Thyroid cancer pathology: Insights from a developing region

Authors

  • W Conradie Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa https://orcid.org/0000-0002-9220-331X
  • J Lübbe Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa https://orcid.org/0000-0001-8397-8685
  • L Martin Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa https://orcid.org/0000-0003-2887-647X
  • T Luvhengo Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa https://orcid.org/0000-0002-2901-1809
  • R Razack National Health Laboratory Service and Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa https://orcid.org/0000-0002-2981-4724
  • A Afrogheh National Health Laboratory Service and Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa https://orcid.org/0000-0001-5818-7945
  • F Crabbia PathCare, Cape Town, South Africa https://orcid.org/0009-0001-9743-730X
  • S Nayler Gritzman and Thatcher Inc. and Donald Gordon Medical Centre, Johannesburg, South Africa https://orcid.org/0000-0002-5041-7811
  • J Davies Ampath Laboratories, Cape Town, South Africa
  • K Baatjes Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa https://orcid.org/0000-0001-8432-8844

DOI:

https://doi.org/10.7196/SAMJ.2025.v115i9.2997

Keywords:

thyroid cancer, healthcare, south africa, thyroid, oncology, pathological types

Abstract

Background. The South African (SA) health sector and laboratories comprise a dual system that includes public and private providers. SA studies illustrate diverse thyroid cancer incidence across provinces, with papillary thyroid cancer (PTC) more prevalent in urban provinces than follicular thyroid cancer (FTC) and anaplastic thyroid carcinoma.

Objectives. To provide a deeper insight into the geographic intricacies of thyroid cancer types from public and private provider perspectives.

Methods. This study investigated thyroid cancer pathology in SA between 2015 and 2019, overall and by province and facility type (private, public). Laboratories provided data in different formats, requiring manual processing. The data extracted included date of birth, sex, province, specimen type and final histology results.

Results. A total of 14 157 reports were included, of which 3 235 were thyroid cancers. Multiple challenges were experienced in terms of data processing. The public sector contributed 53.6% of thyroid cancer cases. Preoperative cytology was performed in 19.8% of thyroid cancers, and was diagnostic in 23.6%. There was significantly more FTC in the public sector (20.8% v. 5.6%), and more PTC in the private sector (87.1% v. 55.2%). T3 tumours were most prevalent in the public sector (52.3%), and T1 tumours in the private (38.8%).

Conclusion. The dual SA health system and the geographical distribution of the population appear to influence the pathological landscape of thyroid cancer. Standardised thyroid cancer reporting across all public and private laboratories in the form of a prospective national thyroid registry would allow for a more accurate evaluation of thyroid disease, ultimately improving thyroid cancer care in SA.

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Published

2025-10-02

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Section

Research

How to Cite

1.
Conradie W, Martin L, Luvhengo T, Razack R, Afrogheh A, Crabbia F, et al. Thyroid cancer pathology: Insights from a developing region. S Afr Med J [Internet]. 2025 Oct. 2 [cited 2025 Oct. 7];115(9):e2997. Available from: https://samajournals.co.za/index.php/samj/article/view/2997