RISK FACTORS FOR THE DEVELOPMENT OF THYROID NODULES AND CANCER IN CHILDREN

1.Iodine deficiency

2.Prior radiation exposure, including radiation therapy for Hogdkin lymphoma, leukemia, and central nervous system tumors (in cancer survivors thyroid nodules develop at a rate of about 2 % annually, reaching a peak incidence 15-25 years post-exposure).The risk is higher among those who received radiation therapy at a younger age and with doses up to 20-30 Gy

3.History of antecedent thyroid cancer in the family (≥2 members especially when diagnosed at a young age)

4.Several genetic syndromes

(i)Familial adenomatous polyposis syndrome (FAP) and variants (attenuated FAP, Gardner syndrome, Turcot syndrome)

(ii)Carney complex

(iii)DICER1 syndrome

(iv)PTEN hamartoma tumor syndrome

(v)Werner syndrome

(vi)Familial nonmedullary thyroid cancer

(vii)MEN2 syndrome (medullary thyroid cancer)

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