Abstract: Objective To investigate the impact of work and lifestyle factors on the malignant transformation of benign thyroid nodules in young and middle-aged patients. Methods Patients pathologically confirmed to have thyroid cancer via biopsy or surgery from January 2023 to December 2024 at the Suqian Hospital Affiliated to Xuzhou Medical University were selected as the case group. For the control group, thyroid nodule patients undergoing health check-ups at the hospital were selected at a 1∶3 ratio, matched by gender, age (±3 years), and nodule duration (±1 year). Questionnaires surveyed work and lifestyle factors, with univariate and multivariate analyses comparing the two groups. Results The study included 213 case group patients (41 males, 172 females, mean age 41.98±9.54 years, mean nodule duration 5.56±2.32 years) and 639 control group patients (123 males, 516 females, mean age 41.77±9.47 years, mean nodule duration 5.44±2.29 years). No significant differences were found in gender, age, or nodule duration between groups (χ²=0.005, 0.492; t=0.724; all P>0.05). Multivariate logistic regression identified BMI (overweight OR=2.015, obese OR=5.533), work stress (OR=1.454), daily sleep <6 h (OR=1.808), consumption of fried/grilled foods >5 times/month (OR=1.932), seafood/fish >5 times/month (OR=2.076), iodized salt use (OR=1.503), annual CT/X-ray exposure (OR=1.702), history of thyroid dysfunction (OR=3.681), and family history of thyroid cancer (OR=2.008) as significant risk factors (all P<0.05). Conclusions Malignant transformation of benign thyroid nodules in young and middle-aged patients is influenced by multiple factors. Risks increase with overweight/obesity, work stress, insufficient sleep, frequent consumption of fried/grilled and seafood/fish, iodized salt use, radiation exposure, thyroid dysfunction history, and family history of thyroid cancer. Interventions targeting these factors, such as lifestyle adjustments and reduced radiation exposure, may lower transformation risk.

Key words: Young and middle-aged, Thyroid nodules, Benign, Malignant transformation, Influence factors