Only select incidental thyroid nodules need further evaluation

(HealthDay)—Only a few select incidental thyroid nodules require further evaluation, according to a review published online April 20 in JAMA Otolaryngology-Head & Neck Surgery.

Jenny K. Hoang, M.B.B.S., from the Duke University Medical Center in Durham, N.C., and Xuan V. Nguyen, M.D., Ph.D., from The Ohio State University Wexner Medical Center in Columbus, discuss the risks and harms of management of incidental thyroid nodules.

The authors note that indiscriminate workup of incidental thyroid nodules with ultrasonography is not cost-effective and is potentially harmful. Evidence-based recommendations for incidental thyroid nodules include selection criteria for nodule workup based on suspicious imaging findings, patient age, and nodule size. In the absence of clinical risk factors or suspicious imaging findings, workup with dedicated thyroid ultrasonography is recommended only for nodules at least 1.5 or 1 cm in patients aged 35 years or older or younger than 35 years, respectively.

"The recommendations aim to promote identification of significant thyroid cancers, reduce unnecessary workup, and provide guidance for clinical practice," the authors write.