Factors Associated with Thyroid Malignancy among Patients Presenting with Thyroid Nodule

Abstract

Background: Thyroid nodules are increasingly detected worldwide, and while most are benign, a meaningful proportion harbor malignancy. Regional differences in incidence and mortality suggest contributions from demographic, environmental, and clinical factors—underscoring the need for context-specific risk assessment. Objective: To determine the clinical and demographic factors associated with malignancy among patients presenting with thyroid nodules. Methods: We will conduct a case–control study in the Department of ENT, Bolan Medical College/Hospital, Quetta, over six months following ethical approval. Using non-probability consecutive sampling, 110 participants will be enrolled (55 malignant, 55 benign). Malignancy will be confirmed on histopathology. Candidate factors include female gender, obesity (BMI ≥30 kg/m²), raised TSH (>4.5 mIU/L), comorbidity (diabetes, hypertension, COPD or asthma), family history of thyroid malignancy, prior radiation exposure, and recent increase in neck swelling; additional variables captured are age, residence, smoking, nodule size, and duration. Data will be analyzed in SPSS v26 using binary logistic regression to estimate crude and adjusted odds ratios (95% CI). Variables with p<0.25 on invariable analysis will enter multivariable modeling; retention will be based on clinical relevance or p<0.10, with effect modifiers controlled in the final model. Expected Impact: By identifying independent predictors of thyroid malignancy among patients with nodules in our setting, this study aims to inform local risk stratification, guide diagnostic decision-making, and highlight modifiable factors for targeted prevention.