title: Risk Factors Associated with Thyroid Carcinoma in North Pakistan.
abstract: BACKGROUND
  Epidemiological data on thyroid cancer and associated risk factors are scarce in our setting. The present study was therefore designed to gather data which could be helpful in providing insights to thyroid physicians and surgeons for better management of affected patients.
  
  
  OBJECTIVE
  To determine the frequency of carcinoma thyroid among patients presenting with goiter and its association with TSH, Tg/ATg and other demographic factors.
  
  
  METHODS
  A total of 73 adult patients of either gender with solitary solid cold nodules and/or multi-ndoular goiter (MNG) with predominant solid cold nodules were enrolled. All surgically resected samples were sent for histopathology. The frequency of thyroid cancer and its subtypes was noted and tested for association with gender, age (< or ≥40 years), recent increase in swelling size, TSH, Tg and ATg.
  
  
  RESULTS
  Thyroid cancer was diagnosed in 26% (n=19) of the patients, 14 (73.7%) being diagnosed with papillary thyroid cancer and 5 (26.3%) with follicular thyroid cancer. No other subtypes were noted. Presence of thyroid cancer was significantly associated with recent increase in swelling size and higher TSH Values mean TSH values (P<0.05). No significant association was found with gender, age, Tg and ATg values (P>0.05).
  
  
  CONCLUSIONS
  Overall percentage of thyroid cancer in our study sample was found to be 26%, with a predominance of papillary over follicular lesions. Rates were significantly higher in patients who had history of recent increase in swelling size and higher and higher pre-surgery TSH values.
authors.affiliation: Nuclear Medicine Department, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan E-mail : draleemkhan@yahoo.com.
authors.forename: Muhammad Aleem
authors.initials: MA
authors.lastname: Khan
authors.forename: Kamran Hakeem
authors.initials: KH
authors.lastname: Khan
authors.forename: Sajid Ali
authors.initials: SA
authors.lastname: Shah
authors.forename: Kahkashan Ali
authors.initials: KA
authors.lastname: Mir
authors.forename: Mubarik
authors.initials: M
authors.lastname: Khattak
authors.forename: Muhammad Faheem
authors.initials: MF
authors.lastname: Shahzad
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D002291:Carcinoma, Papillary; D003710:Demography / Q000379:methods; D019468:Disease Management; D005260:Female; D006042:Goiter / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D010154:Pakistan; D012307:Risk Factors; D066231:Surgeons; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000378:metabolism / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D013972:Thyrotropin / Q000378:metabolism
chemical_list: D013972:Thyrotropin