BACKGROUND
Thyroid cancer is common among adults. While thyroid cancer during childhood is rare, the number of patients diagnosed with thyroid cancer has increased over the last several decades. Patients in this age group tend to have larger cancers and higher likelihood that the cancer has spread beyond the thyroid gland and to other places in the body when the cancer is diagnosed as compared to thyroid cancer in adults. There are likely many factors leading to these differences, including changes related to puberty and possible different approaches to the evaluation of thyroid nodules in young patients. Despite the statistics, thyroid cancer during childhood continues to share the same excellent prognosis as in adults.

The present study sought to determine long-term outcomes of thyroid cancer in individuals diagnosed at age 20 or younger and to propose recommendations as to how best to follow these patients.

THE FULL ARTICLE TITLE
Valenciaga P et al. Long-term outcomes of patients diagnosed with differentiated thyroid cancer in childhood and young adulthood. J Clin Endocrinol Metab. Epub 2025 Sep 18:dgaf522; doi: 10.1210/clinem/dgaf522. PMID: 40973122.

SUMMARY OF THE STUDY
This study looked at a group of 155 patients with thyroid cancer that were diagnosed at the age of 20 or younger at a large Medical Center. Patients with a rare form of thyroid cancer called medullary thyroid cancer were excluded from the study.

The average age at the time that the thyroid cancer was diagnosed was 17 years. More than 80% of patients were female. Most of the patients had a diagnosis of papillary thyroid cancer. About 80% of the patients had thyroid cancer limited to the thyroid. Most patients were treated with surgery and then received radioactive iodine therapy. Additional surgery was required and about 1/3rd of the patients. The average follow-up was 16 years.

Excellent response to treatment was seen in >50% of the patients. The remainder had an unclear or incomplete response to therapy. Overall, 9 patients were followed for more than 50 years. Among these patients, 2/3 of the patients had a recurrence of the cancer following a longer period of stability. A younger age and diagnosis, need for multiple surgeries or more advanced cancer at the time of diagnosis were linked to a higher risk for worse outcomes.

WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study suggests that patients diagnosed with thyroid cancer during childhood and adolescence have excellent long-term survival, similar to that seen in adults with thyroid cancer. The study also suggests patients diagnosed with thyroid cancer in childhood may experience recurrences many years later. This emphasizes the need for long-term follow up of patients who were diagnosed with thyroid cancer during childhood.

— Vibhavasu Sharma, MD, FACE

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