Aldharman Sarah S, Albalawi Danah M, Daghistani Ghadeer, Almutairi Meshari S, Alharbi Sarah A, Alreshidi Nahlah F
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
College of Medicine, University of Tabuk, Tabuk, SAU.
Cureus. 2023 Feb 16;15(2):e35043. doi: 10.7759/cureus.35043. eCollection 2023 Feb.
Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. Papillary thyroid microcarcinoma (PTMC) is a specific subgroup of PTC. Given their small size, PTMCs are often asymptomatic and behave benignly. This puts physicians in a challenging situation about how to prevent overdiagnosis and overtreatment of PTMC. This study aimed to assess the preferences regarding the route of PTMC diagnosis and treatment among Saudi Arabia's general population.
This is a cross-sectional questionnaire-based-study conducted among the general population in Saudi Arabia. The target subjects were the general population of Saudi Arabia both genders and different age groups from various regions of Saudi Arabia (Western, Central, Eastern, Southern, and North). Participants who did not complete the questionnaire or did not agree to participate were excluded. A self-administered questionnaire was distributed on different social media platforms to collect data from different regions. Data analysis was conducted by using Statistical Package for the Social Sciences (SPSS) 24.0 version (IBM Inc., Chicago, USA) statistical software. A Chi-square test was used to compare categorical variables.
A total of 1,428 participants were included. The majority of them were females (64.4%), and most of them were aged between 19 and 25 years. Moreover, we found that 4.8% of the study population had a medical history of thyroid cancer. Our results revealed that more than half of respondents (54.6%) would select surgical operation immediately if they have a thyroid nodule less than 1 cm in maximal diameter, which turns out to be a PTC. The vast majority of participants (90.1%) would prefer to do cytologic confirmation immediately if they have a thyroid nodule less than 1 cm in maximal diameter, which has suspicious characteristics of PTC in neck ultrasound examination. Regarding PTMC operation, 59.8% of responders were more concerned about complications than recurrences. We found that neither age nor gender significantly affects decision-making for management or operative extent for PTC. There was a significant difference between age and decision-making for the diagnosis of suspicious thyroid nodules (p value = 0.041).
Our results concluded that most of the participants preferred to select immediate surgery and cytologic confirmation regarding the management and diagnosis of PTC. More research is advised. The need to inform patients about their disease state and treatment options should be highlighted more.
甲状腺乳头状癌（PTC）是最常见的甲状腺癌类型。甲状腺微小乳头状癌（PTMC）是PTC的一个特定亚组。鉴于其体积小，PTMC通常无症状且表现为良性。这使医生在如何预防PTMC的过度诊断和过度治疗方面面临挑战。本研究旨在评估沙特阿拉伯普通人群对PTMC诊断和治疗途径的偏好。
这是一项在沙特阿拉伯普通人群中进行的基于问卷调查的横断面研究。目标受试者是沙特阿拉伯的普通人群，包括来自沙特阿拉伯不同地区（西部、中部、东部、南部和北部）的不同性别和不同年龄组。未完成问卷或不同意参与的参与者被排除。通过在不同社交媒体平台上发放自填式问卷，从不同地区收集数据。使用社会科学统计软件包（SPSS）24.0版本（美国伊利诺伊州芝加哥IBM公司）进行数据分析。采用卡方检验比较分类变量。
共纳入1428名参与者。其中大多数为女性（64.4%），且大多数年龄在19至25岁之间。此外，我们发现4.8%的研究人群有甲状腺癌病史。我们的结果显示，如果最大直径小于1cm的甲状腺结节经诊断为PTC，超过一半的受访者（54.6%）会立即选择手术。如果最大直径小于1cm的甲状腺结节在颈部超声检查中具有PTC的可疑特征，绝大多数参与者（90.1%）会倾向于立即进行细胞学确认。关于PTMC手术，59.8%的受访者更关注并发症而非复发。我们发现年龄和性别对PTC的管理决策或手术范围均无显著影响。年龄与可疑甲状腺结节的诊断决策之间存在显著差异（p值 = 0.041）。
我们的结果表明，大多数参与者在PTC的管理和诊断方面倾向于选择立即手术和细胞学确认。建议进行更多研究。应更加强调告知患者其疾病状态和治疗选择的必要性。
