Trends in symptomatology of thyroid malignancy in southern India and the efficacy of targeted fine needle aspiration cytology with ultrasonography guidance in diagnosis

Abstract

Background: Thyroid cancers are on the rise all over the world. Studies have shown a tripling incidence of thyroid cancer in the United States in the past 35 years. Similar studies from Korea have also shown similar trends of 15 times increase in incidence. This study aims at assessing the recent trends in clinical presentation of thyroid malignancy and the efficacy of ultrasound targeted fine needle aspiration cytology (FNAC) in the diagnosis of thyroid malignancy.Methods: A cross sectional study was conducted involving 275 patients with thyroid disorders treated in the department of General Surgery at Dr. Somervell Memorial CSI Medical College, Trivandrum, India. Chi-square test was done for statistical test of significance and odds ratio for strength of association.Results: In this study group, 89% of the patients presented with swelling in front of the neck as chief complaint both in benign and malignancy. Swelling in front of the neck is the predominant symptom in thyroid malignancy. 52% of patients presented with the described symptoms of more than 6 months duration. The specificity of USG guided FNAC is 90% in diagnosing malignancy in goitre in this study group.Conclusions: The commonest symptom of thyroid malignancy was a painless swelling in the front of the neck. Most common thyroid pathology presenting as thyroid swelling was multinodular goitre. Nearly half of the patients presenting with symptoms more than 6 months had thyroid malignancy. FNAC under ultrasound guidance is an inexpensive accurate and practical investigation for evaluation of thyroid carcinomas.