Differentiated thyroid cancer (DTC) refers to papillary and follicular variants

Aetiology

• Can affect any age group - childhood to elderly
• In females, rates increase from 15-40 then plateaus
• In males rates steadily increase with age
• Not associated with diet, other proven malignancies, family history, smoking or other lifestyle factors
• Other than clusters associated with nuclear incidence, the overall incidence is constant at present

Papillary carcinoma

• Derived from follicular epithelium
• Associated with Hashimotos
• Associated with ionising radiation

Genetic associations

• Activation of MAP kinase pathway
• Rearrangements of RET or NTKR1
• Activating point mutation in BRAF
• Mutation of ras

Follicular carcinoma

• Derived from follicular epithelium
• Higher incidence in females
• Higher incidence at 40-50 years