Evaluation of Thyroid Pathologies Detected During School Screening in Healthy School-Age Children

Objective: The authors of this study took part in a screening program in schools in Aydin province (unpublished study). This study assessed the final thyroid pathologies of these children with pathology detected during ultrasonography (USG) screening obtained as part of the screening program. Methods: A handheld wireless point -of -care USG device was used to screen the thyroid gland. Children with thyroid pathology were invited to the hospital where detailed lab study and an USG was examined. The study obtained the thyroid measurements, parenchymal features, and noted the presence of nodules in the detailed USG examination. Nodules were classified according to the Thyroid Imaging Reporting & Data System (TI-RADSTM) and an USG -guided fine needle aspiration (FNA) was performed according to TI-RADS. Results: A total of 1,553 cases from 21 schools between the ages of 6-17 were evaluated in the screening program. Thyroid pathology was detected in 176 (11.3%) cases. One hundred twenty of 176 patients' families agreed to attend our centre for further examination, where pathology was confirmed in 108 (90.0%) of the 120 cases. Among the 108 thyroid USG pathologies, 52 (48.1%) patients had a nodule and thyroiditis; 28 (25.9%) patients had only a nodule; 28 (25.9%) patients had only thyroiditis. Thyroiditis was present in 74.0% (n=80) of the cases, of those cases 56.3% (n=45) had peripheral thyroiditis, 31.3% (n=25) had diffuse thyroiditis and 12.5% (n=10) had overweight -related changes. Nodules were present in 73.4% (n=80) of the cases. A total of 9 USG -guided FNA were performed, and their pathology results were as followed; 55.6% (n=5) benign cytology, 11.1% (n=1) follicular adenoma, 11.1% (n=1) atypia of indeterminate significance, 11.1% (n=1) non -diagnostic cytology and 11.1% (n=1) papillary thyroid cancer. Conclusion: This study showed that thyroiditis and nodules in the thyroid gland are common disorders in children. Thyroid nodules may also have a high malignancy potential and the chance of early diagnosis of thyroid cancers with screening is demonstrated.