Thyroid cancer pathology: Insights from a developing region

Area of Science:

• Oncology
• Public Health
• Pathology

Background:

• South Africa's healthcare system is dualistic, with distinct public and private providers.
• Previous studies show varied thyroid cancer incidence across South African provinces.
• Papillary thyroid cancer (PTC) is more common in urban areas than follicular thyroid cancer (FTC) or anaplastic thyroid carcinoma.

Purpose of the Study:

• To analyze geographic variations in thyroid cancer types.
• To compare thyroid cancer pathology between public and private healthcare providers in South Africa.

Main Methods:

• A retrospective study of thyroid cancer pathology data from South African laboratories (2015-2019).
• Data included patient demographics, specimen type, and histology results, requiring manual processing.
• Analysis was conducted overall, by province, and by facility type (public vs. private).

Main Results:

• Of 14,157 reports, 3,235 were thyroid cancers; the public sector accounted for 53.6% of cases.
• Follicular thyroid cancer (FTC) was significantly more prevalent in the public sector (20.8%) compared to the private sector (5.6%).
• Papillary thyroid cancer (PTC) was more common in the private sector (87.1%) than the public sector (55.2%). T3 tumors were most common in the public sector (52.3%), and T1 tumors in the private (38.8%).

Conclusions:

• South Africa's dual health system and population distribution influence thyroid cancer pathology.
• Standardized thyroid cancer reporting via a national registry is crucial for accurate evaluation and improved patient care.