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Number stages for papillary and follicular thyroid cancer

The stage of a cancer tells you about its size and whether it has spread. Doctors use the number staging system and the TNM staging system.

The number staging system groups cancers into 4 groups, from stage 1 to 4. The higher the number the more the cancer has spread. The staging for papillary and follicular thyroid cancer are the same.

Papillary and follicular thyroid cancer are classified as differentiated thyroid cancers. Younger people with these cancers generally have a better outlook than older people. So the number staging system for papillary and follicular thyroid cancer is different for people under 55 years old compared to those over 55.

There are 2 number stages for people under 55 years old and 4 stages for people over 55 years old.

If you are under 55 years of age

Stage 1

Stage 1 means you have thyroid cancer which may or may not have spread to nearby lymph nodes Open a glossary item. The tumour can be any size but it hasn't spread to distant areas of the body.

In TNM staging, this is the same as any T, any N, M0.

Stage 2

Stage 2 means the cancer has spread to other parts of your body, such as distant lymph nodes, the lungs or bone. 

In TNM staging this is the same as any T, any N, M1.

If you are over 55 years of age

Stage 1

Stage 1 means the cancer is only inside the thyroid and is up to 4cm across. It hasn’t spread to the lymph nodes or other parts of the body.

In TNM staging, this is the same as T1 or T2, N0, M0.

Stage 2

Stage 2 means the cancer is either:

  • up to 4cm across and has spread to the nearby lymph nodes. In TNM staging this is the same as T1 or T2, N1, M0.

or

  • more than 4cm inside the thyroid or has started to grow outside the thyroid into surrounding muscle or nearby lymph nodes. In TNM staging this is the same as T3, any N, M0.

Stage 3

Stage 3 means the cancer has grown outside the thyroid into nearby soft tissue, such as the voice box (larynx), windpipe (trachea), food pipe (oesophagus) or the voice box nerve (recurrent laryngeal nerve). It might have spread to the nearby lymph nodes but not to other parts of the body.

In TNM staging this is the same as T4a, any N, M0.

Stage 4

Stage 4 is divided into 2 groups A and B.

Stage 4A

Stage 4A means the cancer has grown outside the thyroid into the area surrounding the bones of the spine or one of the main blood vessels. It might have spread to the nearby lymph nodes but not to other parts of the body.

In TNM staging this is the same as T4b, any N, M0.

Stage 4B

Stage 4B means the cancer has spread to another part of the body, such as the lungs.

In TNM staging this is the same as any T, any N, M1.

Treatment

The stage of your thyroid cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • your type of cancer (the type of cells the cancer started in)
  • where the cancer is
  • other health conditions that you have
Last reviewed: 
07 Apr 2021
Next review due: 
08 Apr 2024
  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up
    S Filetti and others
    Annals of Oncology, 2019. Volume 30. Pages 1856-1883

  • Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines
    AL Mitchell and others
    Journal of Laryngology and Otology, 2016. Volume 130, Supplement 2, Pages 150 to 160