Thyroid nodules are common clinically (prevalence, about 5%) and even more common on ultrasound examination (about 25%).
About 5% of thyroid nodules are malignant.
Most thyroid cancers are well-differentiated papillary or follicular tumours with an excellent prognosis (10-year survival, 80%–95%).
The incidence of papillary thyroid cancer appears to be increasing on the east coast of Australia.
Fine-needle aspiration biopsy of the thyroid is the most cost-effective diagnostic tool.
Recommended initial management of all follicular carcinomas and of papillary carcinomas > 1.0 cm is total thyroidectomy followed by radioiodine ablation.
Most patients should be managed postoperatively with doses of thyroid hormone sufficient to suppress plasma levels of thyroid-stimulating hormone.
Recurrences can occur many years after initial therapy, and follow-up should be lifelong.
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