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Thyroid cancer pathology: Insights from a developing region.

W Conradie1, J Lübbe1, L Martin1

  • 1Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|December 11, 2025
PubMed
Summary

Thyroid cancer pathology differs between South Africa's public and private healthcare sectors. Papillary thyroid cancer (PTC) is more common in private facilities, while follicular thyroid cancer (FTC) is more prevalent in public ones.

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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.