Results
The median age of the cohort was 47 years (range 17-87y). Of the patients, 20 were male and 42 female, approximately the 1:2 ratio typical of DTC populations in Scotland (2). Only one patient (2%) died and one patient (2%) did not undergo surgery but was managed with palliative radiotherapy.
Of the 62 non-incidental patients, 47 (76%) had papillary carcinoma, 12 (19%) had follicular carcinoma, two (3%) had foci of anaplastic carcinoma and one (2%) had areas of both papillary and follicular carcinoma.
In terms of waiting times for diagnosis and management, there was no significant difference between patients referred by General Practitioners (GP) on the ‘urgent suspicion of cancer’ pathway (median 114d and 111d) and those referred routinely (median 135d (P=0.39)) and 133d (p=0.26)), or under the urgent, non-cancer referral pathway (median 133d (p=0.37) and 181d (P=0.27)) (Table 1). Despite this, there was a trend for more rapid management of urgent referrals.
All patients underwent pre-treatment fine needle aspiration or core needle biopsy. Within the cohort, patients were grouped according to whether they had a suspicious (Thy4) or diagnostic FNA (Thy5) [Group 1] (35 patients, 56%), or a non-diagnostic (Thy1), benign (Thy2) or indeterminate (Thy3a/Thy3f) FNA [Group 2] (27 patients, 44%).
Patients in Group 1 were diagnosed more expeditiously than those in Group 2 (129d (1-463) vs 204d (65-777), p<0.0005). The time from referral to treatment of the patients in Group 1 (127d (47-442)) was also quicker than that of the patients in Group 2 (182d (54-754), p=0.022).
Within these groups, there were significant (p=<0.0005) differences in tumour characteristics (Table 3). Most notably, there was an increased proportion of papillary cancers, N1 and M1 disease in Group 2 compared with Group 1 (Table 2). There was no significant difference in age between the 2 cohorts (p=0.31).
With a median follow up of 33 months, only one patient has died to date.