ThyroidPub Date : 2025-01-01Epub Date: 2024-12-23DOI: 10.1089/thy.2024.0556
C Christofer Juhlin, Ozgur Mete
{"title":"<i>Letter to the Editor</i>: Morphological Indicators of <i>DICER1</i> Mutations May Guide Somatic and Germline Testing.","authors":"C Christofer Juhlin, Ozgur Mete","doi":"10.1089/thy.2024.0556","DOIUrl":"10.1089/thy.2024.0556","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"120-121"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2024-12-04DOI: 10.1089/thy.2024.0277
Xiaobing Jin, David T Broome, Madelyn Lew, Amer Heider, Megan R Haymart, Maria Papaleontiou, Debbie Chen, Jennifer J Iyengar, Nazanene Esfandiari, Zahrae Sandouk, Liselle Douyon, David T Hughes, Brian Smola, Xin Jing
{"title":"Performance of Afirma Genomic Sequencing Classifier in Binary Subcategories of Atypia of Undetermined Significance Thyroid Nodules: Single Versus Repeat Diagnosis.","authors":"Xiaobing Jin, David T Broome, Madelyn Lew, Amer Heider, Megan R Haymart, Maria Papaleontiou, Debbie Chen, Jennifer J Iyengar, Nazanene Esfandiari, Zahrae Sandouk, Liselle Douyon, David T Hughes, Brian Smola, Xin Jing","doi":"10.1089/thy.2024.0277","DOIUrl":"10.1089/thy.2024.0277","url":null,"abstract":"<p><p><b><i>Background:</i></b> Afirma Genomic Sequencing Classifier (GSC) testing has been utilized for further risk stratification of thyroid nodules categorized as atypia of undetermined significance (AUS). The 2023 Bethesda system subcategorizes AUS diagnosis into AUS with nuclear atypia (AUS-N) and other atypia (AUS-O). The current study aims to determine if performance of GSC testing differs between the two AUS subcategories and between single AUS cohort and repeat AUS cohort. <b><i>Methods:</i></b> This retrospective study analyzed consecutive thyroid nodule fine-needle aspiration with a single or a repeat AUS diagnosis and a diagnostic GSC testing result (benign vs. suspicious). All AUS nodules were divided into AUS-N or AUS-O subcategory and followed by either surgical intervention or at least 12 months of clinical and/or ultrasound monitoring. We then assessed performance of GSC testing in each subcategory and subsequently compared the individual performance in AUS-N or AUS-O subcategory between single AUS cohort and repeat AUS cohort. <b><i>Results:</i></b> The study identified a total of 365 thyroid nodules subcategorized as AUS-N (<i>N</i> = 106) and AUS-O (<i>N</i> = 259). Both cohorts showed a significantly lower GSC benign call rate (BCR) in AUS-N nodules compared with AUS-O nodules (43% vs. 71% in single AUS, <i>p</i> = 0.001; 58% vs. 74% in repeat AUS, <i>p</i> = 0.02). The proportion of histology-proven malignancies associated with a suspicious GSC result tended to be greater in AUS-N nodules than AUS-O nodules (28% vs. 10% in single AUS, <i>p</i> = 0.09; 38% vs. 27% in repeat AUS, <i>p</i> = 0.3). Compared with AUS-N nodules, AUS-O cohorts demonstrated significantly higher specificity in the single AUS group (73% vs. 51%, <i>p</i> = 0.01). In both subcategories, the repeat AUS cohort yielded greater specificity, positive predictive value, and diagnostic accuracy compared with the single AUS group. However, the differences did not reach statistical significance. <b><i>Conclusions:</i></b> GSC BCR and diagnostic performance of GSC testing may vary in AUS-N versus AUS-O subcategories. However, there were no statistically significant differences in GSC performance between single and repeat AUS cohorts.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"41-49"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2024-12-20DOI: 10.1089/thy.2024.0270
Yoon Young Cho, Bongseong Kim, Sang-Man Jin, Chan-Hee Jung, Ji Oh Mok, Sun Wook Kim, Jae Hoon Chung, Kyung-Do Han, Tae Hyuk Kim
{"title":"Graves' Disease and the Risk of Type 2 Diabetes: A Korean Population-Based Study.","authors":"Yoon Young Cho, Bongseong Kim, Sang-Man Jin, Chan-Hee Jung, Ji Oh Mok, Sun Wook Kim, Jae Hoon Chung, Kyung-Do Han, Tae Hyuk Kim","doi":"10.1089/thy.2024.0270","DOIUrl":"10.1089/thy.2024.0270","url":null,"abstract":"<p><p><b><i>Background:</i></b> Several meta-analyses have found no association between Graves' disease (GD) and an increased risk of incident diabetes; however, the intricate relationship between thyroid dysfunction and diabetes remains underexplored. In this study, we aimed to evaluate the risk of incident type 2 diabetes (T2DM) in a population newly diagnosed with GD, focusing on different treatment methods and treatment duration. <b><i>Methods:</i></b> This was a retrospective population-based study utilizing data from the Korean National Health Insurance database. We included 36,243 patients with GD and 36,243 controls, matched with age and sex. We calculated the incidence of T2DM among patients and controls based on treatment methods, such as medical therapy, radioactive iodine therapy (RAIT), and surgery. We examined the cumulative dose and duration of antithyroid drug (ATD) use for each patient. <b><i>Results:</i></b> The majority of patients (34,867, 96.2%) were treated with ATDs, followed by RAIT (1093 patients, 3%), and surgery (283 patients, 0.8%). After adjusting for age; sex; income; comorbidities, including hypertension, dyslipidemia, and cancer; body mass index; smoking; drinking; and exercise, patients with GD exhibited a higher risk of developing diabetes (hazard ratio [HR] = 1.13 [95% confidence interval 1.06-1.21]) than controls (5.1% vs. 4.5%, respectively). While the risk was the highest within the first six months after GD diagnosis (HR = 3.21), it was significant between six months and two years (HR = 1.36) and was comparable with the controls two years after GD diagnosis (HR = 0.93). A longer duration of ATD treatment and a higher cumulative dose were associated with an increased risk of diabetes. However, the risks for T2DM did not differ according to treatment modality or clinical outcomes, which was probably related to the small number of patients in each subgroup. <b><i>Conclusions:</i></b> Our findings highlight the negative impact of GD on the development of T2DM. Patients newly diagnosed with GD can be considered for diabetes screening to facilitate early detection and intervention.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"60-68"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2024-11-11DOI: 10.1089/thy.2024.0268
Hattie H Huston-Paterson, Yifan V Mao, Chi-Hong Tseng, Jiyoon Kim, Debbie W Chen, James X Wu, Michael W Yeh
{"title":"The Relationship Between Hospital Safety-Net Burden on Outcomes for High-Volume Thyroid Cancer Surgeons.","authors":"Hattie H Huston-Paterson, Yifan V Mao, Chi-Hong Tseng, Jiyoon Kim, Debbie W Chen, James X Wu, Michael W Yeh","doi":"10.1089/thy.2024.0268","DOIUrl":"10.1089/thy.2024.0268","url":null,"abstract":"<p><p><b><i>Background:</i></b> Higher center and surgeon volume correspond to better outcomes for patients with thyroid cancer. This study aims to investigate how a hospital's safety-net burden, the proportion of a hospital's patients who are insured by state Medicaid plans or are uninsured, influences the outcomes of high-volume (HV) surgeons. <b><i>Methods:</i></b> We performed a retrospective cohort study of all patients who underwent surgery for thyroid cancer in California from 1999 to 2017. We stratified treating facilities by the proportion of Medicaid-type and indigent payors into safety-net burden quartiles. We compared the perioperative and oncologic outcomes of HV surgeons (annual case volume ≥10) for patients undergoing total thyroidectomy across safety-net burden quartiles. A mixed-effects regression model controlled for surgeon random effects and fixed effects of patient and tumor characteristics. <b><i>Results:</i></b> Our sample comprised 42,347 patients (78% female, median age 50), of whom 13,848 (32%) were treated by HV surgeons (<i>n</i> = 276). Compared to patients of lower-volume surgeons, patients of HV surgeons were more likely to be White, from the upper quartiles of socioeconomic status and well insured (all <i>p</i> < 0.001). HV surgeons in each hospital's safety-net burden quartile displayed similar case number distributions. Compared to patients treated by HV surgeons at Q1 (lowest safety-net burden) hospitals, those treated by HV surgeons at Q4 (highest safety-net burden) hospitals had higher absolute risks of endocrine complications (+7%, <i>p</i> = 0.007), airway complications (+6%, <i>p</i> = 0.004), disease-specific mortality (+1.3%, <i>p</i> = 0.046), and all-cause mortality during the study period (+3%, <i>p</i> = 0.046) in multivariable analysis. <b><i>Conclusion:</i></b> The performance of HV thyroid cancer surgeons differs by a hospital's safety-net burden, with patients treated at high safety-net burden hospitals experiencing higher rates of operative complications, disease-specific mortality, and all-cause mortality. Having a HV surgeon alone may be insufficient to provide optimal short- and long-term outcomes for patients with thyroid cancer.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"50-59"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2024-11-14DOI: 10.1089/thy.2024.0549
Sara Mazzantini, Christine E Cherella, Cynthia Graziano, Ann Damian, Bethany Furlong, Jean C Solodiuk, Danielle M Richman, Jessica R Smith, Ari J Wassner
{"title":"Thyroid Fine-Needle Aspiration Is Safe and Well-Tolerated in Children.","authors":"Sara Mazzantini, Christine E Cherella, Cynthia Graziano, Ann Damian, Bethany Furlong, Jean C Solodiuk, Danielle M Richman, Jessica R Smith, Ari J Wassner","doi":"10.1089/thy.2024.0549","DOIUrl":"10.1089/thy.2024.0549","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"111-114"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2024-12-20DOI: 10.1089/thy.2024.0433
Eline C Jager, Madelon J H Metman, Inger A C Timmenga, Wouter T Zandee, Liesbeth Jansen, Bettien M van Hemel, Lutske Lodewijk, Menno R Vriens, Medard F M van den Broek, Anton F Engelsman, Koen M A Dreijerink, Romana T Netea-Maier, Tessa M van Ginhoven, Robin P Peeters, Eline de Heus, Thera P Links, Schelto Kruijff
{"title":"Trends in the Incidence, Organization of Care, and Surgical Treatment of Medullary Thyroid Cancer: A Population-Based Study.","authors":"Eline C Jager, Madelon J H Metman, Inger A C Timmenga, Wouter T Zandee, Liesbeth Jansen, Bettien M van Hemel, Lutske Lodewijk, Menno R Vriens, Medard F M van den Broek, Anton F Engelsman, Koen M A Dreijerink, Romana T Netea-Maier, Tessa M van Ginhoven, Robin P Peeters, Eline de Heus, Thera P Links, Schelto Kruijff","doi":"10.1089/thy.2024.0433","DOIUrl":"10.1089/thy.2024.0433","url":null,"abstract":"<p><p><b><i>Background:</i></b> Medullary thyroid cancer (MTC) is a rare cancer with variable disease course. To enable optimal care, centralization and consensus guidelines are essential. This study describes trends in the incidence, organization of care, surgical treatment, and outcomes of MTC over 30 years in the Netherlands. <b><i>Methods:</i></b> All patients with a histological MTC diagnosis between 1989 and 2018 were identified from the Netherlands Cancer Registry and linked to the Dutch Pathology register (PALGA). Incidence rates, relative to the Dutch population, were assessed throughout time. Clinicopathological parameters and extent of lymph node (LN) surgery were extracted from PALGA pathology reports. Period A (1989-1998), period B (1999-2008), and period C (2009-2018) were compared. <b><i>Results:</i></b> Throughout 30 years, the population-adjusted incidence remained stable with 0.17 ± 0.04 diagnoses per 100,000 people per year (<i>p</i> = 0.247). Of all 795 patients, 54% were female and 63% were treated in an academic hospital, at a median age of 48 years (interquartile range [IQR] 34-61). Age at diagnosis increased over time from 42 years (IQR 25-61) in period A to 52 years (IQR 42-63) in period C (<i>p</i> < 0.001). The proportion of treatments occurring in an academic hospital increased from 41% of patients in period A to 58% and 86% in period B and C, respectively (both <i>p</i> < 0.001). At primary treatment, a LN dissection was performed in 582 (73%) patients. Of these patients, 88%, 36%, and 20% underwent a central neck dissection (CND), unilateral neck dissection, and bilateral neck dissection, respectively. CND was performed more frequently in period C (93%) than in period A (77%) or B (87%) (<i>p</i> = 0.009, <i>p</i> = 0.027, respectively). Overall survival improved from period A (55%) to C (88%) and B (65%) to C (<i>p</i> = 0.022, <i>p</i> = 0.007, respectively). Locoregional recurrence rates remained stable. <b><i>Conclusions:</i></b> This study shows a stable incidence and improved survival of MTC in the Dutch population over the last three decades. In addition, these data indicate a transition of treatment to academic hospitals, likely due to centralization, and a higher rate of CNDs, following the introduction of recommendation guidelines.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"87-96"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2025-01-06DOI: 10.1089/thy.2024.0739
Anna M Sawka
{"title":"35th Anniversary of Thyroid-Journal of the American Thyroid Association.","authors":"Anna M Sawka","doi":"10.1089/thy.2024.0739","DOIUrl":"10.1089/thy.2024.0739","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1-2"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2025-01-01Epub Date: 2024-12-27DOI: 10.1089/thy.2024.0512
Clarisse Quignon, Annika Backer, Jessica Kearney, Hannah Bow, Susan Wray
{"title":"Mild Gestational Hypothyroidism in Mice Has Transient Developmental Effects and Long-Term Consequences on Neuroendocrine Systems.","authors":"Clarisse Quignon, Annika Backer, Jessica Kearney, Hannah Bow, Susan Wray","doi":"10.1089/thy.2024.0512","DOIUrl":"10.1089/thy.2024.0512","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyroid hormones (TH) play a key role in fetal brain development. While severe thyroid dysfunction, has been shown to cause neurodevelopmental and reproductive disorders, the rising levels of TH-disruptors in the environment in the past few decades have increased the need to assess effects of subclinical (mild) TH insufficiency during gestation. Since embryos do not produce their own TH before mid-gestation, early development processes rely on maternal production. Notably, the reproductive network governed by gonadotropin-releasing hormone (GnRH) neurons develops during this critical period. <b><i>Methods:</i></b> The risk of mild maternal hypothyroidism on the development of GnRH neurons and long-term effect on neuroendocrine function in the offspring was investigated using a mouse model of gestational hypothyroidism induced by methimazole (MMI) treatment. <b><i>Results:</i></b> MMI treatment during gestation led to reduced litter size, consistent with increased miscarriages due to hypothyroidism. E12/13 embryos, collected from MMI-treated dams, had a decreased number of GnRH neurons, but the migration of the remaining GnRH neurons was normal. Cell proliferation was reduced in the vomeronasal organ (VNO), correlating with the reduced number of GnRH neurons detected in this region. Using a GnRH cell line confirmed attenuated proliferation in the absence of T3. Pups born from hypothyroid mothers had normal postweaning growth and estrus cycles, yet adult offspring had significantly more cells expressing estrogen receptor alpha in the arcuate nucleus. Notably, by adulthood, GnRH cell number and distribution was comparable with nontreated controls indicating that compensatory mechanisms occurred after E13. <b><i>Conclusion:</i></b> Overall, our work shows that mild TH disruption during gestation transiently affects proliferation of the pool of GnRH neurons within the VNO and has a long-term impact on neuroendocrine systems.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"97-110"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2024-12-20DOI: 10.1089/thy.2024.0438
Chris Zajner, Nikhil Patil, Rachel McInnis, Stan Van Uum, Alexander Fraser, Pavlo Ohorodnyk, Lulu L C D Bursztyn
{"title":"Patterns of Extraocular Muscle Enlargement in Graves' Orbitopathy and Acromegaly.","authors":"Chris Zajner, Nikhil Patil, Rachel McInnis, Stan Van Uum, Alexander Fraser, Pavlo Ohorodnyk, Lulu L C D Bursztyn","doi":"10.1089/thy.2024.0438","DOIUrl":"https://doi.org/10.1089/thy.2024.0438","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Extraocular muscle (EOM) enlargement occurs in both acromegaly and Graves' disease, but the degree and pattern of enlargement have not been directly compared in these patient groups. This study investigated whether acromegaly and Graves' orbitopathy (GO) are associated with different patterns of EOM enlargement at the time of diagnosis. <b><i>Study Design:</i></b> Retrospective cohort. <b><i>Methods:</i></b> All new patients with a diagnosis of acromegaly or GO who presented to St Joseph's Health Care in London, Ontario, between January 1, 2015, and July 1, 2020, and who underwent computed tomography (CT) scanning with adequate orbital imaging were considered for inclusion. We included age- and sex-matched control patients with pituitary macroadenomas without thyroid or growth hormone abnormalities. Orbital CT scans were analyzed by a single neuroradiologist, who measured the maximum diameter and cross-sectional area of each EOM. The relative likelihood of involvement of each rectus EOM was analyzed separately using an analysis of variance test. <b><i>Results:</i></b> We included 16 patients with GO, 17 with acromegaly, and 18 controls. Ages (mean ± standard deviation) of groups were 55.6 ± 18.0, 50.2 ± 15.7, and 49.3 ± 14.0 years. The mean maximum diameter of EOMs in GO, acromegaly, and controls was inferior rectus (IR) = 4.77 ± 1.53, 4.66 ± 0.61, and 3.68 ± 0.61 mm; medial rectus (MR) = 5.35 ± 2.23, 4.84 ± 0.81, and 3.65 ± 0.42 mm; superior rectus (SR) = 4.94 ± 1.84, 4.88 ± 0.91, and 3.68 ± 0.61 mm; and lateral rectus (LR) = 3.91 ± 1.59, 4.55 ± 0.60, and 3.20 ± 0.43 mm. The IR, MR, and SR muscles were significantly larger in the GO group compared with controls (IR, <i>p</i> = 0.020; SR, <i>p</i> = 0.004; MR, <i>p</i> < 0.001; and LR, <i>p</i> = 0.166), and all four EOMs were larger in acromegaly compared with controls (IR, <i>p</i> = 0.039; SR, <i>p</i> = 0.006; MR, <i>p</i> = 0.006; and LR, <i>p</i> = 0.001). There was no significant difference between the GO and acromegaly groups (IR, <i>p</i> = 0.959; SR, <i>p</i> = 0.987; MR, <i>p</i> = 0.408; and LR, <i>p</i> = 0.250). <b><i>Conclusions:</i></b> GO and acromegaly groups demonstrated the enlargement of the IR, MR, and SR muscles when compared with controls. The GO group did not show significantly larger EOM sizes compared with the acromegaly group. In the GO group, the IR, MR, and SR were similarly affected and did not follow previously described patterns of enlargement in GO.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ThyroidPub Date : 2024-12-01Epub Date: 2024-11-28DOI: 10.1089/thy.2024.0344
Sara Fernandes-Taylor, Erin J Aiello Bowles, Manasa Venkatesh, Rachael Doud, Craig Krebsbach, Natalia Arroyo, Bret Hanlon, Amy Y Chen, Louise Davies, David O Francis
{"title":"Differential Ultrasound Rates Mirror Sex Disparities in Thyroid Cancer.","authors":"Sara Fernandes-Taylor, Erin J Aiello Bowles, Manasa Venkatesh, Rachael Doud, Craig Krebsbach, Natalia Arroyo, Bret Hanlon, Amy Y Chen, Louise Davies, David O Francis","doi":"10.1089/thy.2024.0344","DOIUrl":"10.1089/thy.2024.0344","url":null,"abstract":"<p><p><b><i>Background:</i></b> Expanding ultrasound use has increased the detection of thyroid cancer. Incidence has always been higher among females, a disparity that has grown over time. The sex difference in thyroid cancer is understudied in the context of diagnostic testing, particularly among privately insured adults in whom thyroid cancer is most common. We evaluated the association between thyroid ultrasound, fine needle aspiration biopsy (FNAB), and cancer incidence by sex in a large, integrated health system. <b><i>Methods:</i></b> This longitudinal retrospective cohort study included Kaiser Permanente of Washington enrollees aged 18 and over who underwent thyroid ultrasound from 1997 to 2019. Data included electronic billing claims for patients linked to tumor registry diagnoses. We estimated (1) annual overall ultrasound, FNAB, and cancer incidence rates; (2) the proportion of ultrasound requiring FNAB; and (3) cancer diagnoses per FNAB. A Poisson model with offset determined the relationship between sex and the proportion of ultrasound requiring FNAB adjusting for patient and sociodemographic characteristics. <b><i>Results:</i></b> A total of 33,589 patients underwent ultrasound (78% females; mean age 56). Ultrasound rates per 100,000 covered lives, defined as insured individuals per year, increased five-fold among males (111.11-490.97) and >four-fold among females (382.27-1331.14) between 1997 and 2019. FNAB rates also increased over time (rates per 100,000: 174.09-430.37 in females vs. 58.38-189.13 in men). Overall, FNAB rates per ultrasound changed little over time, and FNAB per ultrasound was greater in males compared with females (Adj rate ratio = 1.06 [confidence interval 1.01-1.11]). Cancer incidence was higher in females over the study period, but cancer incidence per FNAB was similar between sexes (both 0.06, <i>p</i> = 0.4). <b><i>Conclusions:</i></b> Sex disparities in thyroid ultrasound rates are stark and are a likely driver of sex disparities in thyroid cancer incidence. Interestingly, ultrasound-triggered FNAB was more common in males and changed little over time, challenging the prevailing understanding that females have much higher rates of thyroid cancer. Although the population-based differences between sexes for FNAB and cancer were large, the differences among people who had ultrasound were small.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1531-1539"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}