Search Results
Search for other papers by Jan Jiskra in
Google Scholar
PubMed
Search for other papers by Jiří Horáček in
Google Scholar
PubMed
Search for other papers by Sylvie Špitálníková in
Google Scholar
PubMed
Search for other papers by Jan Paleček in
Google Scholar
PubMed
Search for other papers by Zdeňka Límanová in
Google Scholar
PubMed
Search for other papers by Jan Krátký in
Google Scholar
PubMed
Search for other papers by Drahomíra Springer in
Google Scholar
PubMed
Search for other papers by Kristýna Žabková in
Google Scholar
PubMed
Search for other papers by Hana Vítková in
Google Scholar
PubMed
Objective
Thyroid nodules are a common finding in the general population. The primary aim of the study was to determine the prevalence of thyroid nodules and cancer found by ultrasound (US) in women who underwent screening for thyroid dysfunction during pregnancy.
Design
A double-centric, retrospective, cohort study.
Patients and methods
We searched through medical records, including thyroid ultrasonography, of pregnant women who were positively screened for thyroid disorders (using thyroid-stimulating hormone and thyroid antibodies) from an unselected population (‘universal screening group’, n = 690) and of women who underwent the testing based on the presence of clinical risk factors defined by American Thyroid Association (’case-finding group’, n = 249).
Results
Prevalence of benign and malignant thyroid nodules was lower in the ‘universal screening group’ than in the ‘case-finding group’ (9.9% vs 17.7%, P= 0.002, and 0.9% vs 7.2%, P< 0.001, respectively). Consistently, the thyroid cancer rate was lower among the nodules in the ‘universal screening group’ than in the ‘case-finding group’ (8.1% vs 29.0%, P= 0.003). Ultrasound EU-TIRADS (European Thyroid Imaging and Reporting Data System) category ≥4 had a 95.8% sensitivity for thyroid cancer. In palpable nodules, the prevalence of cancer was significantly higher than in the non-palpable ones (44.0% vs 2.2%, P < 0.001). In a multivariate regression analysis, thyroid nodules were associated with a history of infertility and parity.
Conclusions
Compared to the data from cancer registries, universal screening allowed detecting thyroid cancer in pregnancy three to five times more frequently, but the cancer rate among nodules (8.1%) did not differ from the common population. US had very good sensitivity for thyroid cancer in pregnancy.
