title: Thyroid cancer in patients with toxic nodular goiter--is the incidence increasing?
abstract: BACKGROUND
  There has been a dramatic increase in the incidence of thyroid cancer, but it is unclear if this has occurred in patients with toxic nodular goiter (TNG).
  
  
  METHODS
  TNG was defined as one or more thyroid nodules in combination with a low serum TSH level. Patients who underwent thyroidectomy for TNG were identified from a prospectively maintained database. The rates of incidental thyroid cancer were compared over the intervals 1990 to 1999, 2000 to 2009, and 2010 to 2014.
  
  
  RESULTS
  There was no significant difference in cancer rate between the 3 time periods. Overall, 7 (4.7%) of the 148 patients had thyroid cancer; similarly, 1 (3.2%) of the 31 patients from 1990 to 1999, 3 (4.2%) of 72 patients from 2000 to 2009, and 3 (6.7%) of the 45 patients from 2010 to 2014 (P > .05) had thyroid cancer.
  
  
  CONCLUSIONS
  No significant increase in the rate of carcinoma was observed in patients with TNG. As a result, the risk benefit analysis should not change when considering therapeutic options for TNG.
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Choong
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA. Electronic address: cmchenry@metrohealth.org.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McHenry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006044:Goiter, Nodular / Q000150:complications* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology*; D013965:Thyroidectomy; D055815:Young Adult
keywords: Thyroid cancer; Thyroidectomy; Toxic nodular goiter