Epidemiology of Thyroid Cancer in a Low-to-Middle Income Country: A 10 Year Retrospective Cohort Study
Angel Velarde, Luis Alejandro González Barrios, Carlos Mauricio Zeron Parrales, Javier Figueroa, Vicky de Falla, Franky Reyes, Abraham Isaí Tábora Escobar, Paul Ernesto Álvarez Melgar, Milton Estuardo Ixquiac Cabrera, David Bartaman Estrada GarcíaPURPOSE
In Guatemala, thyroid cancer is ranked as the eight-cancer incidence in our population, and no assessment of the thyroid cancer patient population at LIGA-INCAN has been performed, therefore, to understand the demographics, treatment outcomes, and access to care, we sought to assess the treatment access compliance of patients with thyroid cancer at the only comprehensive LIGA-INCAN Cancer Institute.
METHODS
A secondary analysis was performed using thyroid cancer data base from the years 2013 to 2022. Descriptive analysis with Epi info7 was applied to the variables age, sex, ethnicity, type of treatment, diagnosis and tumor stage, therapy discontinuation, alcohol, tobacco, and family history of cancer.
RESULTS
From the 841 patients with thyroid cancer (ICD10-C73), there were 697 (82.88%) women and 144 (17.12%) men respectively, mean (SD) age was 50.5 (15) and 53 (15.6) for women and men respectively, 628 (74.67%) were of mestizo ethnicity, 125 (15%) came to LIGA-INCAN in advanced cancer stages III or IV, 83 (9%) discontinued therapy, 306 (36.32%) underwent surgery, surgery with radiotherapy 64 (7.6%), and 300 (35%) received other combinations of therapy, 76 (9%) reported tobacco used, 112 (13%) reported alcohol abuse and 126 (15%) reported family history of cancer (ICD10 most commons codes, C73, C539,C169). Of note, 451 (52.5%) have already started any type of treatment before coming to LIGA-INCAN and 92 (13.20%) of females received therapy for palliative purpose. The most common tumor morphologies were 322 (38.29%) papillary carcinoma and 324 (38.53%) papillary adenocarcinoma.
CONCLUSION
Given that thyroid cancer is more common in the underserved female population of Guatemala, there is need of timely effective creation of strategies for earlier detection at the community level with government health policies fully covering the health-related costs of multidisciplinary treatment for thyroid cancer, including efforts that can fruitfully fund the establishment of modern equipment for nuclear medicine therapy for thyroid cancer.