Nonpalpable Thyroid Nodules—Managing an Epidemic

Prevalence of thyroid nodulesThyroid nodules are extraordinarily common.The prevalence of palpable thyroid nodules in two non-biased population-based studies-Framingham, Massachusetts, and Whickham, England-was 4.2 and 3.2%, respectively (1, 2).In the Framingham study, the prevalence was 6.4% in women and 1.5% in men (1).The true prevalence of thyroid nodules, however, requires autopsy data.A 1955 study at the Mayo Clinic found thyroid nodules in 50.5% of 821 consecutive autopsies of patients with clinically normal thyroid glands (3).Because 7.4% of autopsies were excluded from analysis because of premortem thyroid disease, the true prevalence is slightly higher than half the population.Even in an unlikely group of patients to have thyroid nodules, men in the military aged 18 -39 yr, the prevalence of thyroid nodules at autopsy was 13% (4). Nonpalpable thyroid nodules detected by ultrasound