Thyroid Nodular Evaluation and Treatment in Elderly Patients

Introduction The clinical detection of thyroid nodules is increasing in our population, especially due to greater awareness and the use of imaging modalities in the neck. Thyroid nodules are clinically present in 5% of the population, and this prevalence increases considerably with the use of neck ultrasound.1 The incidence of malignancy in clinically apparent thyroid nodules varies from 5–20%, and women are more affected than men by a ratio of 3:1.2-4 When properly treated, it is quite unusual for patients to die of thyroid malignancy. In the United States, there are approximately 1,300 deaths from thyroid malignancy per annum; the figure in Canada is about one-tenth of that.5 In this article, we will describe the management of thyroid nodule, with an emphasis on management in the elderly patient (over 65 years of age), within the full context of thyroid nodular disease and malignancy.