Endocrine Abstracts

Background

In Liguria, a region of north-western Italy, the Albanian population is currently estimated to be around 20 000, constituting 15% of foreign citizens living in this area; approximately 50% of these Albanians reside in the Genoa district.

Methods

We retrospectively reviewed the medical records of all the outpatients of the Endocrine Unit of San Martino Polyclinic Hospital from 2002 to 2019. Data on subjects born in Albania and now living in the Genoa district were extracted and compared with that reported in a database registered in the same period in the district of Tirana, Albania. The International Classification of Diseases – 9th revision – Clinical Modification (ICDM-9) was used for diagnosis classification. The management of differentiated thyroid cancer (DTC) was also evaluated. The 8th edition of the AJCC was used for DTC staging.

Results

We identified 48 Albanian patients affected by benign thyroid pathology. Our data were compared with those recorded in 2915 people living in the Tirana district. Similar F/M ratios were found in both districts (Genoa: 5:1 and Tirana: 4:1). Excluding cases of congenital hypothyroidism, the median age at the time of first examination was the same (41 years). No statistically significant differences in the incidence of simple and unspecified goitre, thyrotoxicosis with or without goitre, or other thyroid disorders were found between the Genoa and Tirana districts. Non-toxic nodular goitres were less frequently diagnosed in Genoa (29%) than in Tirana (64%, P<0.0001), while acquired hypothyroidism and thyroiditis were more often recorded in Genoa (29% and 19%, respectively) than in Tirana (3%, P<0.0001; 4% P = 0.0003). From 2002 to 2019, 401 DTC patients were followed up at our centre; 8% were not Italian and 19% of non-Italians were Albanian (n = 6; stage 1–2). The median age of the Albanians on diagnosis (59 years) was similar to that of the Italians (53 years). Structural disease was observed in 2 Albanian DTC patients, in whom initial surgery had been performed in Tirana and further treatments were needed in Italy. The rate of loss to follow-up was similar in Albanian subjects (19%) and in other patients (10%) of the DTC cohort. At present, all DTC Albanians in the Genoa district are alive.

Conclusion

A difference in nutritional iodine load and in facilities for laboratory evaluations could explain the significant differences observed in some ICDM-9 between Albanians living in Genoa and those living in Tirana. The diagnosis and surgical treatment of thyroid malignancy probably needs to be improved in Albania.