The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Electron Kebebew - One of the best experts on this subject based on the ideXlab platform.
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results of screening in familial non medullary Thyroid Cancer
Thyroid, 2017Co-Authors: Joanna Klubogwiezdzinska, Samira M Sadowski, Naris Nilubol, Electron Kebebew, Maria J Merino, Dhaval Patel, Lily Yang, Roxanne Merkel, Monica C SkarulisAbstract:Background: Although a family history of Thyroid Cancer is one of the main risk factors for Thyroid Cancer, the benefit of screening individuals with a family history of Thyroid Cancer is not known. Methods: A prospective cohort study was performed with yearly screening using neck ultrasound and fine-needle aspiration biopsy of Thyroid nodule(s) >0.5 cm in at-risk individuals whose relatives were diagnosed with familial non-medullary Thyroid Cancer (FNMTC). The eligibility criteria were the presence of Thyroid Cancer in two or more first-degree relatives and being older than seven years of age. Twenty-five kindred were enrolled in the study (12 families with two members affected, and 13 with three or more members affected at enrollment). Results: Thyroid Cancer was detected by screening in 4.6% (2/43) of at-risk individuals from families with two members affected, and in 22.7% (15/66) of at-risk members from families with three or more patients affected (p = 0.01). FNMTC detected by screening was characte...
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mir 126 3p inhibits Thyroid Cancer cell growth and metastasis and is associated with aggressive Thyroid Cancer
PLOS ONE, 2015Co-Authors: Yin Xiong, Lisa Zhang, Martha A Zeiger, Shweta Kotian, Electron KebebewAbstract:Background Previous studies have shown that microRNAs are dysregulated in Thyroid Cancer and play important roles in the post-transcriptional regulation of target oncogenes and/or tumor suppressor genes.
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germline habp2 mutation causing familial nonmedullary Thyroid Cancer
The New England Journal of Medicine, 2015Co-Authors: Sudheer Kumar Gara, Lisa Zhang, Maria J Merino, Sunita K Agarwal, Dhaval Patel, Electron KebebewAbstract:Familial nonmedullary Thyroid Cancer accounts for 3 to 9% of all cases of Thyroid Cancer, but the susceptibility genes are not known. Here, we report a germline variant of HABP2 in seven affected members of a kindred with familial nonmedullary Thyroid Cancer and in 4.7% of 423 patients with Thyroid Cancer. This variant was associated with increased HABP2 protein expression in tumor samples from affected family members, as compared with normal adjacent Thyroid tissue and samples from sporadic Cancers. Functional studies showed that HABP2 has a tumor-suppressive effect, whereas the G534E variant results in loss of function.
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mir 145 suppresses Thyroid Cancer growth and metastasis and targets akt3
Endocrine-related Cancer, 2014Co-Authors: Myriem Boufraqech, Naris Nilubol, Lisa Zhang, Yin Xiong, Maria J Merino, Dhaval Patel, Meenu Jain, Ryan J Ellis, Electron KebebewAbstract:The expression and function of miR-145 in Thyroid Cancer is unknown. We evaluated the expression and function of miR-145 in Thyroid Cancer and its potential clinical application as a biomarker. We found that the expression of miR-145 is significantly downregulated in Thyroid Cancer as compared with normal. Overexpression of miR-145 in Thyroid Cancer cell lines resulted in: decreased cell proliferation, migration, invasion, VEGF secretion, and E-cadherin expression. miR-145 overexpression also inhibited the PI3K/Akt pathway and directly targeted AKT3. In vivo, miR-145 overexpression decreased tumor growth and metastasis in a xenograft mouse model, and VEGF secretion. miR-145 inhibition in normal primary follicular Thyroid cells decreased the expression of Thyroid cell differentiation markers. Analysis of indeterminate fine-needle aspiration samples showed miR-145 had a 92% negative predictive value for distinguishing benign from malignant Thyroid nodules. Circulating miR-145 levels were significantly higher in patients with Thyroid Cancer and showed a venous gradient. Serum exosome extractions revealed that miR-145 is secreted. Our findings suggest that miR-145 is a master regulator of Thyroid Cancer growth, mediates its effect through the PI3K/Akt pathway, is secreted by the Thyroid Cancer cells, and may serve as an adjunct biomarker for Thyroid Cancer diagnosis.
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mir 20a is upregulated in anaplastic Thyroid Cancer and targets limk1
PLOS ONE, 2014Co-Authors: Yin Xiong, Lisa Zhang, Electron KebebewAbstract:Background There have been conflicting reports regarding the function of miR-20a in a variety of Cancer types and we previously found it to be dysregulated in sporadic versus familial papillary Thyroid Cancer. In this study, we studied the expression of miR-20a in normal, benign and malignant Thyroid samples, and its effect on Thyroid Cancer cells in vitro and in vivo. Methodology/Principal Findings The expression of miR-20a in normal, benign and malignant Thyroid tissue was determined by quantitative RT-PCR. Thyroid Cancer cells were transfected with miR-20a and the effect on cellular proliferation, tumor spheroid formation, and invasion was evaluated. Target genes of miR-20 were determined by genome-wide mRNA expression analysis with miR-20a overexpression in Thyroid Cancer cells and target prediction database. Target genes were validated by quantitative PCR and immunoblotting, and luciferase assays. MiR-20a expression was significantly higher in anaplastic Thyroid Cancer than in differentiated Thyroid Cancer, and benign and normal Thyroid tissues. MiR-20a significantly inhibited Thyroid Cancer cell proliferation in vitro (p<0.01) and in vivo (p<0.01), tumor spheroid formation (p<0.05) and invasion (p<0.05) in multiple Thyroid Cancer cell lines. We found that LIMK1 was a target of miR-20a in Thyroid Cancer cell lines and direct knockdown of LIMK1 recapitulated the effect of miR-20a in Thyroid Cancer cells. Conclusions/Significance To our knowledge, this is the first study to demonstrate that miR-20a plays a role as a tumor suppressor in Thyroid Cancer cells and targets LIMK1. Our findings suggest the upregulated expression of miR-20a in anaplastic Thyroid Cancer counteracts Thyroid Cancer progression and may have therapeutic potential.
Benjamin C James - One of the best experts on this subject based on the ideXlab platform.
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financial burden of Thyroid Cancer in the united states an estimate of economic and psychological hardship among Thyroid Cancer survivors
Surgery, 2020Co-Authors: Courtney E Barrows, Janeil M Belle, Aaron Fleishman, Carrie C Lubitz, Benjamin C JamesAbstract:Abstract Background Annual Cancer-related healthcare expenditure in the United States is estimated to exceed $150 billion by 2020. As the prevalence of Thyroid Cancer increases worldwide, Thyroid Cancer survivorship is associated with increasing personal and cumulative costs. Few studies have examined the psychological and material economic costs experienced by Thyroid Cancer survivors. We seek to estimate the comparative prevalence of financial and psychological hardship among Thyroid Cancer and non-Thyroid Cancer patients in the United States. Methods The 2011 Medical Expenditure Panel Survey Experiences with Cancer databank was queried to identify Thyroid and non-Thyroid (colon, breast, lung, prostate) Cancer survivors. This survey includes assessments of financial stress, material hardship, and psychological financial hardship. Cancer incidence–based weighted estimates of responses were compared between Thyroid and non-Thyroid Cancer survivors. Independent predictors of material and psychological financial burden were identified through separate multivariate regression models. Results Thyroid Cancer survivors more frequently reported psychological financial burden compared to non-Thyroid Cancer (46.1% vs 24.0%, P = .04). Material financial hardship (28.1% vs 19.9%, P = .37) and concurrent material and psychological hardship (25.1% vs 12.5%, P = .09) were noted at similar frequencies between Thyroid and non-Thyroid Cancer survivors. However, on multivariate analysis, only younger age and lack of health insurance coverage were independently associated with psychological financial hardship. Conclusion Thyroid Cancer survivors report greater psychological financial hardship than non-Thyroid Cancer survivors. Because this financial burden may be underrecognized in the medical community, further studies should be conducted to aid physicians in better understanding the impact of a Thyroid Cancer diagnosis.
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prophylactic versus selective central neck dissection in pediatric papillary Thyroid Cancer
2018Co-Authors: Benjamin C James, Raymon H Grogan, Edwin L Kaplan, Peter AngelosAbstract:The first case of Thyroid carcinoma in a child was described in 1902. Following this, Crile published the first case series of pediatric Thyroid Cancer in 1959, whereby he characterized pediatric Thyroid Cancer in 18 children. He noted that pediatric Thyroid Cancer was more commonly metastatic to cervical lymph nodes and to the lungs than was described in the adult population. Despite finding these Cancers to be more aggressive than in adults, only one of the patients died of Thyroid Cancer and four of them were alive with lung metastases. This publication spawned many subsequent studies confirming these findings. As a result, there has been much debate on the appropriate surgical treatment of Thyroid Cancer in the pediatric population both with respect to the extent of surgery and the use of radioactive iodine.
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risk factors for decreased quality of life in Thyroid Cancer survivors initial findings from the north american Thyroid Cancer survivorship study
Thyroid, 2015Co-Authors: Brisa Aschebrookkilfoy, Benjamin C James, Sapna Nagar, Sharone P Kaplan, Vanessa Seng, Habibul Ahsan, Peter Angelos, Edwin L Kaplan, Marlon A Guerrero, Jennifer H KuoAbstract:Background: The prevalence of Thyroid Cancer survivors is rising rapidly due to the combination of an increasing incidence, high survival rates, and a young age at diagnosis. The physical and psychosocial morbidity of Thyroid Cancer has not been adequately described, and this study therefore sought to improve the understanding of the impact of Thyroid Cancer on quality of life (QoL) by conducting a large-scale survivorship study. Methods: Thyroid Cancer survivors were recruited from a multicenter collaborative network of clinics, national survivorship groups, and social media. Study participants completed a validated QoL assessment tool that measures four morbidity domains: physical, psychological, social, and spiritual effects. Data were also collected on participant demographics, medical comorbidities, tumor characteristics, and treatment modalities. Results: A total of 1174 participants with Thyroid Cancer were recruited. Of these, 89.9% were female, with an average age of 48 years, and a mean time fro...
Brisa Aschebrookkilfoy - One of the best experts on this subject based on the ideXlab platform.
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the breast Thyroid Cancer link a systematic review and meta analysis
Cancer Epidemiology Biomarkers & Prevention, 2016Co-Authors: Sarah M Nielsen, Brisa Aschebrookkilfoy, Peter Angelos, Edwin L Kaplan, Michael G White, Susan Hong, Swati Kulkarni, Olufunmilayo I Olopade, Raymon H GroganAbstract:Rates of Thyroid Cancer in women with a history of breast Cancer are higher than expected. Similarly, rates of breast Cancer in those with a history of Thyroid Cancer are increased. Explanations for these associations include detection bias, shared hormonal risk factors, treatment effect, and genetic susceptibility. With increasing numbers of breast and Thyroid Cancer survivors, clinicians should be particularly cognizant of this association. Here, we perform a systematic review and meta-analysis of the literature utilizing PubMed and Scopus search engines to identify all publications studying the incidence of breast Cancer as a secondary malignancy following a diagnosis of Thyroid Cancer or Thyroid Cancer following a diagnosis of breast Cancer. This demonstrated an increased risk of Thyroid Cancer as a secondary malignancy following breast Cancer [OR = 1.55; 95% confidence interval (CI), 1.44-1.67] and an increased risk of breast Cancer as a secondary malignancy following Thyroid Cancer (OR = 1.18; 95% CI, 1.09-1.26). There is a clear increase in the odds of developing either Thyroid or breast Cancer as a secondary malignancy after diagnosis with the other. Here, we review this association and current hypothesis as to the cause of this correlation.
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financial toxicity in Thyroid Cancer an analysis from the north american Thyroid Cancer survivorship study
Journal of Clinical Oncology, 2016Co-Authors: Jonas A De Souza, Raymon H Grogan, Brisa AschebrookkilfoyAbstract:17 Background: Financial toxicity (FTox) has been associated with worse health-related quality-of-life (HRQoL), compliance, and even survival in Cancer patients (pts). Measuring FTox and understanding its predictors are of paramount importance when planning intervention strategies, the value of care, and healthcare policies. We report FTox and its predictors in a large cohort of Thyroid Cancer pts and survivors. Methods: Pts with Thyroid Cancer were surveyed in the North American Thyroid Cancer Survivorship Study. FTox was assessed by the previously validated COmprehensive Score for financial Toxicity (COST), as well as by questions related to financial distress (out-of-pocket costs, loss of income and bankruptcy). Data on sociodemographics, income, type of disease, length of diagnosis (LOD), and prior therapies were collected. Predictors of FTox were assessed in multivariate analyses, controlling for potential confounders, such as HRQoL (as measured by the Thyroid Cancer-specific City of Hope instrument)...
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risk factors for decreased quality of life in Thyroid Cancer survivors initial findings from the north american Thyroid Cancer survivorship study
Thyroid, 2015Co-Authors: Brisa Aschebrookkilfoy, Benjamin C James, Sapna Nagar, Sharone P Kaplan, Vanessa Seng, Habibul Ahsan, Peter Angelos, Edwin L Kaplan, Marlon A Guerrero, Jennifer H KuoAbstract:Background: The prevalence of Thyroid Cancer survivors is rising rapidly due to the combination of an increasing incidence, high survival rates, and a young age at diagnosis. The physical and psychosocial morbidity of Thyroid Cancer has not been adequately described, and this study therefore sought to improve the understanding of the impact of Thyroid Cancer on quality of life (QoL) by conducting a large-scale survivorship study. Methods: Thyroid Cancer survivors were recruited from a multicenter collaborative network of clinics, national survivorship groups, and social media. Study participants completed a validated QoL assessment tool that measures four morbidity domains: physical, psychological, social, and spiritual effects. Data were also collected on participant demographics, medical comorbidities, tumor characteristics, and treatment modalities. Results: A total of 1174 participants with Thyroid Cancer were recruited. Of these, 89.9% were female, with an average age of 48 years, and a mean time fro...
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the clinical and economic burden of a sustained increase in Thyroid Cancer incidence
Cancer Epidemiology Biomarkers & Prevention, 2013Co-Authors: Brisa Aschebrookkilfoy, Peter Angelos, Edwin L Kaplan, Rebecca B Schechter, Ya Chen Tina Shih, Brian C H Chiu, Raymon H GroganAbstract:Background: Thyroid Cancer incidence is increasing worldwide at an alarming rate, yet little is known of the impact this increase will have on society. We sought to determine the clinical and economic burden of a sustained increase in Thyroid Cancer incidence in the United States and to understand how these burdens correlate with the National Cancer Institute's (NCI) prioritization of Thyroid Cancer research funding. Methods: We used the NCI's SEER 13 database (1992–2009) and Joinpoint regression software to identify the current clinical burden of Thyroid Cancer and to project future incidence through 2019. We combined Medicare reimbursement rates with American Thyroid Association guidelines, and our clinical practice to create an economic model of Thyroid Cancer. We obtained research-funding data from the NCI's Office of Budget and Finance. Results; By 2019, papillary Thyroid Cancer will double in incidence and become the third most common Cancer in women of all ages at a cost of $18 to $21 billion dollars in the United States. Despite these substantial clinical and economic burdens, Thyroid Cancer research remains significantly underfunded by comparison, and in 2009 received only $14.7 million (ranked 30th) from the NCI. Conclusion: The impact of Thyroid Cancer on society has been significantly underappreciated, as is evidenced by its low priority in national research funding levels. Impact: Increased awareness in the medical community and the general public of the societal burden of Thyroid Cancer, and substantial increases in research on Thyroid Cancer etiology, prevention, and treatment are needed to offset these growing concerns. Cancer Epidemiol Biomarkers Prev; 1–8. ©2013 AACR .
Raymon H Grogan - One of the best experts on this subject based on the ideXlab platform.
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prophylactic versus selective central neck dissection in pediatric papillary Thyroid Cancer
2018Co-Authors: Benjamin C James, Raymon H Grogan, Edwin L Kaplan, Peter AngelosAbstract:The first case of Thyroid carcinoma in a child was described in 1902. Following this, Crile published the first case series of pediatric Thyroid Cancer in 1959, whereby he characterized pediatric Thyroid Cancer in 18 children. He noted that pediatric Thyroid Cancer was more commonly metastatic to cervical lymph nodes and to the lungs than was described in the adult population. Despite finding these Cancers to be more aggressive than in adults, only one of the patients died of Thyroid Cancer and four of them were alive with lung metastases. This publication spawned many subsequent studies confirming these findings. As a result, there has been much debate on the appropriate surgical treatment of Thyroid Cancer in the pediatric population both with respect to the extent of surgery and the use of radioactive iodine.
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the breast Thyroid Cancer link a systematic review and meta analysis
Cancer Epidemiology Biomarkers & Prevention, 2016Co-Authors: Sarah M Nielsen, Brisa Aschebrookkilfoy, Peter Angelos, Edwin L Kaplan, Michael G White, Susan Hong, Swati Kulkarni, Olufunmilayo I Olopade, Raymon H GroganAbstract:Rates of Thyroid Cancer in women with a history of breast Cancer are higher than expected. Similarly, rates of breast Cancer in those with a history of Thyroid Cancer are increased. Explanations for these associations include detection bias, shared hormonal risk factors, treatment effect, and genetic susceptibility. With increasing numbers of breast and Thyroid Cancer survivors, clinicians should be particularly cognizant of this association. Here, we perform a systematic review and meta-analysis of the literature utilizing PubMed and Scopus search engines to identify all publications studying the incidence of breast Cancer as a secondary malignancy following a diagnosis of Thyroid Cancer or Thyroid Cancer following a diagnosis of breast Cancer. This demonstrated an increased risk of Thyroid Cancer as a secondary malignancy following breast Cancer [OR = 1.55; 95% confidence interval (CI), 1.44-1.67] and an increased risk of breast Cancer as a secondary malignancy following Thyroid Cancer (OR = 1.18; 95% CI, 1.09-1.26). There is a clear increase in the odds of developing either Thyroid or breast Cancer as a secondary malignancy after diagnosis with the other. Here, we review this association and current hypothesis as to the cause of this correlation.
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financial toxicity in Thyroid Cancer an analysis from the north american Thyroid Cancer survivorship study
Journal of Clinical Oncology, 2016Co-Authors: Jonas A De Souza, Raymon H Grogan, Brisa AschebrookkilfoyAbstract:17 Background: Financial toxicity (FTox) has been associated with worse health-related quality-of-life (HRQoL), compliance, and even survival in Cancer patients (pts). Measuring FTox and understanding its predictors are of paramount importance when planning intervention strategies, the value of care, and healthcare policies. We report FTox and its predictors in a large cohort of Thyroid Cancer pts and survivors. Methods: Pts with Thyroid Cancer were surveyed in the North American Thyroid Cancer Survivorship Study. FTox was assessed by the previously validated COmprehensive Score for financial Toxicity (COST), as well as by questions related to financial distress (out-of-pocket costs, loss of income and bankruptcy). Data on sociodemographics, income, type of disease, length of diagnosis (LOD), and prior therapies were collected. Predictors of FTox were assessed in multivariate analyses, controlling for potential confounders, such as HRQoL (as measured by the Thyroid Cancer-specific City of Hope instrument)...
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the clinical and economic burden of a sustained increase in Thyroid Cancer incidence
Cancer Epidemiology Biomarkers & Prevention, 2013Co-Authors: Brisa Aschebrookkilfoy, Peter Angelos, Edwin L Kaplan, Rebecca B Schechter, Ya Chen Tina Shih, Brian C H Chiu, Raymon H GroganAbstract:Background: Thyroid Cancer incidence is increasing worldwide at an alarming rate, yet little is known of the impact this increase will have on society. We sought to determine the clinical and economic burden of a sustained increase in Thyroid Cancer incidence in the United States and to understand how these burdens correlate with the National Cancer Institute's (NCI) prioritization of Thyroid Cancer research funding. Methods: We used the NCI's SEER 13 database (1992–2009) and Joinpoint regression software to identify the current clinical burden of Thyroid Cancer and to project future incidence through 2019. We combined Medicare reimbursement rates with American Thyroid Association guidelines, and our clinical practice to create an economic model of Thyroid Cancer. We obtained research-funding data from the NCI's Office of Budget and Finance. Results; By 2019, papillary Thyroid Cancer will double in incidence and become the third most common Cancer in women of all ages at a cost of $18 to $21 billion dollars in the United States. Despite these substantial clinical and economic burdens, Thyroid Cancer research remains significantly underfunded by comparison, and in 2009 received only $14.7 million (ranked 30th) from the NCI. Conclusion: The impact of Thyroid Cancer on society has been significantly underappreciated, as is evidenced by its low priority in national research funding levels. Impact: Increased awareness in the medical community and the general public of the societal burden of Thyroid Cancer, and substantial increases in research on Thyroid Cancer etiology, prevention, and treatment are needed to offset these growing concerns. Cancer Epidemiol Biomarkers Prev; 1–8. ©2013 AACR .
David S Cooper - One of the best experts on this subject based on the ideXlab platform.
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follicular Thyroid Cancer and hurthle cell carcinoma challenges in diagnosis treatment and clinical management
The Lancet Diabetes & Endocrinology, 2017Co-Authors: Giorgio Grani, Sebastiano Filetti, Livia Lamartina, Cosimo Durante, David S CooperAbstract:Follicular Thyroid Cancer is the second most common differentiated Thyroid Cancer histological type and has been overshadowed by its more common counterpart-papillary Thyroid Cancer-despite its unique biological behaviour and less favourable outcomes. In this Review, we comprehensively review the literature on follicular Thyroid Cancer to provide an evidence-based guide to the management of these tumours, to highlight the lack of evidence behind guideline recommendations, and to identify changes and challenges over the past decades in diagnosis, prognosis, and treatment. We highlight that correct identification of Cancer in indeterminate cytological samples is challenging and ultrasonographic features can be misleading. Despite certain unique aspects of follicular Thyroid Cancer presentation and prognosis, no specific recommendations exist for follicular Thyroid Cancer and Hurthle cell carcinoma in evidence-based guidelines. Efforts should be made to stimulate additional research in this field.
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thyrotropin and Thyroid Cancer diagnosis a systematic review and dose response meta analysis
The Journal of Clinical Endocrinology and Metabolism, 2012Co-Authors: David S Cooper, D S Mcleod, Karen Watters, Anthony D Carpenter, Paul W Ladenson, Eric L DingAbstract:Context: TSH is the major growth factor for thyrocytes and may have a causative role in Thyroid Cancer. Objective: The objective of the study was to systematically assess the association between serum TSH and Thyroid Cancer. Data Sources: The MEDLINE and EMBASE databases were searched using synonyms for TSH and Thyroid Cancer, supplemented with reference list searches and author contact. Study Selection: Prospective cohort, case-control, and cross-sectional studies were identified with TSH the exposure and Thyroid Cancer the outcome. Data Extraction: Three reviewers independently extracted data. Studies reporting odds ratio (OR) for TSH levels and Thyroid Cancer were analyzed via meta-analysis and generalized least-squares trend estimation for dose-response relationships. Data Synthesis: Data extracted from 28 studies included a total of 42,032 subjects and 5,786 Thyroid Cancer cases. Dose-response spline analysis revealed a nonlinear relationship (P < 0.001). For TSH levels less than 1 mU/liter, the OR f...
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ectopic lingual Thyroid masquerading as Thyroid Cancer metastases
The Journal of Clinical Endocrinology and Metabolism, 2001Co-Authors: Shehzad Basaria, William H Westra, David S CooperAbstract:The endocrine literature is replete with reports of false positive iodine-131 (I) uptake in many parts of the body in patients with a history of Thyroid Cancer, thus simulating metastatic disease. The occurrence of lingual Thyroid in patients with Thyroid Cancer is also a rarity. We present a case of an elderly woman with papillary Thyroid Cancer who had a positive I uptake at the level of the chin that was presumed to be metastatic disease. However, the histopathological diagnosis showed normal lingual Thyroid tissue.
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thyrotropin suppression and disease progression in patients with differentiated Thyroid Cancer results from the national Thyroid Cancer treatment cooperative registry
Thyroid, 1998Co-Authors: David S Cooper, Bryan R. Haugen, Paul W Ladenson, Bonny Specker, Matthew Sperling, Douglas S Ross, Kenneth B Ain, Thomas S Bigos, James D Brierley, Irwin KleinAbstract:The ideal therapy for differentiated Thyroid Cancer is uncertain. Although Thyroid hormone treatment is pivotal, the degree of thyrotropin (TSH) suppression that is required to prevent recurrences has not been studied in detail. We have examined the relation of TSH suppression to baseline disease characteristics and to the likelihood of disease progression in a cohort of Thyroid Cancer patients who have been followed in a multicenter Thyroid Cancer registry that was established in 1986. The present study describes 617 patients with papillary and 66 patients with follicular Thyroid Cancer followed annually for a median of 4.5 years (range 1-8.6 years). Cancer staging was assessed using a staging scheme developed and validated by the registry. Cancer status was defined as no residual disease; progressive disease at any follow-up time; or death from Thyroid Cancer. A mean TSH score was calculated for each patient by averaging all available TSH determinations, where 1 = undetectable TSH; 2 = subnormal TSH; 3 = normal TSH; and 4 = elevated TSH. Patients were also grouped by their TSH scores: group 1: mean TSH score 1.0-1.99; group 2: mean TSH score 2.0-2.99; group 3: mean TSH score 3.0-4.0. The degree of TSH suppression did not differ between papillary and follicular Thyroid Cancer patients. However, TSH suppression was greater in papillary Cancer patients who were initially classified as being at higher risk for recurrence. This was not the case for follicular Cancer patients, where TSH suppression was similar for all patients. For all stages of papillary Cancer, a Cox proportional hazards model showed that disease stage, patient age, and radioiodine therapy all predicted disease progression, but TSH score category did not. However, TSH score category was an independent predictor of disease progression in high risk patients (p = 0.03), but was no longer significant when radioiodine therapy was included in the model (p = 0.09). There were too few patients with follicular Cancer for multivariate analysis. These data suggest that physicians use greater degrees of TSH suppression in higher risk papillary Cancer patients. Our data do not support the concept that greater degrees of TSH suppression are required to prevent disease progression in low-risk patients, but this possibility remains in high-risk patients. Additional studies with more patients and longer follow-up may provide the answer to this important question.