Thyroid Nodules: Reducing Overdiagnosis and Investigations

Thyroid nodules (TN) are incredibly common, with approximately 5% of the population presenting with palpable TN. However, the widespread utilization of sensitive imaging techniques over the past few decades has led to a rapid increase in their prevalence. Notwithstanding the clinically palpable TN, the rate of incidental nodules picked up on imaging studies varies remarkably with the underlying imaging modality. For instance, the prevalence of TNs on computed tomography (CT) scans of the neck is reported to be 16.5%,3 FDG-PET to be 2% and on neck ultrasounds (US) well over 50%. The prevalence of TN is higher in females and increases with age, and while there has been little change in the overall reported incidence of palpable TNs, the rising prevalence can be almost exclusively attributed to the expanded use of imaging, particularly the widespread availability of sensitive US. It is estimated that over 60% of the population may have at least one TN.