Is serum TSH a biomarker of thyroid carcinoma in patients residing in a mildly iodine-deficient area?

Kristine Zøylner Swan*, Viveque Egsgaard Nielsen, Christian Godballe, Jens Faunø Thrane, Marie Riis Mortensen, Sten Schytte, Henrik Baymler Pedersen, Peer Christiansen, Steen Joop Bonnema

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


PURPOSE: To investigate the association between the pre-operative serum TSH (s-TSH) level and differentiated thyroid carcinoma (DTC) in a mildly iodine-deficient area.

METHODS: Patients undergoing surgery for thyroid nodular disease (TND) were included from three tertiary surgical departments. Data were collected from a national thyroid surgery database (THYKIR) and from patient charts. Individuals with overtly coexisting thyroid disorders were excluded for subgroup analyses. Patients were compared with the Danish background population, employing previous data from DanThyr, a study initiated to monitor the iodine fortification program in Denmark.

RESULTS: Nine-hundred ninety-eight patients [cases/controls: 265/733; female/male: 794/204; age (mean ± SD): 51 ± 15 years] were included. S-TSH was significantly higher in the DTC group [median (IQR): 1.3 (0.9-1.9 mIU/L)] compared with the benign TND group [0.9 (0.6-1.5 mIU/L)] (p < 0.0001). The median s-TSH in the background population was similar to that found among DTC patients (p = 1.00), but markedly higher than the s-TSH level in the benign TND group (p < 0.0001). There was no association between s-TSH and DTC disease stage (p = 0.08-0.87).

CONCLUSIONS: s-TSH was significantly higher in patients with DTC than in those with benign TND. However, this difference can be explained by abnormally lower s-TSH level in the latter group, probably caused by subtle nodular functional autonomy. Due to the huge overlap and the small difference in median s-TSH between patients with benign and malignant TND, s-TSH is not suitable as a biomarker of DTC in a clinical setting.

Original languageEnglish
Issue number2
Pages (from-to)308–316
Publication statusPublished - Aug 2018


  • Diagnosis
  • Prognosis
  • Thyroid carcinoma
  • Thyroid nodules
  • TSH
  • Geography
  • Residence Characteristics
  • Humans
  • Middle Aged
  • Risk Factors
  • Carcinoma/blood
  • Male
  • Thyrotropin/blood
  • Case-Control Studies
  • Iodine/deficiency
  • Denmark/epidemiology
  • Thyroid Neoplasms/blood
  • Adult
  • Biomarkers/blood
  • Female
  • Aged


Dive into the research topics of 'Is serum TSH a biomarker of thyroid carcinoma in patients residing in a mildly iodine-deficient area?'. Together they form a unique fingerprint.

Cite this