Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
A Thyroid Cancer Registry containing data of patients treated at our department during a 20-year period (1980-1999) has been established. The aim of the study was to analyze the possible effects of the 1990-1995 war in Croatia on the prevalence, type, and age and sex distribution of thyroid carcinoma. Three different 2-year periods were analyzed: distant prewar (1980-1981), immediate prewar (1989-1990) and postwar (1998-1999) period. There was no statistically significant difference in age at diagnosis and sex ratio among the three study periods. The incidence of follicular cancer was at the upper limit for countries with normal iodine uptake when the 20-year period was analyzed, however, in the 1980-1981 period follicular cancer accounted for 34.9%, and in 1998-99 for only 2.8% of all cases. Papillary cancer was diagnosed in less advanced stages than others. Five-year survival for papillary, follicular and anaplastic cancer was 100%, 100% and 0%, respectively. Analysis of the 2-year periods for all cancer types except anaplastic cancer showed the mean age at onset to be on a decrease. In the 1998-1999 period, papillary cancer was diagnosed in a more advanced stage. The number of follicular cancer cases decreased from 22 in 1980-1981 to 3 in 19891990 and 2 in 1998-1999. Analysis of the epidemiology of thyroid cancer in the pre- and post-Chernobyl period did not reveal any increase in the number of papillary cancer in younger patients. It was concluded that in the postwar period, patients presented in more advanced stages of the disease. However, the effects of war on the epidemiology of thyroid carcinoma and other malignant tumors should be further investigated.Na našoj Klinici uspostavljeni Registar raka štitne žlijezde sadrži podatke o svim bolesnicima obrađenim u Klinici u 20godišnjem razdoblju (1980.-1999.). Cilj ovoga istraživanja bio je utvrditi moguće učinke rata u Hrvatskoj na učestalost, histološki tip te spolnu i dobnu raspodjelu bolesnika sa zloćudnim tumorom štitne žlijezde. Analizom su obuhvaćena 3dvogodišnja razdoblja uključujući vrijeme znatno prije rata (1980.-1981.), neposredno prije rata (1989.-1990.) i nakon rata(1998.-1999.). Nije utvrđena statistički značajna razlika u starosti i spolnoj raspodjeli tumora između tri navedena razdoblja.
Učestalost folikularnog raka bila je na gornjoj granici učestalosti za zemlje bez gušavosti, s tim da je u razdoblju 1980.-1981. bilo ukupno 34,9%, a u razdoblju 1998.-1999. samo 2,8% folikularnog karcinoma. Petogodišnje preživljenje bilo je 100%, 100% odnosno 0% za papilarni, folikularni i anaplastični rak. U uspoređivanim razdobljima prosječna starost bolesnika se snižavala, ali se rak dijagnosticirao u sve uznapredovalijem stadiju. Analiza populacije prije i nakon Černobila nije pokazala povećan broj mladih bolesnika s papilarnim karcinomom. Na temelju rezultata ovoga istraživanja zaključeno je da nije bilo povećanja učestalosti karcinoma štitnjače u poratnom razdoblju, međutim, bolesnici su se javljali s uznapredovalijim stadijima tumora.
Ovaj i moguće druge učinke rata na karcinom štitnjače, kao i na druge zloćudne tumore, valja dalje istraživati
