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World Journal of Surgery

, Volume 38, Issue 6, pp 1312–1317 | Cite as

Trends in Incidentally Identified Thyroid Cancers Over a Decade: A Retrospective Analysis of 2,090 Surgical Patients

  • Manisha Bahl
  • Julie A. Sosa
  • Rendon C. Nelson
  • Ramon M. Esclamado
  • Kingshuk Roy Choudhury
  • Jenny K. HoangEmail author
Article

Abstract

Background

The aim of this study was to describe trends in the incidence of incidental thyroid cancers and compare their characteristics with clinically presenting cancers.

Methods

We performed a retrospective review of patients with thyroid cancer who underwent thyroid surgery from 2003 to 2012. Patients’ initial presentation was categorized as incidental (on imaging or final surgical pathology) or clinical (palpable or symptomatic) cancer. Characteristics of incidental and clinical cancers were compared.

Results

Of the 2,090 patients who underwent thyroid surgery, 680 (33 %) were diagnosed with cancer. One hundred ninety (28 %) were incidental cancer, of which 101 were detected on imaging studies and 89 were detected on analysis of the surgical pathology specimens. The incidence of thyroid cancer increased by 7.6-fold from 2003 to 2012. The proportion of incidental cancers on imaging did not increase, but incidental cancers found on pathology steadily increased from 6 % in 2003 to 20 % in 2012. 84 % of the cancers were papillary cancer, and the proportion of papillary cancer was similar for both clinical and incidental cancers. Clinical cancers were larger than incidental cancers on imaging (2.2 vs. 1.8 cm, p = 0.02). Incidental cancers on imaging were less likely to have lateral compartment nodal metastases (7 vs. 13 %, p < 0.001).

Conclusions

Thyroid cancer diagnoses have increased at our institution, but the proportion of incidental cancers identified on imaging relative to clinical cancers has been stable over a decade and is not the sole explanation for the observed increase in thyroid cancer diagnoses. Incidental cancers on imaging are smaller in size and less likely to have lateral compartment nodal metastases than clinical cancers.

Keywords

Thyroid Cancer Incidental Cancer Thyroid Nodule Papillary Thyroid Cancer Thyroid Malignancy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

The authors have no conflicts of interest or financial ties to disclose.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Manisha Bahl
    • 1
  • Julie A. Sosa
    • 2
  • Rendon C. Nelson
    • 3
  • Ramon M. Esclamado
    • 4
  • Kingshuk Roy Choudhury
    • 5
  • Jenny K. Hoang
    • 6
    Email author
  1. 1.Department of RadiologyDuke University Medical CenterDurhamUSA
  2. 2.Division of Surgical Oncology, Department of SurgeryDuke University School of MedicineDurhamUSA
  3. 3.Division of Abdominal Imaging, Department of RadiologyDuke University Medical CenterDurhamUSA
  4. 4.Division of Otolaryngology, Head and Neck Surgery, Department of SurgeryDuke University Medical CenterDurhamUSA
  5. 5.Department of RadiologyDuke University Medical CenterDurhamUSA
  6. 6.Division of Neuroradiology, Department of Radiology and Radiation OncologyDuke University Medical CenterDurhamUSA

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