• Yee Sian Tiong, Edwin Tong Yuen Hao, Chia Ching Lee, Rajeev Parameswaran, Timothy Cheo, Wei Li Cindy Ho, and Samantha Peiling Yang.
• Department of Endocrinology, National University Health System, Singapore.
• Ann Acad Med Singap. 2021 May 1; 50 (5): 402-410.

IntroductionChildhood radiation exposure is a known risk factor for thyroid malignancy and dysfunction. However, local data are limited and there is no consensus on the modality and frequency of screening in this high-risk group.MethodsRetrospective analysis study evaluating patients with childhood radiation exposure in 2006-2016 and minimum of 1-year follow-up.ResultsOf the 132 childhood cancer survivors in the study, thyroid malignancy was detected in 2 cases (1.5%) and thyroid nodules in 13 (9.8%). The earliest thyroid malignancy was detected 5 years post-radiotherapy via ultrasound. Of the 84 patients who had screening thyroid function test, 26 (31.0%) were detected with abnormal test results post-radiation, majority being subclinical hypothyroidism.ConclusionRegular screening via clinical examination for thyroid nodules should be performed at least annually. Where feasible and if resources permit, consideration should be given to using ultrasound for thyroid nodule(s) and malignancy screening at 5 years post-radiation therapy. Screening for thyroid dysfunction can be considered from 6-12 months post-radiotherapy.

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