Julie Ann Sosa, MD, MA, FACS, FSSO, chair, Department of Surgery, Leon Goldman, MD Distinguished Professor of Surgery, professor, Department of Medicine, affiliated faculty, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, discusses risk factors for thyroid cancer.

Individuals with a family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2A or type 2B have an increased risk of developing medullary thyroid cancer, says Sosa. Additionally, papillary thyroid cancer also can run in families in the form of familial papillary thyroid cancer, Sosa adds. 

Exposure to radiation in childhood or adolescence is a risk factor for papillary thyroid cancer, anaplastic thyroid cancer, and primary hyperparathyroidism, Sosa explains. Additionally, although rare, iodine deficiency increases one’s chances of developing thyroid cancer, Sosa says.

Although additional research is needed, obesity could be a contributing factor in 20% to 25% of thyroid cancers, Sosa says. Moreover, obesity appears to correlate with more aggressive and larger tumors, Sosa explains.

Finally, environmental exposures to compounds, such as flame retardants, may be associated with an increased risk of thyroid cancers, as well as other malignancies, concludes Sosa. 

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Julie Ann Sosa, MD, MA, FACS, FSSO, discusses risk factors for thyroid cancer.  



Dr. Sosa on Risk Factors for Thyroid Cancer 

Julie A. Sosa, MD, MS, professor of surgery and medicine, chief of endocrine surgery, Duke University, discusses molecular testing for thyroid cancer.

One of the most contentious issues in thyroid cancer is the utilization and interpretation of molecular testing and markers, Sosa believes. This field is rapidly evolving, which creates a challenge for clinicians to stay up to date.

At the ATA Annual Meeting, Sosa gave a presentation on the utilization of molecular testing for patients who have indeterminate thyroid nodules, which occurs in about 30% of all biopsies preformed in the United States. The main challenge for physicians is knowing when to use molecular testing and how to interpret the results. To aid in this process, it is important to know the unique institutional incidence of thyroid cancer for each of the Bethesda indeterminate categories, Sosa notes.

At this point, there is not a perfect test for detecting cancer in indeterminate nodules, placing importance on taking history, physical examination, ultrasonographic characteristics, and a second opinion to help determine the status of the nodule. Patients must also be counseled about the risks and benefits of molecular testing, since they are the critical decision maker, Sosa notes.

New ATA guidelines on molecular testing and differentiated thyroid cancer are expected to be released early next year.

View more from the 2014 ATA Annual Meeting

Julie A. Sosa, MD, MS

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Dr. Sosa on Risk Factors for Thyroid Cancer

Dr. Sosa Discusses Molecular Testing in Thyroid Cancer