[Prevalence of thyroid cancer in Réunion from scintigraphic data]

This work is a retrospective two years study of thyroid cancer, diagnosed in Reunion Island, using scintigraphic cold regions. Between April 1993 and April 1995, 1,364 thyroid scintigraphic studies were performed in the CHD F. Guyon at Saint Denis, Réunion). These studies resulted from all types of indication and of them 691 had cold regions, with 22 thyroid cancers among them, (i.e. a prevalence of 3.20% of cold areas). Analysis of these cancers allowed recognition of various characteristics. A large majority (82%) were in females, whose median age at the time of diagnosis was 49 years (as opposed to 48 years for the male patients). The associated cold zones were usually isolated cold nodules. Anatomical pathology investigation indicated six were papillary, five mixed, three vesicular nodule, four microcarcinoma, one each of anaplastic, one follicullar thyroid carcinoma, and two were metastases. Their geographical distribution was superposed on their medical demography. Treatment was surgical, but a variety of procedures was used. Generally the diagnostical, therapeutical and follow up procedures were not standardised. Needle cell biopsy was virtually excluded from the decision-making trees and a variety of protocols was used. In addition there are no local epidemiological data available concerning thyroid cancers. An improved method for dealing with these cancers appears to be essential for Reunion. It must be associated with a greater awareness from medical practitioners, agreement on procedures for diagnosis, treatment and follow up and the setting up of a register for thyroid cancer in the "Department". Some thought before detailed involvement should be given to the setting up of a team, trained in needle cell biopsy, and an associated metabolic radiotherapy facility, so allowing appropriate procedures and follow up for thyroid cancers in this "Department".