Endocrine Abstracts

Introduction: We assessed the incidence of ultrasound (US) thyroid scan anomalies in adult volunteers in the district of Modena

Methods: From December 2010 to October 2011 we performed US thyroid scan (Siemens Acuson Antares, 10 Mega Hertz-Linear scanner- B mode) in a cohort of 201 volunteers, recruited by local advertisement, women (n=135) and men (n=66), mean age 46±10.7. All participants were unaware of any thyroid disease and at their first thyroid US scan. Fine needle aspiration cytology (FNA) was performed in 13 subjects.

Results: US thyroid scan anomalies were found in 101 subjects (50.3%): 93 nodular goiters (95%) and 13 subjects with ultrasound features of thyroiditis (12.8%), 11 of them confirmed by positive anti Tg and/or anti TPO antibodies. Positive family history was present in 30% of subjects affected by thyroid US anomalies. In all subjects with nodules serum calcitonin was normal. 13 subjects (6.5%) with nodular goiter underwent FNA with the following citology: 10 patients THY 2 (77%), 1 patient THY 3 (7.7%), 2 patients had THY 4 (15%) followed by histological confirmation of thyroid papillary carcinoma after total thyroidectomy (both women aged 48)

Conclusions: The incidence of thyroid anomalies, mainly nodular goiter, is very high in subjects unaware of any thyroid disease in the district of Modena, Italy. Thyroid cancer was found in 1% of all subjects, 2% of those affected by nodular goiter. Among subjects who underwent FNA the prevalence of cancer was 15%. Compared to other well-established screening programs like breast and colorectal cancer providing a yearly detection rate of about 0.45% and 0.27% respectively, the incidence of thyroid cancer seems to be much higher: thyroid US mass screening could allow the detection of asymptomatic cancer at a very early stage with a high cost-benefit ratio.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.