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I hyroid cancer is the most common endocrine cancer, and the number of new cases in the United States is increasing annually by 3% per 100,000. Most thyroid nodules or tumors develop from thyroid follicular cells; 95% of these nodules and tumors are benign. The remaining 5% of

896 Thyroid Cancer thyroid nodules or tumors are cancerous, and there are several forms of thyroid cancer. Papillary carcinoma is the most common form of primary thyroid cancer. It is also the slowest-growing thyroid cancer and is usually multifocal and bilateral in distribution. Papillary carcinoma metastasizes slowly into the cervical lymph nodes and the nodes of the mediastinum and lungs. Follicular cancer is the next most common form. It is more likely to recur than other forms; it generally metastasizes to the regional lymph nodes and is spread by the blood to distant areas such as the bones, liver, and lungs. More than 90% of patients treated for either papillary or follicular carcinoma will live for 15 years or longer after their diagnosis.

Anaplastic carcinoma of the thyroid is a less common form of thyroid cancer and is resistant to both surgical resection and radiation; the 5-year survival rate is between 3% and 17%. Anaplastic cells metastasize quickly, invade the trachea and surrounding tissues, and compress vital structures. Medullary cancer is even less common (3% to 4% of thyroid cancers); it originates in the parafollicular cells of the thyroid. Metastasis occurs to the bones, liver, and kidneys if the disease is not treated. In addition to metastases, other life-threatening complications include compression of surrounding structures (particularly in the neck), thus leading to difficulty swallowing and breathing. Surgery can cure medullary thyroid cancer; 86% have 5-year survival rate, and 65% survive 10 years or more.

The American Cancer Society estimated that in the year 2005 roughly 25,690 new cases of thyroid cancer would be diagnosed in the United States. An estimated 860 women and 630 men were expected to die of thyroid cancer during the year 2005.

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