Objective: The incidence of thyroid cancer has rapidly increased in the United States (US) and other developed countries over the past 30 years but there was no study to find out the true incidence of thyroid cancer in Bangladesh.The aim of this study is to compare FNAC with histopathology reports , to find out the true incidence of thyroid malignancy in thyroidectomy patients presenting with thyroid swelling and to know is it increasing and if so what is the reason of it?
Methods: This is a retrospective study of 140, 200, and 300 thyroidectomy patients underwent thyroid surgery done at Matin Specialised Hospital, Bogura, Shaheed Suhrawardy Medical College Hospital, a tertiary Care Hospital in Dhaka and Bangladesh ENT Hospital Dhaka from January 2016 to April 2022. FNAC and histopathology reports were studied to find out the incidence of benign and thyroid malignancy among the thyroid swelling.
Results: The age of the patients ranged from 6 to 75 years. The mean age was 37.2 -38.85years. All these 3 studies showed more female with female male ratio 3.54:1 to 3.76:1 . Histopathology of the first 140 thyroidectomy patients (Jan 2016 to July 2019 done at Matin Hospital) showed 67% benign and 33% malignant lesions. Second study of 200 thyroidectomy patients( July 2017 to December 2020 at Shaheed Suhrawardy Medical College hospital) also showed similar result with benign and malignant ratio of 2:1 . 3rd study of 300 thyroidectomy patients (from Jan 2021 to April 2022 at Shaheed Suhrawardy Medical college and Bangladesh ENT hospital) showed increased number of cancer patients with benign malignant ratio of 1.5:1. Benign lesions is mostly colloid goiter in all these studies and malignant lesions is mosly papillary carcinoma(>90%).
Conclusion: Why there is drastic increase of thyroid cancer in most recent years we still do not know but our study population are mostly from endemic zone, patients are more conscious, easy availability of diagnostic facilities may be the reason. We recommend surgery for any thyroid swelling even it is benign on FNAC .