TRENDS IN THYROID MALIGNANCIES IN ACCRA GHANA: A RETROSPECTIVE HISTOPATHOLOGICAL REVIEW IN THE DEPARTMENT OF PATHOLOGY (1994-2013), KORLE-BU TEACHING HOSPITAL

Background: Malignancies of the thyroid gland are common in certain parts of the world. In Ghana there are no available data on the trends and gender characteristics of thyroid malignancies (TMs). The aim of this retrospective study was to determine the trends and gender characteristics of TMs in the Department of Pathology. Keywords: Thyroid malignancies; Trends; Gender characteristics; Ghana Introduction Malignancies of the thyroid gland are relatively rare neoplasms worldwide, accounting for approximately 1-5% of all cancers in females and less than 2% in males [1]. Emerging evidence across the globe have shown an association between iodine intake and thyroid malignancies [2,3]. Ghana is among the world’s top six countries with iodine deficiency [4,5] and hence the introduction of the national iodization program in 1996 [6-9]. Similarly, ionizing radiation has historically been linked to thyroid cancer particularly papillary thyroid carcinoma [10,11]. There is no published data implicating the atomic nuclear reactor in Ghana, nor any published literature reports that workers of the two radiotherapy centres in Ghana have developed thyroid cancers due to exposure to radiations. Published data on thyroid cancers in Ghana, particularly the incidence and trends, are limited compared to other African countries [12]. The aim of this retrospective study was to determine the trends and gender characteristics of thyroid malignancies using data from the Department of Pathology, Korle-Bu Teaching Hospital (KBTH), Accra, Ghana. Material and Methods This was a retrospective review of all reported thyroid gland cases in the Department of Pathology of KBTH from January Material and methods: This was a retrospective review of all thyroid cases reported from January 1994 to December 2013. Data was analysed using SPSS software version 23.0 Chicago. Fisher’s exact test was used to compute association between variables. Results: Approximately 6.8% of all thyroid specimens received in our institution were malignant. There was a gradual decline in the relative proportions of TMs over the 20-year period of review. The commonest TM in this study was papillary thyroid carcinoma (PTC). The mean age of females diagnosed with TMs was 40.7 years (SD ±16.7), compared to 43.0 years (SD±15.5) for males. TMs were common in females younger than 40.0 years compared to their male counterparts (51.0% versus 42.0%; P=0.025). Systemic disease at diagnosis was common in males than females (8.7% versus 4.6%, P=0.042). The commonest TM diagnosed in females was PTC {90 (59.6%); P=0.004}, while in males it was follicular thyroid carcinoma (FTC) {30 (43.5%); P=0.094}. Conclusion: The current study found a decline in the relative proportions of TMs over the period of review. TMs were common in young females compared to their male counterparts. A significant number of the study population had metastatic disease at diagnosis.