Clinical and Genetic Studies in Familial Non-medullary Thyroid Cancer
Clinical and Genetic Studies in Familial Non-medullary Thyroid Cancer
Background:

 - Researchers are studying types of thyroid cancer that seem to cluster in families.
 Non-medullary thyroid cancer accounts for the vast majority of all types of thyroid cancer,
 but little is known about possible genes that may cause the cancer. More research is needed
 to develop the best ways to screen for familial non-medullary thyroid cancer (FNMTC) so that
 it can be diagnosed and treated at an early stage.

 Objectives:

 -  To evaluate the natural history of FNMTC.

 -  To determine the best screening strategy for FNMTC.

 -  To identify genes that may indicate susceptibility to FNMTC.

 Eligibility:

 - Individuals at least 7 years of age who have two first-degree relatives (e.g., parents,
 children, siblings) who have or have had non-medullary thyroid cancer or a documented
 diagnosis of non-medullary thyroid cancer and one living relative with documented
 non-medullary thyroid cancer.

 Design:

 -  Participants will be evaluated by family history pedigree, physical examination, imaging
 (including possible neck ultrasound and radioactive iodine scans), and laboratory
 testing.

 -  Participants who agree to have blood or other biological samples collected will be asked
 to enroll in an additional study to provide the appropriate samples and tissues.

 -  After the initial study evaluation, participants who are not found to have a malignant
 thyroid tumor will be re-screened every year with non-invasive imaging studies.
 Participants who are found to have a malignant thyroid tumor will be informed of
 possible treatment options.
Background:

 -  Thyroid cancer is one of the fastest growing cancer diagnoses in the United States.

 -  Non-medullary thyroid cancer accounts for 95% of all thyroid cancer cases.

 -  Up to 8% of all non-medullary thyroid cancers are hereditary.

 -  Familial non-medullary thyroid cancer (FNMTC) is more aggressive than sporadic disease.

 -  No susceptibility gene for FNMTC has been identified.

 -  The best approach for screening at risk family members for FNMTC is unknown.

 -  This protocol is designed to determine the natural history and best screening strategy
 for FNMTC, and to identify susceptibility gene(s) for FNMTC.

 Objectives:

 -  To evaluate the natural history of FNMTC.

 -  To determine the best screening strategy for FNMTC.

 -  To identify susceptibility gene(s) for FNMTC.

 Eligibility:

 - An individual with 2 first-degree relatives who have or have had non-medullary thyroid
 cancer or a documented diagnosis of non-medullary thyroid cancer and one living relative with
 documented non-medullary thyroid cancer (Note: as this is a familial study, subjects do not
 need to present with the disease)

 Or

 Any member of an affected family.

 -  Age greater than 7 years

 -  Adults must be able to understand and sign the informed consent document

 -  Adults must be able to complete the family history questionnaire

 Design:

 -  Prospective observational study.

 -  Demographic, clinical and pathologic data will be collected from the medical record and
 patient interview for each patient participant and family members. Data will be securely
 stored in a computerized database. When possible, pathology slides and blocks will be
 obtained from all cases in the family for verification of diagnoses.

 -  Patients will be evaluated by family history pedigree, physical examination, imaging,
 and laboratory testing as indicated.

 -  Biospecimens, including peripheral blood or buccal cell samples as well as thyroid
 tissue (normal and affected by cancer), if participants have thyroidectomy, and thyroid
 cancer metastases tissue if patients undergo surgical removal of thyroid cancer
 metastases, will be collected for molecular analysis.

 -  After their initial on-study evaluation, patients who are not found to have a malignant
 thyroid tumor will be re-screened every year with non-invasive imaging studies.

 -  Treatment of patients with a thyroid neoplasm will be performed based on established
 clinical guidelines.

 -  Projected accrual will be 20 patients per year for a total of 15 years. Thus, we
 anticipate accruing 300 patients on this protocol.
-  INCLUSION CRITERIA:

 1. An individual with 2 first-degree relatives who have or have had non-medullary
 thyroid cancer or a documented diagnosis of non-medullary thyroid cancer and one
 living relative with documented non-medullary thyroid cancer. (Note: as this is a
 familial study, subjects do not need to present with the disease.)

 OR

 Any member of an affected family. (Note: for this study, an affected family is
 defined as a family having 2 or more 1st degree relatives with a documented
 diagnosis of FNMTC.)

 2. Age greater than 7 years.

 Note: at least one parent must provide consent for pediatric patients; patients
 will be re-consented once they reach 18 years of age.

 3. Adults must be able to understand and sign the informed consent document.

 4. Adults must be able to complete the family history questionnaire.