Profiles Of Thyroid Cancer Reveal Significant Age- and Gender-Specificity in Papillary Carcinoma, Hereditary Medullary Types, and Mult-Nodularity Patterns in Males and Contraceptive Users

Background/Objectives: Effective thyroid-cancer care in Saudi Arabia demands local data on age-linked histology and nodule architecture—factors rarely studied beyond the worldwide dominance of papillary thyroid carcinoma (PTC). Methods: We retrospectively analysed 208-adult cases managed at King Salman Specialist Hospital, a Ha’il tertiary hospital (2022-2025). Extracted variables included age, sex, first-degree family history, smoking, obesity (BMI≥30 kg m⁻²), oral-contraceptive-pill (OCP) use, hypertension, diabetes, Hashimoto thyroiditis, nodule pattern (single vs multinodular) and final tumour subtype. Associations were tested with χ² or Fisher’s exact (α=0.05); effect size was expressed as odds ratios (ORs, 95% CI). Results: Patients were primarily female (70.2%) and aged 30–39 years (52.4%). Histology was dominated by papillary carcinoma (PTC, 87.5%), followed by follicular (8.2%), medullary (3.4%) and anaplastic (1.0%). Age strongly influenced subtype (χ²=30.7, p<0.001): PTC comprised 98.2% of tumours<40 years but only 72.5% were ≥50 years, where follicular and medullary cancers reached 27.5%. A positive family history markedly enriched for medullary carcinoma (11.4% vs 1.7%; χ²=8.95, p=0.030; OR=7.4). Smoking occurred exclusively in men (9.7% vs 0 %; χ²=14.5, p<0.001). Multinodularity was far more pronounced in males (43.5% vs 8.9%; χ²=33.6, p<0.001) and in women not using OCPs (32.7% vs 7.3%; χ²=21.5, p<0.001). Obesity, hypertension, and diabetes were correlated albeit no significant associations found in this study. Conclusions: Saudi thyroid cancer displays clear age-, sex- and heredity-linked heterogeneity patterns: non-PTC subtypes rise with age, medullary tumours cluster in families, multinodularity is predominantly male, and OCP exposure relates to single-nodule disease. These findings support age-stratified diagnostics, targeted RET proto-oncogene testing and consideration of hormonal influences in local management algorithms.