Prevalence of Ultrasound-Detected Thyroid Abnormalities in an Apparently Healthy Volunteer Cohort from Alexandria

Background: We aimed to evaluate the prevalence of US-detected thyroid abnormalities among a volunteer group from Alexandria with no prior history of thyroid diseases. Methods: A cross-sectional cohort included 1000 volunteer participants from the Alexandria population. Based on ultrasound (US) findings, cases were categorized as normal, diffuse non-nodular thyroid disease (NNTD), or nodular thyroid disease (NTD). Thyroid-stimulating hormone (TSH), total triiodothyronine, and tetraiodothyronine were measured in patients with US-abnormal thyroid findings. Thyroid peroxidase antibodies (TPOAbs) were measured in cases with US features suggestive of thyroiditis and thyromegaly. Fine-needle aspiration cytology in NTD followed the ATA-2015 guidelines. Results: Among our studied cohort, 54.3% were females, with a mean age of 24.2 ± 4.6 years. US thyroid abnormalities were detected in 197/1000 (19.7%); NTD in 68/1000 (6.8%); 129 cases had DNND; 91 cases had thyroiditis (9.1%); and 38 had homogeneous thyromegaly (3.8%). US-detected thyromegaly was found in 103 (10.3%) of 1000 cases. Differentiated thyroid cancer was identified in 5.8% of cases with NTD. TSH was higher in patients with US-detected thyroiditis than in those with NTD and homogenous thyromegaly (P =0.002). Eighty-one % of cases with thyroiditis, and 30% with homogeneous thyromegaly, tested positive for TPOAbs. Conclusions: In this volunteer group, ultrasound detected thyroid abnormalities in nearly one-fifth of asymptomatic adults, with thyroiditis and nodular disease being the most common findings. These results provide prevalence data for an iodine-sufficient population but should not be viewed as support for routine ultrasound screening, which current guidelines, including the USPSTF, do not recommend.