The Influence of Incidental Detection of Thyroid Nodule on Thyroid Cancer Risk and Prognosis - a Systematic Review
Bibliographic record
Abstract
Abstract Clinically unapparent thyroid nodules discovered serendipitously on imaging for non-thyroid indications are termed ‘thyroid incidentalomas’. The increase in the detection of these incidentalomas (which are known to be very common) has been attributed to the widespread use of diagnostic imaging and the increase in sensitivity and resolution of these modalities. It is unclear whether these incidentalomas have a lower prevalence of thyroid cancer or slower tumour progression compared to symptomatic thyroid nodules. This systematic review aimed to determine the risk of malignancy in incidentally detected thyroid nodules and its impact on prognosis in patients with thyroid cancer. PubMed and MEDLINE® on Web of Science databases were searched from inception to March 2020 for English language articles reporting on human studies of thyroid cancer risk and/or prognosis in incidental and non-incidental nodules. Quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Seventeen observational studies published between 1998 and 2018 were eligible for analysis; 4 studies reported on risk, 8 studies on prognosis and 5 studies on both risk and prognosis. In the risk review, the odds ratios calculated from the six case-control studies (3246 patients) ranged from 0.64 to 2.86 whilst the relative risks calculated from the three cohort studies (489 patients) ranged from 0.13 to 6.27. NOS score for included risk studies (n=9) ranged from 22.2% to 66.7%. A meta-analysis of the eligible case-control studies (n=3) showed a non-significant summated odds ratio of 1.04 (95% CI=0.63-1.70, p=0.88). In the prognosis review of thirteen studies, three direct and thirteen indirect markers of prognosis were compared between the incidental (1923 patients) and non-incidental (2639 patients) groups. NOS score for included prognosis studies ranged from 66.7% to 100%. Incidentally detected thyroid nodules were significantly more likely to be smaller, have lower rates of extra-thyroidal and extra-nodal extension and lymph node metastasis, and interestingly more likely to have advanced disease. Other indirect prognostic markers were not shown to be significantly different between the two groups. A meta-analysis was not possible but incidentally detected thyroid cancer had better progression-free and overall survival; this finding may be affected by ‘lead time’ bias. Current evidence suggests that the investigation and management of thyroid nodules should not be influenced by the mode of detection.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".