{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:02:24Z","timestamp":1789984944409,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Goiter is a common condition in the northwest regions of Pakistan, with multinodular goiter (MNG) being a frequent presentation of thyroid diseases. Multinodular goiter (MNG) is common worldwide, with variable reported risks of malignancy. Data from South Asia, particularly Pakistan, remains limited and somewhat outdated. This study highlights important expectations regarding suspicion of malignancy and emphasizes the prevalence of different types of malignancies in MNG patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cross\u2010sectional study was conducted with data collected from patient records who underwent thyroidectomy in the Department of Surgery from June 2019 to April 2024 in Karachi, Pakistan. A total of 520 patients aged 30\u201370 years undergoing total thyroidectomy for clinically and radiologically diagnosed MNG were included. Suspicious nodules were identified preoperatively by ultrasound and\/or FNAC (Bethesda V\u2013VI). Histopathology confirmed carcinoma. Patients with recurrent goiter, solitary nodules, thyroid crisis, pre\u2010existing malignancy, or significant comorbidities were excluded. Descriptive statistics, Chi\u2010square testing, and multivariate logistic regression were applied using SPSS version 25, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2010values below 0.05 considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 520 patients with MNG were included, of whom 84 (16%) had thyroid carcinoma. The mean age of carcinoma patients was 49.2\u2009\u00b1\u20099.4 years, and 76.9% were female. Histological subtypes included papillary carcinoma (64.2%), follicular carcinoma (23.8%), and anaplastic carcinoma (11.9%). In multivariate analysis, smoking (OR 2.41, 95% CI 1.08\u20135.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and urban residence (OR 1.89, 95% CI 1.03\u20133.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) were independent predictors of papillary carcinoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thyroid carcinoma was present in 16% of MNG cases, predominantly papillary type. Smoking and urban residence emerged as significant risk factors for papillary thyroid carcinoma. Preoperative ultrasound and FNAC remain critical for risk stratification. Larger multicenter studies with molecular profiling are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72652","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:24:32Z","timestamp":1781155472000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency of Thyroid Cancer in Multinodular Goiter Undergoing Thyroidectomy in Tertiary Care Centre in Pakistan: A Cross\u2010Sectional Analysis"],"prefix":"10.1002","volume":"9","author":[{"given":"Hasan","family":"Ahmed","sequence":"first","affiliation":[{"name":"Sindh Government Hospital New Karachi Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hira","family":"Moosa","sequence":"additional","affiliation":[{"name":"Department of Surgery Jinnah Postgraduate Medical Centre Rafiqui Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Hafiz","family":"Yusuf","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Ziauddin University Hospital  Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleena","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rameez","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afnan W. M.","family":"Jobran","sequence":"additional","affiliation":[{"name":"Department of Medicine Al\u2010Quds University Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8665-4288","authenticated-orcid":false,"given":"Syed Ali","family":"Arsal","sequence":"additional","affiliation":[{"name":"Shaheed Mohtarma Benazir Bhutto Medical College Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8275-5713","authenticated-orcid":false,"given":"Inibehe Ime","family":"Okon","sequence":"additional","affiliation":[{"name":"Department of Research Medical Research Circle (MedReC) Bukavu DR Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazhar","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Surgery Jinnah Postgraduate Medical Centre Rafiqui Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Aniq","family":"Amir","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arbaz","family":"Zaman","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakina","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Tauseef","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2008.09.019"},{"issue":"2","key":"e_1_2_15_3_1","article-title":"Epidemiology of Thyroid Cancer: A Review of the National Cancer Database, 2000\u20132013","volume":"11","author":"Olson E.","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.18.2164"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.110"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/965212"},{"issue":"1","key":"e_1_2_15_8_1","first-page":"1","article-title":"Incedience of Occult Carcinoma in Multinodular Goiter Using Histopathological Findings","volume":"17","author":"Pedamallu R.","year":"2008","journal-title":"Internet Journal of Surgery"},{"issue":"4","key":"e_1_2_15_9_1","first-page":"134","article-title":"Prevalence of Malignancy in Goitre\u2010A Review of 718 Thyroidectomies","volume":"21","author":"ul Haq R. N.","year":"2009","journal-title":"Journal of Ayub Medical College, Abbottabad: JAMC"},{"issue":"4","key":"e_1_2_15_10_1","article-title":"Frequency and Type of Thyroid Carcinoma in Patients With Multinodular Goiter","volume":"15","author":"Amin A.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_15_11_1","first-page":"457","article-title":"Thyroid Cancer in Multinodular Goiter: An Analysis of Prevalence and Associated Risk Factors","volume":"8","author":"Rahman M.","year":"2025","journal-title":"Fortune Journal of Health Sciences"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jmms12010036"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.955358"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-017-1170-6"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(00)00731-6"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.29309\/TPMJ\/2013.20.06.1784"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/SR9.0000000000000035"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.18203\/2320-6012.ijrms20161807"},{"key":"e_1_2_15_19_1","first-page":"f4706","article-title":"Thyroid Cancer: Zealous Imaging Has Increased Detection and Treatment of Low Risk Tumours","volume":"347","author":"Brito J. P.","year":"2013","journal-title":"BMJ (London)"},{"issue":"6","key":"e_1_2_15_20_1","first-page":"131","article-title":"Morphological Pattern and Frequency of Thyroid Tumors","volume":"49","author":"Shah S. H.","year":"1999","journal-title":"JPMA. The Journal of the Pakistan Medical Association"},{"key":"e_1_2_15_21_1","article-title":"Morphological Pattern and Frequency of Thyroid Tumors","author":"Soomro I.","year":"1999","journal-title":"JPMA. The Journal of the Pakistan Medical Association"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0602"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-11-0360"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/030089169708300305"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.3329\/jdmc.v27i2.45829"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zraa014"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.7314\/APJCP.2014.15.14.5565"},{"key":"e_1_2_15_28_1","unstructured":"R.Lloyd R.Osamura andJ.RosaiWHO Classification of Tumours Editorial Board: Endocrine and Neuroendocrine Tumours. International Agency for Research on Cancer Lyon France 2022."}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72652","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.72652","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72652","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:18:41Z","timestamp":1789982321000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.72652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/hsr2.72652"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.72652","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72652"}}