Author: Dennis Carter, MD
Nearly 45,000 people are diagnosed with thyroid cancer every year. Around 12,000 of them are men, and around 33,000 are women.
Women have always experienced thyroid problems more frequently than men, with overactive and underactive thyroid being common conditions. Women are more likely to have autoimmune diseases, which can affect the thyroid. Thyroid diseases affect menstrual cycles, cause difficulties getting pregnant and during pregnancy, and have symptoms that mimic menopause, which may be why women are more likely than men to seek help for thyroid problems.
For many years, it was believed that women experienced thyroid cancer at higher rates than men as well, but recent research suggests that may not be the case. Rates of thyroid cancer in men may be equal to thyroid cancer in women, but women are more likely to get diagnosed.
The study, published in JAMA Internal Medicine found a growing gap in thyroid cancer diagnosis, particularly in small tumors that may never cause health issues. During the study period, 90% of thyroid cancers diagnosed were papillary thyroid cancers, the most common form of the disease. These small tumors were found four times more often in women than men while they were living. Yet undiagnosed small papillary thyroid cancers are equally common in men and women, based on studies that look at autopsies.
Meanwhile, diagnosis of more aggressive forms of the disease remained even between men and women. The study does not address what has caused this gap, but some clinicians believe it’s because women are more likely to seek medical care overall. Women are also more likely to be receiving medical care for other thyroid problems. Providers are then more likely to recommend tests for other conditions that can also detect thyroid tumors or order screenings more often for their female patients.
Thyroid Cancer: An Overview
Your thyroid is a small butterfly-shaped gland located just above the collarbone on the front of your neck. The gland produces hormones that regulate your body’s metabolism, heart rate, blood pressure, and body temperature. When your thyroid is healthy, you can’t feel it, but a lump or swelling in your neck may be one of the first signs of thyroid cancer.
Not every thyroid cancer is the same. Papillary thyroid cancers make up 80% of all cases of thyroid cancer and are rarely fatal. In many cases, they can be treated successfully.
The other forms of thyroid cancer include:
- Anaplastic thyroid cancer, a very rare form representing only 1% of all thyroid cancers that grows fast and can be difficult to treat
- Follicular thyroid cancer, which comprises 10% of cases and rarely spreads to the lymph nodes
- Hürthle cell cancer, which begins in the follicular cells and can spread to the lymph nodes
- Medullary thyroid cancer, another type that can be controlled through early diagnosis and treatment
Women Are at Risk Earlier in Life Than Men
Thyroid cancer can occur at any age. According to the American Cancer Society, around two-thirds of all cases are diagnosed in people between the ages of 20 and 55. However, it’s more likely to occur in middle-aged and older people. Men are more likely to develop thyroid cancer in their 60s and 70s, but women experience increased risks much earlier, starting in their 40s and 50s.
Anaplastic thyroid cancer is more likely to be diagnosed in adults ages 60 and older, while medullary thyroid cancer, though rare, can show up in adolescents and even infants.
When the Best Treatment Is Watchful Waiting
Rocky Mountain Cancer Centers sometimes recommends watchful waiting for small papillary thyroid tumors. If your doctor recommends this “wait-and-see” approach, you’ll return to the clinic for periodic screenings to monitor changes in the tumors.
New diagnostic techniques, such as ultrasounds and needle biopsies, have detected more than three times the number of thyroid cancers in the last 30 years. Meanwhile, the number of thyroid cancer fatalities has hardly changed. Many people live with thyroid tumors all their lives without knowing it.
During watchful waiting, your doctor will monitor the growth of small tumors to make sure they aren’t growing or spreading. It’s common for small papillary tumors to remain the same or even get smaller without ever causing symptoms.
Watchful waiting allows patients to avoid potentially unpleasant side effects of chemotherapy, radiation, surgery, and other thyroid cancer treatments. Thyroid removal surgery, for instance, can damage your voice or the glands that control calcium levels in your body – a risk factor for osteoporosis.
How Can You Tell If You Have Thyroid Cancer?
Talk to your doctor if you notice any of these four main signs of thyroid cancer:
- Difficulty breathing
- Difficulty swallowing
- Hoarse or strained voice
- Lump or swelling on the neck
These symptoms aren’t exclusive to thyroid cancer, but they often accompany it. Waiting until thyroid cancer symptoms get worse can increase your risk of the cancer spreading or becoming more aggressive, difficult to treat, and potentially fatal. It’s important to ask your primary care provider about these symptoms as soon as you notice them.
What Are the Main Causes of Thyroid Cancer?
According to the American Thyroid Association, a history of radiation exposure, especially during childhood, is a major risk factor that can lead to thyroid cancer. Radiation therapy to treat cancers such as Hodgkin lymphoma or breast cancer can raise the risk, but routine X-rays are not associated with a high risk of thyroid cancer. Additional risk factors include certain gene mutations, being overweight, or having a diet that’s either too low or too high in iodine.
Although these are some of the most commonly attributed causes of thyroid cancer, the causes of most cases of thyroid cancer are unknown, and patients can have few or no known risk factors.
After a Thyroid Cancer Diagnosis: What Comes Next?
After your biopsy test for thyroid cancer comes back positive, your RMCC oncology team will learn the stage of the disease to determine the best treatment. The stage of thyroid cancer is based on the size of the nodule, whether it has spread, and if so, where it has spread in your body. Your doctor may ask for CT scans, ultrasounds, MRIs, X-rays, or whole-body scans.
If you have been diagnosed with cancer, Rocky Mountain Cancer Centers can help you understand your options for treatment and recovery. Contact us today to schedule an appointment.