22nd Annual Scientific & Clinical Congress of the American Association of Clinical Endocrinologists:

Physical Examination Detects a Greater Percentage of Thyroid Cancer

This purpose of this study was to determine (1) how thyroid nodules were found and (2) if there is a correlation between the method of detection and the rate of thyroid cancer.  The study involved analyzing the medical records of 200 "consecutive cases referred" to the clinicians and 141 biopsies.

(1)     Detection Methods

  • N=35: CT scan
  • N=15: MRI
  • N=8: Carotid ultrasound (US)
  • N=9: Other imaging studies
  • Total: 67 (33.5%)
  • N=75 (37.5%) by physical examination
  • N=24 (12%) by patient finding
  • N=34 (17%) by thyroid ultrasound performed for a different reason

(2)    Biopsy Results

  • In 141 (70%) cases, biopsies were obtained
  • 12 biopsies surgically confirmed as malignant
  • N=7 (58%) detected by physical examination
  • N=3 (25%) detected by patients
  • 1 thyroid cancer detected on imaginh
  • 1 thyroid cancer detected during US

A higher rate of thyroid cancer was detected by physical examination compared with incidental detection on imaging.

  • 9% of the thyroid nodules detected during physical examination were malignant
  • 1.5% of the thyroid nodules found incident to other imaging were malignant
  • 67% (N=8) of the malignancies were lymph node negative
  • 33% (N=4) of the malignancies were positive lateral lymph nodes
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