Prevalence and Histological Subtypes of Thyroid Cancer in the Aljouf Region, Saudi Arabia

Background: Thyroid cancer, the most common endocrine neoplasm, has a strong female predominance. There has been a
steady increase in the incidence of thyroid cancer worldwide. This study aimed to investigate the prevalence of thyroid cancer and
identify its predominant histological subtypes in the Aljuf region of Saudi Arabia. The study findings and new data obtained will
contribute to advancing knowledge about thyroid cancer at the national level.
Methods and Results: This retrospective, cross-sectional descriptive study was conducted in Sakaka, Aljouf region, Saudi
Arabia. Data from thyroid specimens collected at King Abdul-Aziz Specialist Hospital and Prince Mutaib Hospital between January
and December 2022 was analyzed. Among 3102 histopathological samples and 298 cytology samples received in both hospitals,
181 were thyroid specimens: histopathology samples [63(34.8%)] and fine-needle aspiration (FNA) samples for cytological
diagnosis [118(65.2%)]. The age of patients with thyroid disorders ranged from 17 to 69, with a mean age of 38.4±(SD)1.2 years.
The highest percentage, 76(42%), were in the age group over 40. The majority of patients with thyroid disorders, 139(76.8%),
were women compared to 42(23.2%) men, giving a female-to-male ratio of 3.3: 1. 165(91.2%) of the study population were Saudi
patients, while the non-Saudis represented only 16(8.8%) cases.
Among 181 thyroid specimens, thyroid cancer was diagnosed in 33 patients (18.2%), benign tumors in 43 patients (23.8%)
[follicular adenoma 39(90.7%) and Hürthle cell adenoma 4(9.3%)], goiter in 96(53.0%) cases, Hashimoto’s thyroiditis in 6(3.3%)
cases, and chronic lymphocytic thyroiditis in 3(1.7%) cases. The age of patients with thyroid cancer ranged from 20 to 57 years,
with a mean age of 36.9 years. There were 25(75.8%) females versus 8(24.2%) males, with a ratio of 3.1:1. Papillary thyroid
carcinoma was the most frequent histological subtype among patients with thyroid cancer, accounting for 75.8%, while follicular
thyroid carcinoma represented only 24.2%. Among 155 cancer cases, thyroid cancer ranked third (21.3%) after breast cancer
(26.4%) and colon adenocarcinoma (23.9%).
Conclusion: Thyroid pathology, including cancer, is notably prevalent among females and older age groups in the Al-Jouf
region. Thyroid carcinoma is the third most diagnosed cancer type after breast carcinoma and colon adenocarcinoma in Al
Jouf in 2022. Papillary thyroid carcinoma is the most frequent histological subtype among Saudi patients with thyroid cancer.