictors for pediatric thyroid cancer include radiation exposure, palpable lymphadenopathy, intranodal calcifications, increased vascularity, and elevated thyroid-stimulating hormone. Identifying these factors improves preoperative diagnosis for children with thyroid nodules.

Area of Science:

  • Pediatric Endocrinology
  • Oncology
  • Radiology

Background:

  • Thyroid nodules in children are rare but carry a higher risk of malignancy than in adults.
  • Risk factors and predictors for thyroid cancer in pediatric patients are not well-established.

Purpose of the Study:

  • To systematically review and evaluate risk factors and predictors of malignancy in pediatric thyroid nodules.
  • To enhance the understanding of factors associated with thyroid cancer in children.

Main Methods:

  • A systematic review of PubMed, Embase, and Cochrane databases was conducted.
  • Meta-analysis using a random-effects model was performed on data from 16 studies.
  • Quality assessment of included studies was done using the Newcastle-Ottawa Scale.

Main Results:

  • The review included 2,634 patients (794 malignant, 1,840 benign); papillary thyroid cancer was the most common malignancy (84.5%).
  • Significant predictors of thyroid cancer included previous radiation exposure (OR 1.96), palpable lymphadenopathy (OR 7.73), intranodal calcifications (OR 10.33), increased vascularity (OR 3.21), and elevated thyroid-stimulating hormone (mean difference +0.92 mIU/L).

Conclusions:

  • Identifying these key predictors is crucial for improving the preoperative diagnosis of thyroid cancer in children.
  • This knowledge can inform the development of diagnostic models for pediatric thyroid nodules.
Abstract

Keywords:
MalignancyPaediatricsRisk factorsThyroid cancerThyroid nodules

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