In February 2024, the National Cancer Center released the latest cancer report in mainland China in the Journal of the National Cancer Center (JNCC). According to the report, the top three cancers in 2022 are lung cancer, colorectal cancer, and thyroid cancer, among which thyroid cancer has become the top three high-incidence cancers in mainland China for the first time. In addition, the number of women who get thyroid cancer (341,200 cases) is almost three times that of men (124,900 cases). Previous studies have shown that in the 16 years from 2000 to 2016, the incidence of thyroid cancer in the female population increased by nearly 20 times. While this growing trend is not unrelated to our aggressive screening, the impact of thyroid cancer cannot be underestimated.
"Lazy cancer" is also cancer
Thyroid cancer is known as "lazy cancer" mainly due to its relatively slow progression. Among the four main types of thyroid cancer, papillary carcinoma and follicular cell carcinoma account for more than 90% of all pathological types of thyroid cancer and have the best prognosis. These two types of thyroid cancer usually develop more slowly, hence the name "lazy cancer." However, even these "lazy cancers" can progress to lymph node metastasis if left untreated.
It is important to note that there are also more malignant types of thyroid cancer, such as undifferentiated carcinoma, which develop rapidly and tend to have large, fixed, and rapidly growing masses when found. The survival period of undifferentiated carcinoma is relatively short.
What are the causes of thyroid nodules?
The causes of thyroid nodules are complex and can be influenced by a variety of factors. Here are some common causes of thyroid nodules.
Contact with radioactive sources
Long-term exposure to radioactive sources is a significant factor in thyroid nodules and thyroid cancer, especially in childhood. In recent years, there has been increasing concern about the long-term effects of medical radiation such as diagnostic X-rays and CT scans on the thyroid gland, but it is still recommended to perform the necessary radiological tests in order to ensure early detection and treatment of the disease, following the advice of medical professionals.
Autoimmune diseases
In chronic lymphocytic thyroiditis, the incidence of thyroid nodules is significantly increased.
Genetic factors
At present, a variety of genes have been found to be associated with the risk of thyroid nodules and thyroid cancer, and the incidence of thyroid nodules also shows obvious familial clustering.
Iodine intake
Insufficient or excessive iodine intake can cause thyroid disease, which can lead to thyroid inflammation and nodules.
Other reasons
These include obesity, estrogen and progesterone changes in women, work-life stress, and more.
How to self-test your thyroid gland
The thyroid gland is located 20~30 mm below the Adam's apple, resembling a butterfly and resembling two shields.
Observe neck symmetry: Look in the mirror with your head slightly back to see if the sides of the neck are symmetrical and swollen. Under normal circumstances, the thyroid gland cannot be seen or touched.
Swallowing action: Continue to look in the mirror and swallow saliva to see if there is a lump moving up and down with the swallowing action.
Manual touch examination: While swallowing, gently touch the thyroid gland on the neck with your fingers to see if you can feel a small hard nodule, small bulge, or small lump.
It is important to note that thyroid self-test can only be used as a reference and cannot replace professional medical examination. If you find a problem during the self-test, you should go to the hospital as soon as possible to consult a medical professional.
What should I do if a thyroid nodule is found during a physical examination?
If a thyroid nodule is found on physical examination, repeat ultrasound is recommended. This is an important means of evaluating thyroid nodules, and classifying nodules according to the ultrasound findings, including cystic solidity, echo level, margin, aspect ratio, and the presence or absence of fine calcifications, to estimate the likelihood that the nodule is malignant.
Ultrasound features and the size of the nodule are combined to determine the need for fine-needle aspiration biopsy. Most biopsies report benign, a few are malignant, or have indeterminate features, which means cancer may be present.
In other words, if a nodule is found during the physical examination, there is no need to be too anxious, because most of the cases are benign and do not need to be treated at all. Rarely, if fine-needle aspiration proves malignant, surgery is required, and follow-up ultrasound may be an option if the puncture criteria are uncertain or not met.
How can I protect my thyroid?
Adjust the diet: Moderate intake of iodized salt, no more than 5 grams of salt per person per day, and avoid eating too much seafood (high iodine).
Regular check-ups: Adults should have a check-up once a year, while people with a family history of thyroid cancer are advised to have thyroid function and thyroid ultrasound every 6 months to monitor for abnormal function and the appearance of lumps. Pregnant women should be screened for hypothyroidism and Hashimoto's thyroiditis after 3 months of pregnancy.
Reduce radiation exposure: Try to avoid unnecessary radiation exposure, especially in children; When undergoing medical examinations, it is customary to wear radiation protective gear.
Maintain good living habits: maintain emotional stability, ensure adequate sleep, avoid obesity, eat a reasonable diet, exercise appropriately, and enhance physical resistance.
Self-examination of the thyroid gland: Learn and perform thyroid self-examinations regularly, and seek medical attention if you find a lump or nodule in your neck.
It is comprehensively compiled from Popular Science China, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Xiangya Hospital of Central South University, etc