Thyroid malignancy among patients with thyroid nodules in the united arab emirates: A five-year retrospective tertiary centre analysis

Abstract

Objectives: Thyroid malignancy constitutes the sixth common cancer type in the United Arab Emirates (UAE). There are no epidemiological data outlining the prevalence of cancer in thyroid nodules, nor previous analysis of ultra-sonographic features correlating with thyroid malignancy in the UAE. This study aimed to estimate the prevalence of thyroid malignancy in patients with thyroid nodules and to describe the ultra-sonographic characteristics of thyroid nodules harbouring malignancy. Methods: A retrospective electronic medical records review of all thyroid nodules in patients (aged 18 to 80 years) with normal thyroid-stimulating hormone (TSH) levels, who underwent ultrasound guided fine needle aspiration cytology (UG-FNA) at Sheikh Khalifa Medical City (SKMC) during 2011-2015. Results: 436 patients with normal TSH underwent UG-FNA cytological examination of thyroid nodules (n = 555 nodules). The overall crude prevalence of thyroid cancer among patients was 10.1% (95% CI 7.5-13.3). The ageadjusted prevalence of thyroid cancer among UAE nationals, Arabs, Far East Asians, and Caucasians were 9.6% (3.6-15.6), 10.0% (6.2-13.8), 16.8% (4.5-29.0) and 16.3% (1.7-30.9), respectively. The crude prevalence was 14.5%(95% CI 6. 2-22.8) in men, and 9.3%(95% CI 6.3-12.2) in women. The echogenicity features were significantly different between the cancerous and noncancerous nodules (p = 0.025). Cancerous nodules were relatively more hyper-and hypo-echoic, while noncancerous nodules were mostly complex. Conclusion: We report a higher prevalence of thyroid malignancy among patients with thyroid nodules relative to that reported in other parts of the world. The rate of thyroid malignancy was higher in patients of Far-East Asian and Caucasian ethnic background.

Thyroid nodules in the gulf: Renewed interest and ongoing debate

“…The accumulated prevalence of thyroid cancer among thyroid nodules has varied from 5% to 14% with peculiar peak incidence occurring before the age of 45 years was observed by several groups. [2][3][4] The average age in this study was 41, and the median age was 40 years making it a decade earlier than what is seen in the USA and Western countries in general. However, the most commonly encountered type of thyroid cancer remains papillary, followed by follicular thyroid cancer with a female-to-male ratio, swirling around a ratio of 4.9:1.…”

“…Imperial College London Diabetes Center,3 National Reference Laboratory,4 Cleveland Clinic Abu Dhabi,5 Department of Pathology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, 2 Department of Medicine,…”

Estimation of Serum Thyroid Stimulating Hormone and Anti-Thyroid Antibodies as Biomarkers of Malignancy in Thyroid Nodule Patients

“…FNAC specimen are read by an experienced cytopathologist and be reported according to The Bethesda System for Reporting Thyroid Cytology (TBSRTC) with six diagnostic categories 14 . Diagnostic Surgery is indicated for FNAC findings of indeterminate cytology (Bethesda category III) or suspicious for differentiated thyroid carcinoma (Bethesda category IV/V) 16 . Clinicians have been looking for diagnostic biomarkers to predict the risk of carcinoma in patients with indeterminate cytology or suspicion of malignancy on FNAC to avoid unnecessary diagnostic surgeries.…”