General Characteristics of Papillary Thyroid Cancer Among Adolescents and Young Adults: A Single Large Center Experience
Abstract
1. Introduction
2. Methods
2.1. Study Design and Setting
2.2. Study Population
2.3. Data Collection Procedures
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
6. Recommendations
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Lim, H.; Devesa, S.S.; Sosa, J.A.; Check, D.; Kitahara, C.M. Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974–2013. JAMA 2017, 317, 1338–1348. [Google Scholar] [CrossRef]
- Davies, L.; Welch, H.G. Increasing incidence of thyroid cancer in the United States, 1973–2002. J. Am. Med. Assoc. 2006, 295, 2164–2167. [Google Scholar] [CrossRef]
- Hekimsoy, İ.; Ertan, Y.; Serin, G.; Karabulut, A.K.; Özbek, S.S. Comparison of ultrasound findings of papillary thyroid carcinoma subtypes based on the 2022 WHO classification of thyroid neoplasms. Front. Endocrinol. 2024, 15, 1434787. [Google Scholar] [CrossRef] [PubMed]
- Li, N.; Du, X.L.; Reitzel, L.R.; Xu, L.; Sturgis, E.M. Impact of enhanced detection on the increase in thyroid cancer incidence in the United States: Review of incidence trends by socioeconomic status within the surveillance, epidemiology, and end results registry, 1980–2008. Thyroid 2013, 23, 103–110. [Google Scholar] [CrossRef]
- Brito, J.P.; Davies, L. Is there really an increased incidence of thyroid cancer? Curr. Opin. Endocrinol. Diabetes Obes. 2014, 21, 405–408. [Google Scholar] [CrossRef]
- La Vecchia, C.; Malvezzi, M.; Bosetti, C.; Garavello, W.; Bertuccio, P.; Levi, F.; Negri, E. Thyroid cancer mortality and incidence: A global overview. Int. J. Cancer 2015, 136, 2187–2195. Available online: https://pubmed.ncbi.nlm.nih.gov/25284703/ (accessed on 1 January 2025). [CrossRef]
- Chen, M.M.; Luu, M.; Sacks, W.L.; Orloff, L.; Wallner, L.P.; Clair, J.M.S.; Pitt, S.C.; Ho, A.S.; Zumsteg, Z.S. Trends in incidence, metastasis, and mortality from thyroid cancer in the USA from 1975 to 2019: A population-based study of age, period, and cohort effects. Lancet Diabetes Endocrinol. 2025, 13, 188–195. Available online: https://pubmed.ncbi.nlm.nih.gov/39922210/ (accessed on 1 January 2025). [CrossRef]
- Cho, J.S.; Yoon, J.H.; Park, M.H.; Shin, S.H.; Jegal, Y.J.; Lee, J.S.; Kim, H.K. Age and prognosis of papillary thyroid carcinoma: Retrospective stratification into three groups. J. Korean Surg. Soc. 2012, 83, 259–266. [Google Scholar] [CrossRef] [PubMed]
- Tuttle, R.M.; Haugen, B.; Perrier, N.D. Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why? Thyroid 2017, 27, 751–756. Available online: https://pmc.ncbi.nlm.nih.gov/articles/PMC5467103/ (accessed on 1 January 2025). [CrossRef]
- Tricoli, J.V.; Bleyer, A. Adolescent and Young Adult Cancer Biology. Cancer J. 2018, 24, 267–274. [Google Scholar] [CrossRef]
- Chen, Z.; Mosha, S.S.; Zhang, T.; Xu, M.; Li, Y.; Hu, Z.; Liang, W.; Deng, X.; Ou, T.; Li, L.; et al. Incidence of microcarcinoma and non-microcarcinoma in ultrasound-found thyroid nodules. BMC Endocr Disord. 2021, 21, 38. [Google Scholar] [CrossRef] [PubMed]
- Rahbari, R.; Zhang, L.; Kebebew, E. Thyroid cancer gender disparity. Future Oncol. 2010, 6, 1771–1779. Available online: https://pubmed.ncbi.nlm.nih.gov/21142662/ (accessed on 1 January 2025). [CrossRef]
- Adam, M.A.; Pura, J.; Goffredo, P.; Dinan, M.A.; Reed, S.D.; Scheri, R.P.; Hyslop, T.; Roman, S.A.; Sosa, J.A. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J. Clin. Oncol. 2015, 33, 2370–2375. [Google Scholar] [CrossRef]
- Nilubol, N.; Zhang, L.; Kebebew, E. Multivariate analysis of the relationship between male sex, disease-specific survival, and features of tumor aggressiveness in thyroid cancer of follicular cell origin. Thyroid 2013, 23, 695–702. Available online: https://pubmed.ncbi.nlm.nih.gov/23194434/ (accessed on 1 January 2025). [CrossRef]
- Loh, K.C.; Greenspan, F.S.; Gee, L.; Miller, T.R.; Yeo, P.P.B. Pathological tumor-node-metastasis (pTNM) staging for papillary and follicular thyroid carcinomas: A retrospective analysis of 700 patients. J. Clin. Endocrinol. Metab. 1997, 82, 3553–3562. [Google Scholar] [CrossRef]
- Alqahtani, W.S.; Almufareh, N.A.; Domiaty, D.M.; Albasher, G.; Alduwish, M.A.; Alkhalaf, H.; Almuzzaini, B.; Al-Marshidy, S.S.; Alfraihi, R.; Elasbali, A.M.; et al. Epidemiology of cancer in Saudi Arabia thru 2010–2019: A systematic review with constrained meta-analysis. AIMS Public Health 2020, 7, 679–696. [Google Scholar] [CrossRef]
- Flemban, A.F.; Kabrah, S.; Alahmadi, H.; Alqurashi, R.K.; Turaes, A.S.; Almaghrabi, R.; Al Harbi, S.; Khogeer, A.A. Patterns of Thyroid Cancer Mortality and Incidence in Saudi Arabia: A 30-Year Study. Diagnostics 2022, 12, 2716. Available online: https://pmc.ncbi.nlm.nih.gov/articles/PMC9689402/ (accessed on 1 January 2025). [CrossRef] [PubMed]
- Alzahrani, A.S.; Alomar, H.; Alzahrani, N. Thyroid Cancer in Saudi Arabia: A Histopathological and Outcome Study. Int. J. Endocrinol. 2017, 2017, 8423147. [Google Scholar] [CrossRef] [PubMed]
- Al-Hakami, H.A.; Alqahtani, R.; Alahmadi, A.; Almutairi, D.; Algarni, M.; Alandejani, T. Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care Hospital in Saudi Arabia. Cureus 2020, 12, e7478. [Google Scholar] [CrossRef] [PubMed]
- Battistella, E.; Pomba, L.; Toniato, R.; Piotto, A.; Toniato, A. Total Thyroidectomy vs. Lobectomy in Papillary Thyroid Microcarcinoma: A Contested Gold Standard. J. Pers Med. 2025, 15, 324. [Google Scholar] [CrossRef]
- Lang, B.H.H.; Lo, C.Y.; Chan, W.F.; Lam, K.Y.; Wan, K.Y. Prognostic factors in papillary and follicular thyroid carcinoma: Their implications for cancer staging. Ann. Surg. Oncol. 2007, 14, 730–738. Available online: https://pubmed.ncbi.nlm.nih.gov/17103065/ (accessed on 1 January 2025). [CrossRef]
- Cerfolio, R.J.; Bryant, A.S.; Scott, E.; Sharma, M.; Robert, F.; Spencer, S.A.; Garver, R.I. Women with pathologic stage I, II, and III non-small cell lung cancer have better survival than men. Chest 2006, 130, 1796–1802. [Google Scholar] [CrossRef] [PubMed]
- Twining, C.L.; Lupo, M.A.; Tuttle, R.M. Implementing key changes in the American thyroid association 2015 thyroid nodules/differentiated thyroid cancer guidelines across practice types. Endocr. Pract. 2018, 24, 833–840. [Google Scholar] [CrossRef]
- Francis, G.L.; Waguespack, S.G.; Bauer, A.J.; Angelos, P.; Benvenga, S.; Cerutti, J.M.; Dinauer, C.A.; Hamilton, J.; Hay, I.D.; Luster, M.; et al. Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2015, 25, 716–759. [Google Scholar] [CrossRef]
- Haugen, B.R.; Alexander, E.K.; Bible, K.C.; Doherty, G.M.; Mandel, S.J.; Nikiforov, Y.E.; Pacini, F.; Randolph, G.W.; Sawka, A.M.; Schlumberger, M.; et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016, 26, 1–133. Available online: https://pubmed.ncbi.nlm.nih.gov/26462967/ (accessed on 1 January 2025). [CrossRef]
- Rosario, P.W.; da Silva, A.L.; Nunes, M.S.; Ribeiro Borges, M.A.; Mourão, G.F.; Calsolari, M.R. Risk of malignancy in 1502 solid thyroid nodules > 1 cm using the new ultrasonographic classification of the American Thyroid Association. Endocrine 2017, 56, 442–445. [Google Scholar] [CrossRef]
- Carr, A.A.; Yen, T.W.F.; Ortiz, D.I.; Hunt, B.C.; Fareau, G.; Massey, B.L.; Campbell, B.H.; Doffek, K.L.; Evans, D.B.; Wang, T.S. Patients with oncocytic variant papillary thyroid carcinoma have a similar prognosis to matched classical papillary thyroid carcinoma controls. Thyroid 2018, 28, 1462–1467. [Google Scholar] [CrossRef]
- Lee, C.H.; Lee, S.W.; Son, S.H.; Hong, C.M.; Jeong, J.H.; Jeong, S.Y.; Ahn, B.-C.; Lee, J. Prognostic value of lymph node uptake on pretreatment F-18 FDG PET/CT in patients with N1b papillary thyroid carcinoma. Endocr. Pract. 2019, 25, 787–793. [Google Scholar] [CrossRef] [PubMed]
- Zhao, Y.; Zhang, Y.; Liu, X.J.; Shi, B.Y. Prognostic Factors for Differentiated Thyroid Carcinoma and Review of the Literature. Tumori J. 2012, 98, 233–237. [Google Scholar] [CrossRef] [PubMed]
- American Thyroid Association Guidelines Taskforce on Thyroid; Cooper, D.S.; Doherty, G.M.; Haugen, B.R.; Kloos, R.T.; Lee, S.L.; Mandel, S.J.; Mazzaferri, E.L.; McIver, B.; Pacini, F.; et al. Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009, 19, 1167–1214. [Google Scholar] [CrossRef]
- Huang, M.; Yan, C.; Wei, H.; Lv, Y.; Ling, R. Clinicopathological characteristics and prognosis of thyroid cancer in northwest China: A population-based retrospective study of 2490 patients. Thorac. Cancer 2018, 9, 1453–1460. Available online: https://pmc.ncbi.nlm.nih.gov/articles/PMC6209792/ (accessed on 1 January 2025). [CrossRef]
- Wang, Y.; Wang, W. Increasing incidence of thyroid cancer in Shanghai, China, 1983–2007. Asia Pac. J. Public Health 2015, 27, NP223–NP229. [Google Scholar] [CrossRef] [PubMed]
- Rahib, L.; Smith, B.D.; Aizenberg, R.; Rosenzweig, A.B.; Fleshman, J.M.; Matrisian, L.M. Projecting cancer incidence and deaths to 2030: The unexpected burden of thyroid, liver, and pancreas cancers in the united states. Cancer Res. 2014, 74, 2913–2921. [Google Scholar] [CrossRef]
- Trésallet, C.; Seman, M.; Tissier, F.; Buffet, C.; Lupinacci, R.M.; Vuarnesson, H.; Leenhardt, L.; Menegaux, F. The incidence of papillary thyroid carcinoma and outcomes in operative patients according to their body mass indices. Surgery 2014, 156, 1145–1152. [Google Scholar] [CrossRef] [PubMed]
- Kwon, O.; Lee, S.; Bae, J.S. Risk factors associated with high-risk nodal disease in patients considered for active surveillance of papillary thyroid microcarcinoma without extrathyroidal extension. Gland Surg. 2023, 12, 1179–1190. [Google Scholar] [CrossRef] [PubMed]
- Wang, L.Y.; Ganly, I. Nodal metastases in thyroid cancer: Prognostic implications and management. Future Oncol. 2016, 12, 981–994, Erratum in Future Oncol. 2016, 12, 2659. [Google Scholar] [CrossRef] [PubMed]
- Haymart, M.R.; Banerjee, M.; Yang, D.; Stewart, A.K.; Koenig, R.J.; Griggs, J.J. The role of clinicians in determining radioactive iodine use for low-risk thyroid cancer. Cancer 2013, 119, 259–265. [Google Scholar] [CrossRef][Green Version]

| Characteristic | ||
|---|---|---|
| Age (years) Mean (SD) | 32.98 ± 5.19 | |
| Age groups | <30 years | 81 (24.8%) |
| ≥30 years | 245 (75.2%) | |
| Sex | Male | 89 (27.30%) |
| Female | 237 (72.70%) | |
| Ethnicity | Asian | 168 (51.53%) |
| Arab | 98 (30.06%) | |
| Qatari | 46 (14.11%) | |
| Others | 14 (4.29%) | |
| Characteristic | Overall (n = 326) | Male (n = 89) | Female (n = 237) | p-Value |
|---|---|---|---|---|
| Diagnosis Modality (n = 324) | ||||
| Cytology | 204 (62.96%) | 59 (67.05%) | 145 (61.44%) | 0.353 |
| Histopathology | 120 (37.04%) | 29 (32.95%) | 91 (38.56%) | |
| Surgery Type (n = 326) | 0.782 | |||
| Total Thyroidectomy | 253 (77.61%) | 70 (78.65%) | 183 (77.22%) | |
| Partial Thyroidectomy | 73 (22.39%) | 19 (21.35%) | 54 (22.78%) | |
| Tumor Focality (n = 326) | 0.197 | |||
| Unifocal | 183 (56.13%) | 45 (50.56%) | 138 (58.23%) | |
| Multifocal | 130 (39.88%) | 42 (47.19%) | 88 (37.13%) | |
| Undetermined | 13 (3.99%) | 2 (2.25%) | 11 (4.64%) | |
| Tumor Site (n = 311) | 0.509 | |||
| Right lobe | 162 (52.09%) | 46 (54.12%) | 116 (51.33%) | |
| Left lobe | 133 (42.77%) | 33 (38.82%) | 100 (44.25%) | |
| Isthmus | 16 (5.14%) | 6 (7.06%) | 10 (4.42%) | |
| Tumor Size (cm) | 0.0009 * | |||
| Mean ± SD | 2.19 ± 1.58 | 2.65 ± 1.80 | 2.01 ± 1.45 | |
| Histology Subtype (n = 325) | 0.680 | |||
| PTC (Classic) | 271 (83.38%) | 75 (84.27%) | 196 (83.05%) | |
| FTC (Follicular Variant) | 52 (16.00%) | 14 (15.73%) | 38 (16.10%) | |
| PTC (Tall Cell Variant) | 2 (0.62%) | 0 (0.00%) | 2 (0.85%) | |
| Pathological Features | ||||
| Positive Margins (n = 309) | 65 (21.04%) | 20 (22.99%) | 45 (20.27%) | 0.589 |
| Vascular Invasion (n = 306) | 36 (11.76%) | 19 (22.35%) | 17 (7.69%) | <0.001 * |
| Lymphatic Invasion (n = 306) | 44 (14.38%) | 16 (19.28%) | 28 (12.56%) | 0.136 |
| Perineural Invasion (n = 314) | 7 (2.23%) | 4 (4.55%) | 3 (1.33%) | 0.083 |
| Extrathyroidal Extension (n = 291) | 13 (4.47%) | 6 (7.50%) | 7 (3.32%) | 0.123 |
| Characteristic | Category | Overall | Male | Female | p-Value |
|---|---|---|---|---|---|
| Affected LN | Median (IQR) | 0 (0–4) | 0.5 (0–7) | 0 (0–3) | 0.0364 |
| Resected LN | Median (IQR) | 1 (0–6) | 1 (0–13) | 1 (0–5) | 0.3474 |
| Largest LN Size (cm) | Median (IQR) | 1.3 (0.4–2.5) | N/A | ||
| T Stage | T1a | 84 (25.85%) | N/A | ||
| T Stage | T1b | 71 (21.85%) | N/A | ||
| T Stage | T2 | 89 (27.38%) | N/A | ||
| T Stage | T3a | 37 (11.38%) | N/A | ||
| T Stage | T3b | 24 (7.38%) | N/A | ||
| T Stage | Other (T1, T3, T4a) | 20 (6.15%) | N/A | ||
| N Stage | Nx | 150 (46.30%) | N/A | ||
| N Stage | N0 | 80 (24.69%) | N/A | ||
| N Stage | N0a | 3 (0.93%) | N/A | ||
| N Stage | N1a | 35 (10.80%) | N/A | ||
| N Stage | N1b | 42 (12.96%) | N/A | ||
| N Stage | N1 (unspecified) | 14 (4.32%) | N/A | ||
| M Stage | M0 | 322 (99.69%) | N/A | ||
| M Stage | M1 | 1 (0.31%) | N/A | ||
| Prognostic Stage | I | 322 (99.69%) | N/A | ||
| Prognostic Stage | II | 1 (0.31%) | N/A |
| RAI Therapy | Category | N | Percentage |
|---|---|---|---|
| RAI Administration | Not Administered | 117 | 40.91% |
| Administered | 169 | 59.09% | |
| Number of Sessions | 1 Session | 84 | 29.37% |
| 2 Sessions | 55 | 19.23% | |
| 3 Sessions | 23 | 8.04% | |
| 4+ Sessions | 7 | 2.45% | |
| Cumulative Activity (mCi) | Median (IQR) | 60 (31.6–103.95) | - |
| Range | 25–2214.8 | - |
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Share and Cite
Abdelmahmuod, E.A.; Abufaied, M.; Mohamed, S.F.; Elharabi, N.; Osman, A.E.; Al-Shibly, R.; Bataineh, R.; Elhaj, M.F.; Al-Mohanadi, D.; Bashir, M.; et al. General Characteristics of Papillary Thyroid Cancer Among Adolescents and Young Adults: A Single Large Center Experience. Endocrines 2026, 7, 2. https://doi.org/10.3390/endocrines7010002
Abdelmahmuod EA, Abufaied M, Mohamed SF, Elharabi N, Osman AE, Al-Shibly R, Bataineh R, Elhaj MF, Al-Mohanadi D, Bashir M, et al. General Characteristics of Papillary Thyroid Cancer Among Adolescents and Young Adults: A Single Large Center Experience. Endocrines. 2026; 7(1):2. https://doi.org/10.3390/endocrines7010002
Chicago/Turabian StyleAbdelmahmuod, Elabbass A., Mohamad Abufaied, Shehab F. Mohamed, Nada Elharabi, Ahmed Elmudathir Osman, Rafal Al-Shibly, Raghad Bataineh, Maab F. Elhaj, Dabia Al-Mohanadi, Mohammed Bashir, and et al. 2026. "General Characteristics of Papillary Thyroid Cancer Among Adolescents and Young Adults: A Single Large Center Experience" Endocrines 7, no. 1: 2. https://doi.org/10.3390/endocrines7010002
APA StyleAbdelmahmuod, E. A., Abufaied, M., Mohamed, S. F., Elharabi, N., Osman, A. E., Al-Shibly, R., Bataineh, R., Elhaj, M. F., Al-Mohanadi, D., Bashir, M., & Jaber, T. (2026). General Characteristics of Papillary Thyroid Cancer Among Adolescents and Young Adults: A Single Large Center Experience. Endocrines, 7(1), 2. https://doi.org/10.3390/endocrines7010002

