IntroductionCurrently in papillary thyroid cancer (PTC), the correlation between lymph node positivity (LN+) and patient’s age at diagnosis is still inconclusive. The aim of this study was to investigate whether younger PTC patients had higher LN+ rates.Patients and methodsFrom the 1998–2013 Surveillance, Epidemiology, and End Results database, we analyzed PTC patients with at least 1 LN examined. The patients were divided into 5 groups by age separately for each T stage: ≤30; 31–40; 41–50; 51–60; >60 years.ResultsA total of 46,077 PTC patients were identified, including 8,386 (18.2%) patients aged ≤30 years, 10,971 (23.8%) patients aged 31–40 years, 11,646 (25.3%) patients aged 41–50 years, 8,596 (18.7%) patients aged 51–60 years, and 6,478 (14.1%) patients aged >60 years. In each T stage, LN+ rates were inversely associated with age at diagnosis, which was validated by multivariate logistic regression analysis (p<0.001). In addition, the subset of patients 30 or younger had the highest lymph node ratio compared with other subsets (p<0.001).ConclusionWe identified that younger PTC patients have an increased predisposition for LN+ regardless of T stage. This finding could help surgeons to select the optimal treatment for younger PTC patients.