Thyroid Cancer Surge Among Young Adults

At just 31, Jess Cain, a healthy special needs teacher, was taken aback when a small lump in her neck turned out to be cancer. She hadn’t noticed it much until a massage therapist prompted her to seek medical advice.

Expecting some reassurance, she was instead met with a diagnosis of thyroid cancer and was quickly scheduled for surgery, followed by extensive treatment. “My surgeon mentioned I might have had the tumor for nearly a decade,” Jess recalled, noting the absence of any pain or symptoms. “I had never really heard of thyroid cancer. It was truly shocking.”

More cases like Jess’s are being reported these days. The incidence of thyroid cancer, which impacts the butterfly-shaped gland in the neck, has surged 62 percent in the UK over the last decade. Projections indicate it could rise by nearly 75 percent by 2035.

The thyroid gland produces hormones critical for regulating metabolism, heart rate, temperature, and growth. According to the American Cancer Society, thyroid cancer is one of five types of cancer rising in younger adults, alongside cancers of the throat, prostate, kidney, and colon. Women are nearly four times more likely to be diagnosed than men.

Notable figures such as Sofia Vergara, Marisa Abela, and Demi Jones have shared their thyroid cancer journeys, having been diagnosed before turning 30.

Experts speculate that advancements in medical technology have potentially contributed to the increase, allowing more tumors to be detected that previously may have gone unnoticed. However, some doctors argue there’s a more troubling reason: the rise in medical imaging practices may expose patients to unnecessary radiation, thereby increasing cancer risk, particularly in children.

In fact, a significant study indicated that around 5 percent of all new cancers in the US could be connected to CT scans, which is a toll comparable to that of alcohol. Annually, about 4,000 people in the UK are diagnosed with thyroid cancer, most of whom are aged between 70 and 74. Yet, cases have nearly tripled in the last 30 years, with young women forming the fastest-growing demographic.

The broader trend of increasing cancers among younger adults has been attributed to various factors including ultra-processed foods, obesity, and certain gut bacteria, although experts say the reasons for thyroid cancer specifically are more complex.

“There is certainly a rise in the incidence of thyroid cancer over the last 25 years,” says Professor Fausto Palazzo, an endocrine surgeon in London. “A large part of this seems to stem from improved detection, but that doesn’t necessarily mean that more cancers aren’t emerging. It muddies the interpretation.”

One pressing question remains: Is something causing this increase in thyroid cancer among young people? Professor Palazzo notes that the known risk factors are genetic predisposition and radiation exposure. While there’s some speculation about environmental radiation increases, proving such a claim is challenging.

Dr. Riccardo Vigneri, who has researched thyroid cancer for decades, analyzed data from the Californian death registry over 18 years. If the increase were only due to better detection, we would expect to see a rise in smaller, slower-growing tumors. Instead, his findings indicated a surge in larger, more aggressive cancers and higher mortality rates, suggesting that the trend cannot be fully explained by scanning alone.

“The evidence points to recent, environmental, and multiple causes for the global rise in thyroid cancers,” Dr. Vigneri stated, emphasizing a likely link to increased radiation exposure.

Historically, substantial radiation exposure has coincided with nuclear events like Hiroshima and Chernobyl, where nearby children developed thyroid tumors at alarming rates. Today, most man-made radiation exposure comes from medical procedures such as X-rays and CT scans, which utilize high-energy beams for detailed imaging.

A landmark study illustrated that the average radiation dose received by Americans doubled between 1980 and 2006, largely due to CT scans, with about a third targeting the head and neck. Children remain at the highest risk as their developing tissues are particularly sensitive to radiation.

One Australian study involving over 11 million children found that those who underwent CT scans had a 40 percent increased likelihood of later developing thyroid cancer.

In light of rising thyroid cancer rates, some endocrinologists, like those at Mercy Hospital in Chicago, have raised concerns about the extensive use of medical radiation and have advised caution with CT scans in younger patients. Nevertheless, experts underline that while scans are essential for diagnosing serious conditions, the overall risk to individual patients stays relatively low.

Research is also exploring potential links between thyroid cancer and radon gas, a natural byproduct of uranium that can seep into homes. Although previous studies confirmed its role in lung cancer, recent findings suggested it could also elevate thyroid cancer risk.

Yet, many researchers caution against forming definitive conclusions too soon. Professor Palazzo notes that in medicine, we rely on epidemiology to understand diseases in populations, and without robust large-scale studies, certainty eludes us.

Investigations are also looking into the role of iodine, a trace mineral crucial for thyroid hormone production. Commonly found in fish, dairy, and eggs, a study revealed that over two-thirds of UK schoolgirls were iodine deficient. Historically, half of Britain’s iodine intake came from milk, but the decline in free school milk and a rise in dairy-free diets have changed those numbers.

Regions with iodine deficiency often report higher thyroid cancer rates since insufficient iodine leads to thyroid enlargement, prompting potential cell mutations that can lead to cancer. Dr. Jahangir Ahmed explains this process further, noting that increased iodine demands during pregnancy can sometimes leave mothers deficient.

Other potential contributing factors include hormone-disrupting chemicals and air pollution, with a 2022 study linking poorer air quality to elevated thyroid cancer rates. Studies have also identified chemicals in common products that may impair thyroid function.

As for the higher incidence in women, it’s believed to be hormone-related. Dr. Ahmed points out that post-menopausal rates show more similarity between genders. Women may also be more susceptible due to a higher likelihood of autoimmune diseases affecting the thyroid, leading to chronic inflammation that heightens the potential for cell mutations.

While thyroid cancer typically has a good prognosis, with over 90 percent of patients able to be cured if detected early, some forms can be more aggressive. Common warning signs include a lump in the neck, persistent hoarseness, trouble breathing, or swallowing difficulties. Timely consultation with a healthcare professional is essential for anyone experiencing these symptoms.

Treatment often involves surgery to remove part or the entire thyroid, sometimes followed by radioactive iodine therapy. In cases of small tumors, doctors may suggest monitoring rather than immediate intervention.

“I generally reassure most patients that they have time,” says Dr. Ahmed, emphasizing the excellent prognosis of thyroid cancers when addressed promptly.

Personal Account: Jess Cain’s Battle with Thyroid Cancer

Jess Cain, now 35, initially detected the lump during a rare moment of relaxation while receiving a massage. The therapist quickly pointed out something unusual. “I felt it too,” she recounted, describing the sensation as similar to a marble under her skin.

After consulting her GP, who suggested it was likely a swollen lymph node, Jess returned a week later when the lump persisted. Following her insistence, she got referred for a scan.

Months later, an ultrasound revealed a suspicious mass, and just before Christmas, she learned it was cancerous. A biopsy and subsequent surgery confirmed the diagnosis as thyroid cancer.

“I was completely bewildered,” Jess admitted. “I had no symptoms and didn’t know anyone else with thyroid cancer.”

Having undergone the removal of her thyroid and radioactive iodine therapy, she shared her ongoing challenges. “People often call it ‘the good cancer’ because it’s treatable, but I’ve been dealing with it for two years now and had a recurrence just three months after being declared cancer-free,” she expressed emphatically. “There’s no such thing as a good cancer.”