Pattern of Thyroid Cancer and its Associated Factors among Thyroid Patients Underwent Thyroidectomy at Jimma Medical Center, Southwest Ethiopia; A Four Years Retrospective Review

Abstract

Background: Thyroid cancer is the most common malignant disease of endocrine system and its incidence is rapidly increasing globally (about three to four times higher among females and accounts the sixth most common malignancy diagnosed in women). Among the four major types of thyroid cancer, papillary thyroid cancer (PTC) accounts 85-90% from all thyroid cases, followed by follicular thyroid cancer (FTC) which accounts for 5-10% of cases. Objective: The present study aimed to assess the pathologic patterns of thyroid disease at Jimma medical center (JMC). Materials and Methods: A retrospective data of 260 patients who underwent thyroid surgery from 2015 to 2019 were included in the study and the status of the disease (clinical manifestations, laboratory/pathology findings (thyroid function tests (TFTs) and biopsy) were reviewed from patient cards. The pattern of thyroid cancer was discriminated based on histo-pathological biopsy results. Descriptive and analytical statistics were applied to express the finding and reported by tables, figures and narration. Cross tabulation and logistic regression was applied to determine the association between thyroid CA and its predictors. A p-value of <0.05 was declared as statistically significant. Results: From the total sample of 260 patients underwent thyroid surgery, majority of them were females 219(84.2%), belong to age interval of 31-40 years (34.6%), dwellers of Oromia region (91.2%) and Jimma zone (83.8%). Colloid goiter was the most prevalent pattern of thyroid disease (74.6%) followed by follicular CA (4.2%), papillary CA (1.9%) and medullary CA (0.77%) while biopsy results of 48(18.46%) patients were not known. In general, about 194(91.5%) of the thyroid lesion was identified as benign type and malignancy accounts for 18(8.5%) from the total conducted biopsy results of 212 patients. Five variables (marital status, family history of the disease, nodularity, surface and border of the thyroid mass) were the predictors of thyroid malignancy in univariate and finally, two variables (thyroid tissue with surface (rough) and border (irregular)) were identified as the predictors of thyroid malignancy in multivariate [1.9(95%CI; 1.17 to 5.8) P=0.012 and 2.5(95%CI; 1.13 to 16.16) P<0.001] respectively. Conclusion and Recommendation: The burden of malignancy was higher and alarming among thyroid diseases and warrants early screening and management.