Endocrine Abstracts

Introduction: The incidence of thyroid cancer in women, especially in reproductive age seems to be significantly increasing in Georgia and generally, worldwide. Thyroid cancer is the third most common cancer after breast cancer and uterine cervical cancer, among women aged 25 to 45 years. Multiple epidemiological studies have shown, that the prevalence of thyroid cancer is higher in women in the reproductive age (18-49), which could be explained by reproductive and menstrual factors. Aim of presented study was to determine characteristics and incidence of papillary thyroid cancer (PTC) in Georgian reproductive aged females

Methods: Women aged 18–49 years (n =3643) diagnosed with PTC in 2015–2022 were identified from Georgian national Registry Database. For each age group (14-25, 26–35, 36-49) results were stratified by cancer stage, location, ethnicity. Age-adjusted average annual percentage changes in incidence have been estimated based on 5-year survival.

Results: In the 18-49 age group, from 2015 to 2019 incidence had been increasing, whereas 2020-2022 it had been mildly decreasing. In the particular period (2015-2022) 65.5 % of total cases was stage 1, 15.2 % - stage 2, 11.3 % stage 3, 7% stage 4. (other 2 % unidentified). 97.5 % of all cases was malignant, other 2 % was described as precancerous invasion. Incidence was lowest in 14-25, and highest in 36-49 age group. Highest incidence occurred in Tbilisi, the capital from 2015-2019 and in 2020-2022, which could be explained with high screening facilities. High incidence rates was seen in high-mountainous regions (like Svaneti), Regarding ethnicity, in 2015-2019 incidence of ethnical minorities (Russians, Azers, armenians etc) was almost 4 times higher compared to ethnically Georgians, whereas later, from 2019, incidence in ethnically Georgian women has been almost 3.5 fold higher. A-5 year survival was equally high- 95% and 94 %, respectively in stage 1 and stage 2, in both 2015-2019 and 2020-2022 years, stage 3 was insignificantly low 93% and 94.5% respectively, in 2015-2019 and 2022 years.

Discussion: Due to very high survival and other clinical characteristics, PTC seems to be not quite ‘malignant’ disease, however reasons of high incidence, especially in reproductive aged females needs to be investigated properly and possible preventive methods should be well determined. In this particular study, Incidence rate changes from 2015-2019 to 2020-2022 and differences in regions could also be explained with lack/ inability of screening on time because of social isolation in Covid19 pandemic period.