Abstract
It is important to recognize the prevalence and incidence of nodular thyroid disease in order to appreciate its clinical significance. The reported prevalence of nodular disease depends on which population is studied and the methods used to detect nodules. There are many risk factors which lead to an increase in incidence of thyroid nodules. Some factors are nonmodifiable such as age, sex, and history of head and neck irradiation, while modifiable factors can include iodine use, alcohol, and smoking. Here we discuss some of these risks and describe their association to thyroid nodularity.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Carlé A, Krejbjerg A, Laurberg P. Epidemiology of nodular goitre. Influence of iodine intake. Best Pract Res Clin Endocrinol Metab. 2014;28(4):465–79.
Andersson M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab. 2010;24(1):1–11.
Pearce EN, Andersson M, Zimmermann MB. Global iodine nutrition: where do we stand in 2013? Thyroid. 2013;23(5):523–8.
Laurberg P, Pedersen KM, Hreidarsson A, Sigfusson N, Iversen E, Knudsen PR. Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab. 1998;83(3):765–9.
Völzke H, Lüdemann J, Robinson DM, Spieker KW, Schwahn C, Kramer A, John U, Meng W. The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area. Thyroid. 2003;13(8):803–10.
Karger S, Schötz S, Stumvoll M, Berger F, Führer D. Impact of pregnancy on prevalence of goitre and nodular thyroid disease in women living in a region of borderline sufficient iodine supply. Horm Metab Res. 2010;42(2):137–42.
Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015;3(4):286–95.
Kopp P, Kimura ET, Aeschimann S, Oestreicher M, Tobler A, Fey MF, Studer H. Polyclonal and monoclonal thyroid nodules coexist within human multinodular goiters. J Clin Endocrinol Metab. 1994;79(1):134–9.
Laurberg P, Jørgensen T, Perrild H, Ovesen L, Knudsen N, Pedersen IB, Rasmussen LB, Carlé A, Vejbjerg P. The Danish investigation on iodine intake and thyroid disease, DanThyr: status and perspectives. Eur J Endocrinol. 2006;155(2):219–28.
Krejbjerg A, Bjergved L, Pedersen IB, Knudsen N, Jørgensen T, Perrild H, Ovesen L, Rasmussen LB, Laurberg P. Thyroid nodules in an 11-year DanThyr follow-up study. J Clin Endocrinol Metab. 2014;99(12):4749–57.
Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F, Rago T, Grasso L, Valeriano R, Balestrieri A, Pinchera A. The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab. 1999;84(2):561–6.
Aghini Lombardi F, Fiore E, Tonacchera M, Antonangeli L, Rago T, Frigeri M, Provenzale AM, Montanelli L, Grasso L, Pinchera A, Vitti P. The effect of voluntary iodine prophylaxis in a small rural community: the Pescopagano survey 15 years later. J Clin Endocrinol Metab. 2013;98(3):1031–9.
Zhao J, Xu F, Zhang Q, Shang L, Xu A, Gao Y, Chen Z, Sullivan KM, Maberly GF. Randomized clinical trial comparing different iodine interventions in school children. Public Health Nutr. 1999;2(2):173–8.
Baltisberger BL, Minder CE, Bürgi H. Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency. Eur J Endocrinol. 1995;132(5):546–9.
Lamberg BA. Endemic goitre in Finland and changes during 30 years of iodine prophylaxis. Endocrinol Exp. 1986;20(1):35–47.
Zimmermann MB, Hess SY, Adou P, Toresanni T, Wegmüller R, Hurrell RF. Thyroid size and goiter prevalence after introduction of iodized salt: a 5-y prospective study in schoolchildren in Côte d’Ivoire. Am J Clin Nutr. 2003;77(3):663–7.
Zimmermann MB, Wegmüller R, Zeder C, Torresani T, Chaouki N. Rapid relapse of thyroid dysfunction and goiter in school-age children after discontinuation of salt iodization. Am J Clin Nutr. 2004;79(4):642–5.
Antonelli A, Silvano G, Bianchi F, Gambuzza C, Tana L, Salvioni G, Baldi V, Gasperini L, Baschieri L. Risk of thyroid nodules in subjects occupationally exposed to radiation: a cross sectional study. Occup Environ Med. 1995;52(8):500–4.
Trerotoli P, Ciampolillo A, Marinelli G, Giorgino R, Serio G. Prevalence of thyroid nodules in an occupationally radiation exposed group: a cross sectional study in an area with mild iodine deficiency. BMC Public Health. 2005;5:73.
Inskip PD, Hartshorne MF, Tekkel M, Rahu M, Veidebaum T, Auvinen A, Crooks LA, Littlefield LG, McFee AF, Salomaa S, Makinen S, Tucker JD, Sorensen KJ, Bigbee WL, Boice JD Jr. Thyroid nodularity and cancer among Chernobyl cleanup workers from Estonia. Radiat Res. 1997;147(2):225–35.
Takahashi T, Trott KR, Fujimori K, Simon SL, Ohtomo H, Nakashima N, Takaya K, Kimura N, Satomi S, Schoemaker MJ. An investigation into the prevalence of thyroid disease on Kwajalein Atoll, Marshall Islands. Health Phys. 1997;73(1):199–213.
Takahashi T, Schoemaker MJ, Trott KR, Simon SL, Fujimori K, Nakashima N, Fukao A, Saito H. The relationship of thyroid cancer with radiation exposure from nuclear weapon testing in the Marshall Islands. J Epidemiol. 2003;13(2):99–107.
Simon SL, Bouville A, Land CE, Beck HL. Radiation doses and cancer risks in the Marshall Islands associated with exposure to radioactive fallout from Bikini and Enewetak nuclear weapons tests: summary. Health Phys. 2010;99(2):105–23.
Suzuki S, Suzuki S, Fukushima T, Midorikawa S, Shimura H, Matsuzuka T, Ishikawa T, Takahashi H, Ohtsuru A, Sakai A, Hosoya M, Yasumura S, Nollet KE, Ohira T, Ohto H, Abe M, Kamiya K, Yamashita S. Comprehensive survey results of childhood thyroid ultrasound examinations in Fukushima in the first four years after the Fukushima Daiichi Nuclear Power Plant accident. Thyroid. 2016;26(6):843–51.
Suzuki S. Childhood and adolescent thyroid cancer in Fukushima after the Fukushima Daiichi Nuclear Power Plant accident: 5 years on. Clin Oncol (R Coll Radiol). 2016;28(4):263–71.
Imaizumi M, Usa T, Tominaga T, Neriishi K, Akahoshi M, Nakashima E, Ashizawa K, Hida A, Soda M, Fujiwara S, Yamada M, Ejima E, Yokoyama N, Okubo M, Sugino K, Suzuki G, Maeda R, Nagataki S, Eguchi K. Radiation dose-response relationships for thyroid nodules and autoimmune thyroid diseases in Hiroshima and Nagasaki atomic bomb survivors 55–58 years after radiation exposure. JAMA. 2006;295(9):1011–22.
Tu W, Zhang G, Yu S, Tang J, Yu J. Observations on factors that influence thyroid nodules in diabetic and non-diabetic patients in the Zhejiang province of China. Int J Clin Exp Med. 2015;8(10):19332–8.
Anil C, Akkurt A, Ayturk S, Kut A, Gursoy A. Impaired glucose metabolism is a risk factor for increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area. Metabolism. 2013;62(7):970–5.
Völzke H, Friedrich N, Schipf S, Haring R, Lüdemann J, Nauck M, Dörr M, Brabant G, Wallaschofski H. Association between serum insulin-like growth factor-I levels and thyroid disorders in a population-based study. J Clin Endocrinol Metab. 2007;92(10):4039–45.
Curtò L, Giovinazzo S, Alibrandi A, Campennì A, Trimarchi F, Cannavò S, Ruggeri RM. Effects of GH replacement therapy on thyroid volume and nodule development in GH deficient adults: a retrospective cohort study. Eur J Endocrinol. 2015;172(5):543–52.
Herrmann BL, Baumann H, Janssen OE, Görges R, Schmid KW, Mann K. Impact of disease activity on thyroid diseases in patients with acromegaly: basal evaluation and follow-up. Exp Clin Endocrinol Diabetes. 2004;112(5):225–30.
Kim MH, Park YR, Lim DJ, Yoon KH, Kang MI, Cha BY, Lee KW, Son HY. The relationship between thyroid nodules and uterine fibroids. Endocr J. 2010;57(7):615–21.
Knudsen N, Bülow I, Laurberg P, Perrild H, Ovesen L, Jørgensen T. Alcohol consumption is associated with reduced prevalence of goitre and solitary thyroid nodules. Clin Endocrinol. 2001;55(1):41–6.
Karatoprak C, Kartal I, Kayatas K, Ozdemir A, Yolbas S, Meric K, Demirtunc R. Does smoking affect thyroid gland enlargement and nodule formation in iodine-sufficient regions? Ann Endocrinol (Paris). 2012;73(6):542–5.
Knudsen N, Bülow I, Laurberg P, Ovesen L, Perrild H, Jørgensen T. Association of tobacco smoking with goiter in a low-iodine-intake area. Arch Intern Med. 2002;162(4):439–43.
Hegedüs L, Karstrup S, Veiergang D, Jacobsen B, Skovsted L, Feldt-Rasmussen U. High frequency of goitre in cigarette smokers. Clin Endocrinol. 1985;22(3):287–92.
Vejbjerg P, Knudsen N, Perrild H, Carlé A, Laurberg P, Pedersen IB, Rasmussen LB, Ovesen L, Jørgensen T. The impact of smoking on thyroid volume and function in relation to a shift towards iodine sufficiency. Eur J Epidemiol. 2008;23(6):423–9.
Ittermann T, Schmidt CO, Kramer A, Below H, John U, Thamm M, Wallaschofski H, Völzke H. Smoking as a risk factor for thyroid volume progression and incident goiter in a region with improved iodine supply. Eur J Endocrinol. 2008;159(6):761–6.
Knudsen N, Laurberg P, Perrild H, Bülow I, Ovesen L, Jørgensen T. Risk factors for goiter and thyroid nodules. Thyroid. 2002;12(10):879–88.
Brauer VF, Below H, Kramer A, Führer D, Paschke R. The role of thiocyanate in the etiology of goiter in an industrial metropolitan area. Eur J Endocrinol. 2006;154(2):229–35.
Erdogan MF. Thiocyanate overload and thyroid disease. Biofactors. 2003;19(3–4):107–11.
Erdoğan MF, Erdoğan G, Sav H, Güllü S, Kamel N. Endemic goiter, thiocyanate overload, and selenium status in school-age children. Biol Trace Elem Res. 2001;79(2):121–30.
Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, Toppari J, Zoeller RT. Executive summary to EDC-2: the Endocrine Society’s second scientific statement on endocrine-disrupting chemicals. Endocr Rev. 2015;36(6):593–602.
Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab. 1955;15(10):1270–80.
Singer PA. Evaluation and management of the solitary thyroid nodule. Otolaryngol Clin N Am. 1996;29(4):577–91.
Welker MJ, Orlov D. Thyroid nodules. Am Fam Physician. 2003;67(3):559–66.
Wiest PW, Hartshorne MF, Inskip PD, Crooks LA, Vela BS, Telepak RJ, Williamson MR, Blumhardt R, Bauman JM, Tekkel M. Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med. 1998;17(8):487–96.
Gharib H. Changing concepts in the diagnosis and management of thyroid nodules. Endocrinol Metab Clin N Am. 1997;26(4):777–800.
Tan GH, Gharib H, Reading CC. Solitary thyroid nodule. Comparison between palpation and ultrasonography. Arch Intern Med. 1995;155(22):2418–23.
Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules: final report of a 15-year study of the incidence of thyroid malgnancy. Ann Intern Med. 1968;69:537–40.
Christensen SB, Ericsson UB, Janzon L, Tibblin S, Trell E. The prevalence of thyroid disorders in a middle-aged female population, with special reference to the solitary thyroid nodule. Acta Chir Scand. 1984;150(1):13–9.
Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol. 1977;7(6):481–93.
Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin N Am. 1997;26(1):189–218.
Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer. 2006;13(2):427–53.
Rallison ML, Dobyns BM, Keating FR Jr, Rall JE, Tyler FH. Thyroid nodularity in children. JAMA. 1975;233(10):1069–72.
Rallison ML, Dobyns BM, Meikle AW, Bishop M, Lyon JL, Stevens W. Natural history of thyroid abnormalities: prevalence, incidence, and regression of thyroid diseases in adolescents and young adults. Am J Med. 1991;91(4):363–70.
Group, Canadian Pediatric Thyroid Nodule (CaPTN) Study. The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices. J Pediatr Surg. 2008;43(5):826–30.
Mirshemirani A, Roshanzamir F, Tabari AK, Ghorobi J, Salehpoor S, Gorji FA. Thyroid nodules in childhood: a single institute experience. Iran J Pediatr. 2010;20(1):91–6.
Gupta A, Ly S, Castroneves LA, Frates MC, Benson CB, Feldman HA, Wassner AJ, Smith JR, Marqusee E, Alexander EK, Barletta J, Doubilet PM, Peters HE, Webb S, Modi BP, Paltiel HJ, Kozakewich H, Cibas ES, Moore FD Jr, Shamberger RC, Larsen PR, Huang SA. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab. 2013;98(8):3238–45.
Khozeimeh N, Gingalewski C. Thyroid nodules in children: a single Institution’s experience. J Oncol. 2011;2011:1–4.
Papendieck P, Gruñeiro-Papendieck L, Venara M, Acha O, Cozzani H, Mateos F, Maglio S, Calcagno ML, Bergada I, Chiesa A. Differentiated thyroid cancer in children: prevalence and predictors in a large cohort with thyroid nodules followed prospectively. J Pediatr. 2015;167(1):199–201.
Katz JF, Kane RA, Reyes J, Clarke MP, Hill TC. Thyroid nodules: sonographic-pathologic correlation. Radiology. 1984;151:741–5.
Scheible W, Leopold GR, Woo VL, Gosink BB. High-resolution real-time ultrasonography of thyroid nodules. Radiology. 1979;133:413–7.
Desser TS, Kamaya A. Ultrasound of thyroid nodules. Neuroimaging Clin N Am. 2008;18(3):463–78.
Russ G, Leboulleux S, Leenhardt L, Hegedüs L. Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup. Eur Thyroid J. 2014;3(3):154–63.
Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasounography. Arch Intern Med. 1994;154(16):1838–40.
Bruneton JN, Balu-Maestro C, Marcy PY, Melia P, Mourou MY. Very high frequency (13 MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules. J Ultrasound Med. 1994;13(2):87–90.
Bartolotta TV, Midiri M, Runza G, Galia M, Taibbi A, Damiani L, Palermo Patera G, Lagalla R. Incidentally discovered thyroid nodules: incidence, and greyscale and colour Doppler pattern in an adult population screened by real-time compound spatial sonography. Radiol Med. 2006;111(7):989–98.
Kwong N, Medici M, Angell TE, Liu X, Marqusee E, Cibas ES, Krane JF, Barletta JA, Kim MI, Larsen PR, Alexander EK. The influence of patient age on thyroid nodule formation, multinodularity, and thyroid cancer risk. J Clin Endocrinol Metab. 2015;100(12):4434–40.
Jiang H, Tian Y, Yan W, Kong Y, Wang H, Wang A, Dou J, Liang P, Mu Y. The prevalence of thyroid nodules and an analysis of related lifestyle factors in Beijing communities. Int J Environ Res Public Health. 2016;13(4):442.
Kamran M, Hassan N, Ali M, Ahmad F, Shahzad S, Zehra N. Frequency of thyroid incidentalomas in Karachi population. Pak J Med Sci. 2014;30(4):793–7.
Olusola-Bello MA, Agunloye AM, Adeyinka AO. Ultrasound prevalence and characteristics of incidental thyroid lesions in Nigerian adults. Afr J Med Med Sci. 2013;42(2):125–30.
Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):901–11.
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):319–25.
Mitselou A, Vougiouklakis T, Peschos D, Dallas P, Agnantis NJ. Occult thyroid carcinoma. A study of 160 autopsy cases. The first report for the region of Epirus-Greece. Anticancer Res. 2002;22(1A):427–32.
Hermanson L, Gargill SL, Lesses MF. The treatment of nodular goiter. J Clin Endocrinol Metab. 1952;12(1):112–29.
Lang W, Borrusch H, Bauer L. Occult carcinomas of the thyroid. Evaluation of 1,020 sequential autopsies. Am J Clin Pathol. 1988;90(1):72–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Parsa, A.A., Gharib, H. (2018). Epidemiology of Thyroid Nodules. In: Gharib, H. (eds) Thyroid Nodules. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-59474-3_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-59474-3_1
Published:
Publisher Name: Humana Press, Cham
Print ISBN: 978-3-319-59473-6
Online ISBN: 978-3-319-59474-3
eBook Packages: MedicineMedicine (R0)