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An estimated 62,450 new cases of thyroid cancer are expected to be diagnosed in 2015 in the US, with 3 out of 4 cases occurring in women. Thyroid cancer has been increasing world­wide over the past few decades and is the most rapidly increasing cancer in the US. The rise is thought to be partly due to increased detection because of more sensitive diagnostic procedures, per­haps resulting in some overdiagnoses. In the US, rates increased by 4.4% per year from 2007 to 2011.

Signs and symptoms: The most common symptom of thyroid cancer is a lump in the neck that is noticed by a patient or felt by a health care provider during a clinical exam. Other symptoms include a tight or full feeling in the neck, difficulty breathing or swallowing, hoarseness, swollen lymph nodes, and pain in the throat or neck that does not go away. Although most lumps in the thyroid gland are not cancerous, individuals who notice an abnormality should seek timely medical attention. Many thy­roid cancers are diagnosed in people without symptoms because an abnormality is seen on an imaging test performed for another purpose.

Risk factors: Risk factors for thyroid cancer include being female, having a history of goiter (enlarged thyroid) or thyroid nodules, a family history of thyroid cancer, and radiation expo­sure early in life (e.g., as a result of medical treatment). People who test positive for a mutation in a gene called RET, which causes a hereditary form of thyroid cancer (familial medullary thyroid carcinoma), can decrease the risk of developing the dis­ease by having the thyroid gland surgically removed. Certain rare genetic syndromes, such as familial adenomatous polyposis (FAP), also increase risk. Unlike most other adult cancers, for which older age increases risk, 80% of newly diagnosed thyroid cancers are in patients younger than age 65.

Treatment: Most thyroid cancers are highly curable, though about 5% (medullary and anaplastic thyroid cancers) are more aggressive and more likely to spread to other organs. Treatment depends on the cell type, tumor size, and extent of disease. The first choice of treatment is usually surgery to partially or totally remove the thyroid gland (thyroidectomy), and sometimes nearby lymph nodes. Treatment with radioactive iodine (I-131) after complete thyroidectomy to destroy any remaining thyroid tissue may be recommended for large tumors or when cancer has spread outside the thyroid. Thyroid replacement hormone therapy is given after thyroidectomy to replace hormones nor­mally produced by the thyroid gland and to prevent the body from making thyroid-stimulating hormone, decreasing the like­lihood of recurrence.

Survival: The overall 5- and 10-year relative survival rates are 98% and 97%, respectively. However, survival varies by stage, age at diagnosis, and disease subtype. The 5-year survival rate approaches 100% for localized disease, is 98% for regional stage disease, and 55% for distant stage disease.