Journal List > J Korean Thyroid Assoc > v.5(2) > 1056526

Kim, Choi, and Lee: Management of Thyroid Nodules and Cancers Arising in the Elderly


As population is rapidly aging, thyroid nodules and cancers arising in the elderly are increasing. However, treatment strategy is not well established in the elderly. With few guidelines, it is important to identify the characteristics of thyroid nodules and cancers in the elderly. Among this population, thyroid nodules and prevalence of multinodular goiter are increasing with advanced age in both male and female. It is not clear age or multinodular goiter is associated with increased risk of malignancy. The incidence of differentiated thyroid carcinoma in the elderly is increasing, particularly in male patients. Moreover, anaplastic carcinoma is more frequent in the elderly. Prognosis is believed to be worse in the elderly. However, surgery for thyroid cancer increases the survival rate and it is safe to perform thyroid surgery in the elderly. Radical surgery is acceptable in the elderly, if their general condition permits surgery.

Figures and Tables

Table 1
Characteristics of thyroid cancers arising in the elderly


1. Statistics Korea. 2012. cited 2012 Nov 8. Available from:
2. Ministry of Health & Welfare. Incidence Proportion of Major Sites in Korea, 2009. 2009 annual report of cancer statistics in Korea. 2011.
3. Ministry of Health & Welfare. Major cancer sites by age group, 2009. 2009 annual report of cancer statistics in Korea. 2011.
4. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. 1993. 328(8):553–559.
5. Castro MR, Espiritu RP, Bahn RS, Henry MR, Gharib H, Caraballo PJ, et al. Predictors of malignancy in patients with cytologically suspicious thyroid nodules. Thyroid. 2011. 21(11):1191–1198.
6. Suk JH, Kim TY, Kim MK, Kim WB, Kim HK, Jeon SH, et al. Prevalence of ultrasonographically-detected thyroid nodules in adults without previous history of thyroid disease. J Korean Endocr Soc. 2006. 21(5):389–393.
7. Kim WJ, Kim JH, Park DW, Lee CB, Park YS, Kim DS, et al. Prevalence of thyroid nodules detected by ultrasonography in adults for health check-ups and analysis of fine needle aspiration cytology. J Korean Endocr Soc. 2008. 23(6):413–419.
8. Oh EY, Jang HW, Lee JI, Kim HK, Kim SW, Chung JH. Prevalence of thyroid nodules and cancer detected by ultrasonography in healthy Korean adults: clinical features and the risk for malignancy. J Korean Thyroid Assoc. 2010. 3(2):142–148.
9. Yuen AP, Ho AC, Wong BY. Ultrasonographic screening for occult thyroid cancer. Head Neck. 2011. 33(4):453–457.
10. Berghout A, Wiersinga WM, Smits NJ, Touber JL. Interrelationships between age, thyroid volume, thyroid nodularity, and thyroid function in patients with sporadic nontoxic goiter. Am J Med. 1990. 89(5):602–608.
11. Gharib H, Papini E. Thyroid nodules: clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am. 2007. 36(3):707–735.
12. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997. 126(3):226–231.
13. Kim DK. Prevalence of thyroid nodules and thyroid cancers. J Korean Thyroid Assoc. 2009. 2(1):38–44.
14. Yim CH, Oh HJ, Chung HY, Han KO, Jang HC, Yoon HK, et al. Prevalence of thyroid nodules detected by ultrasonography in womens attending health check-ups. J Korean Soc Endocrinol. 2002. 17(2):183–188.
15. Chung WY, Chang HS, Kim EK, Park CS. Ultrasonographic mass screening for thyroid carcinoma: a study in women scheduled to undergo a breast examination. Surg Today. 2001. 31(9):763–767.
16. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology. 1991. 181(3):683–687.
17. Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med. 1994. 154(16):1838–1840.
18. Faggiano A, Del Prete M, Marciello F, Marotta V, Ramundo V, Colao A. Thyroid diseases in elderly. Minerva Endocrinol. 2011. 36(3):211–231.
19. Morganti S, Ceda GP, Saccani M, Milli B, Ugolotti D, Prampolini R, et al. Thyroid disease in the elderly: sex-related differences in clinical expression. J Endocrinol Invest. 2005. 28:11 Suppl Proceedings. 101–104.
20. Knudsen N, Laurberg P, Perrild H, Bulow I, Ovesen L, Jorgensen T. Risk factors for goiter and thyroid nodules. Thyroid. 2002. 12(10):879–888.
21. Mulla ZD, Margo CE. Primary malignancies of the thyroid: epidemiologic analysis of the Florida Cancer Data System registry. Ann Epidemiol. 2000. 10(1):24–30.
22. Haselkorn T, Stewart SL, Horn-Ross PL. Why are thyroid cancer rates so high in southeast asian women living in the United States? The bay area thyroid cancer study. Cancer Epidemiol Biomarkers Prev. 2003. 12(2):144–150.
23. Belfiore A, La Rosa GL, La Porta GA, Giuffrida D, Milazzo G, Lupo L, et al. Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med. 1992. 93(4):363–369.
24. Botrugno I, Lovisetto F, Cobianchi L, Zonta S, Klersy C, Vailati A, et al. Incidental carcinoma in multinodular goiter: risk factors. Am Surg. 2011. 77(11):1553–1558.
25. Toniato A, Bernardi C, Piotto A, Rubello D, Pelizzo MR. Features of papillary thyroid carcinoma in patients older than 75 years. Updates Surg. 2011. 63(2):115–118.
26. Vini L, Hyer SL, Marshall J, A'Hern R, Harmer C. Long-term results in elderly patients with differentiated thyroid carcinoma. Cancer. 2003. 97(11):2736–2742.
27. Girelli ME, Casara D, Rubello D, Mazzarotto R, Saladini G, Busnardo B. Differentiated thyroid carcinoma (DTC) in the elderly: disease outcome, therapeutic approach, and long-term results in a group of 314 patients. J Endocrinol Invest. 1999. 22:10 Suppl. 45–46.
28. Lin JD, Chao TC, Chen ST, Weng HF, Lin KD. Characteristics of thyroid carcinomas in aging patients. Eur J Clin Invest. 2000. 30(2):147–153.
29. Valle LA, Kloos RT. The prevalence of occult medullary thyroid carcinoma at autopsy. J Clin Endocrinol Metab. 2011. 96(1):E109–E113.
30. Kim MJ, Kim JW. Assessment of elderly cancer patients and its clinical importance. Korean J Obstet Gynecol. 2008. 51(7):691–706.
31. Bliss R, Patel N, Guinea A, Reeve TS, Delbridge L. Age is no contraindication to thyroid surgery. Age Ageing. 1999. 28(4):363–366.
32. Passler C, Avanessian R, Kaczirek K, Prager G, Scheuba C, Niederle B. Thyroid surgery in the geriatric patient. Arch Surg. 2002. 137(11):1243–1248.
33. Uruno T, Miyauchi A, Shimizu K, Tomoda C, Takamura Y, Ito Y, et al. Favorable surgical results in 433 elderly patients with papillary thyroid cancer. World J Surg. 2005. 29(11):1497–1501.
34. Biliotti GC, Martini F, Vezzosi V, Seghi P, Tozzi F, Castagnoli A, et al. Specific features of differentiated thyroid carcinoma in patients over 70 years of age. J Surg Oncol. 2006. 93(3):194–198.
35. Matsuyama H, Sugitani I, Fujimoto Y, Kawabata K. Indications for thyroid cancer surgery in elderly patients. Surg Today. 2009. 39(8):652–657.
36. Statistics Korea. Life expectancies, 2010. 2012. [cited 2012 Nov 8]. Available from:
37. Howell GM, Carty SE, Armstrong MJ, Lebeau SO, Hodak SP, Coyne C, et al. Both BRAF V600E mutation and older age ≥ 65 years) are associated with recurrent papillary thyroid cancer. Ann Surg Oncol. 2011. 18(13):3566–3571.
Similar articles