SEX DIFFERENCES IN THE PREVALENCE OF PAPILLARY THYROID CARCINOMA, RISK FACTORS, AND IMAGING FEATURES: A NARRATIVE LITERATURE REVIEW
Keywords:
differentiated thyroid cancer; microcarcinoma; thyroid ultrasonography; fine-needle aspiration; diagnostic imaging; lymph node metastasisAbstract
DOI: https://doi.org/10.46296/yc.v10i19.0990
Abstract
Background: Papillary thyroid carcinoma (PTC) is the most common type of differentiated thyroid cancer, and its reported incidence has increased in recent decades, largely because of greater detection of microcarcinomas using high-resolution ultrasonography and fine-needle aspiration (FNA). Objective: To synthesize the evidence on the prevalence of PTC and its distribution by sex and age, and to identify associated risk factors and imaging features relevant to diagnosis and risk stratification. Methods: A narrative literature review was conducted in PubMed, Scopus, SciELO, and Web of Science for publications from 1990 through 2025 in English and Spanish. An evidence matrix was developed comprising 28 documents included in the final synthesis. Results: The selected studies showed a higher incidence of PTC among women, predominance in adulthood, and increasing incidental detection of small tumors. The most consistent risk factors were ionizing radiation exposure, family history, and molecular alterations. On imaging, marked hypoechogenicity, microcalcifications, irregular margins, and a taller-than-wide shape were the ultrasonographic findings most suggestive of malignancy. Cervical lymph node assessment and integration with TI-RADS EU-TIRADS and the Bethesda System strengthen diagnostic stratification. Conclusion: This review more clearly linked the epidemiology, risk factors, and imaging findings of PTC. The integration of standardized ultrasonography and cytology remains essential to balance timely detection with the reduction of overdiagnosis.
Keywords: differentiated thyroid cancer; microcarcinoma; thyroid ultrasonography; fine-needle aspiration; diagnostic imaging; lymph node metastasis.
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References
Hay ID. Papillary thyroid carcinoma. Endocrinol Metab Clin North Am. 1990;19(3):545–576.
Lanfranchi M. Carcinoma papilar de tiroides: aspectos clínicos y patológicos. Rev Méd Clínica Condes. 2012;23(2):140–148.
Trimboli P, Castellana M, Piccardo A, et al. The ultrasound risk stratification systems for thyroid nodule have been evaluated against papillary carcinoma: a meta-analysis. Rev Endocr Metab Disord. 2021;22:453–460. doi:10.1007/s11154-020-09592-3.
Hekimsoy I, Ertan Y, Serin G, Karabulut AK, Özbek SS. Comparison of ultrasound findings of papillary thyroid carcinoma subtypes based on the 2022 WHO classification of thyroid neoplasms. Front Endocrinol (Lausanne). 2024;15:1434787. doi:10.3389/fendo.2024.1434787.
Tan HL, Duan SL, He Q, et al. A risk stratification model based on ultrasound radiologic features for cervical metastatic lymph nodes in papillary thyroid cancer. World J Surg Oncol. 2025;23:102. doi:10.1186/s12957-025-03722-4.
Almajed E, AlZabin A, Alqntash N, et al. Prognostic factors for survival and recurrence in papillary thyroid carcinoma: a retrospective study. Gland Surg. 2025;14(10):2005–2021. doi:10.21037/gs-2025-216.
Ywata de Carvalho A, Kohler HF, Gomes CC, Vartanian JG, Kowalski LP. Predictive factors for recurrence of papillary thyroid carcinoma: analysis of 4,085 patients. Acta Otorhinolaryngol Ital. 2021;41(3):236–242.
Hakim Tawil JA, Rojas MF, Santivañez JJ, León L, González Devia D. Prognostic factors for recurrence in patients with papillary thyroid carcinoma. Ear Nose Throat J. 2025;104(11):707–714. doi:10.1177/01455613231158792.
Li Y, Tian X, Wang Y, et al. Risk factors and predictive model for recurrence in papillary thyroid carcinoma: development and validation. Front Endocrinol (Lausanne). 2023;14:1268282. doi:10.3389/fendo.2023.1268282.
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133. doi:10.1089/thy.2015.0020.
Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017;14(5):587–595. doi:10.1016/j.jacr.2017.01.046.
Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J. 2017;6(5):225–237. doi:10.1159/000478927.
Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017;27(11):1341–1346. doi:10.1089/thy.2017.0500.
Lyu Z, Zhang Y, Sheng C, Huang Y, Zhang Q, Chen K. Global burden of thyroid cancer in 2022: incidence and mortality estimates from GLOBOCAN. Chin Med J (Engl). 2024;137(21):2567–2576. doi:10.1097/CM9.0000000000003284.
Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024. doi:10.3322/caac.21834.
Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med. 2016;375(7):614–617. doi:10.1056/NEJMp1604412.
Li M, Dal Maso L, Vaccarella S. Global trends in thyroid cancer incidence and the impact of overdiagnosis. Lancet Diabetes Endocrinol. 2020;8(6):468–470. doi:10.1016/S2213-8587(20)30115-7.
Agrawal N, Akbani R, Aksoy BA, et al. Integrated genomic characterization of papillary thyroid carcinoma. Cell. 2014;159(3):676–690. doi:10.1016/j.cell.2014.09.050.
Jung CK, Little MP, Lubin JH, et al. Update from the 2022 World Health Organization classification of thyroid tumors. Endocrinol Metab (Seoul). 2022;37(5):703–718. doi:10.3803/EnM.2022.1553.
Juhlin CC, Mete O, Baloch ZW, et al. The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and classification. Endocr Relat Cancer. 2023;30(2):R31–R47. doi:10.1530/ERC-22-0293.
Tuttle RM, Haugen B, Perrier ND. Updated American Joint Committee on Cancer/Tumor-Node-Metastasis staging system for differentiated and anaplastic thyroid cancer (eighth edition): what changed and why? Thyroid. 2017;27(6):751–756.
Lamartina L, Grani G, Arvat E, et al. 8th edition of the AJCC/TNM staging system of thyroid cancer: what to expect (and what not). Endocr Relat Cancer. 2018;25(3):L7–L11. doi:10.1530/ERC-17-0453.
Ito Y, Miyauchi A, Oda H. Active surveillance of low-risk papillary thyroid microcarcinomas. Endocrinol Metab (Seoul). 2020;35(1):59–66.
Xue S, Wang P, Liu J, Chen G. Active surveillance for papillary thyroid microcarcinoma. Front Endocrinol (Lausanne). 2018;9:736. doi:10.3389/fendo.2018.00736.
Veiga LHS, Holmberg E, Anderson H, et al. Thyroid cancer after childhood exposure to external radiation: an updated pooled analysis of 12 studies. Radiat Res. 2016;185(5):473–484.
Brulé Aldana CD, González-González AI, Peña-Mirabal E. Carcinoma papilar de tiroides y quiste de conducto tirogloso ¿relación o coincidencia? An Orl Mex. 2024;69(1):30-35.
Reverter JL. Cáncer de tiroides. Med Clin (Barc). 2025;164(8):421-428. doi:10.1016/j.medcli.2024.12.005.
Silva Meza EJ, Porras Ríos YA. Factores de riesgo asociados al cáncer papilar de tiroides en adultos: una revisión sistemática con metaanálisis [tesis]. Bogotá (Colombia): Fundación Universitaria del Área Andina; 2022.
Mata MAS. Carcinoma papilar de tiroides. Rev Cubana Investig Biomed. 2024;43(Supl):e3598.
Hernández VA, Jiménez-López M, Serrano F, Obregón G, Itzá Pérez M. Factores de riesgo asociados a recidiva de carcinoma papilar de tiroides. Rev Otorrinolaringol Cir Cabeza Cuello. 2019;79(1):67-74.
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