An audit of 09-10 cohort showed improvements in the management and survival of differentiated thyroid cancer (DTC) since audit of the 98-99 cohort of patients in the Northern and Yorkshire region

There has been significant improvement in the management of DTC in the region since 98/99. This has translated into better survival. Further studies with longer follow up are needed.

Treatment of DTC usually involves thyroidectomy followed by radio-iodine. An audit was done 10 years ago looking at the management and survival for thyroid cancer patients treated in the region during 1998-1999. This showed sub-optimal practise.

The standard: 

The British Thyroid Association guidelines in 02 recommended -

• MDT discussion for all patients and site specialisation of involved clinicians

• Appropriate treatment and investigations

Target: 

Same as Standard.

Indicators: 

• <50% of patients had pre-op Fine Needle Aspiration (FNAC)

• <30% had Post Radioiodine Ablation scan (PAS)

• Few Thyroglobulin(TG) tests

• Poor surgical specialisation (33% patients operated by surgeons performing <5 cases/year)

• Minority of patients were discussed in MDT or had staging

• Poor thyroid cancer survival rates

Data items to be collected: 

• Data was taken from PRAXIS database for the region during 09-10, to look at incidence, pathology, surgery, first treatment modality, survival rates and surgical workload. Comparison was made to data collected in 04 for the 98-99 period

• Data was taken from PRAXIS database for the region during 09-10, to look at incidence, pathology, surgery, first treatment modality, survival rates and surgical workload. Comparison was made to data collected in 04 for the 98-99 period

Suggested number: 

Changes were implemented and a re-audit was done for 09-10.

• In 09-10, all patients diagnosed with DTC in the region were discussed in MDT

• All patients had pre-op FNAC and PAS - 97% of patients had a stimulated TG to assess disease

• Survival for patients with DTC has improved significantly in the last 10 years (Figure 1)

• Surgeon specialisation has improved, 10% of patients were operated on by surgeons who perform <5 cases/year (Figure 2)

1. British Thyroid Association. Guidelines for the management of thyroid cancer [Internet]. 2nd ed. London: Royal College of Physicians; 2007 [cited 2014 June 12]. Available from: http://www.british-thyroid-association.org/current-bta-guidelines-

2. British Thyroid Association. Guidelines for the management of thyroid cancer [Internet]. 3rd ed. London: Royal College of Physicians; 2014 [cited 2014 June 12]. Available from: http://www.british-thyroid-association.org/current-bta-guidelines-

3. Cancer Research UK. Thyroid cancer statistics 2012 [Internet]. London: Cancer Research UK: 2012 [cited 2014 June 12]. Available from: http://www.cancerresearchuk.org/cancer-info/cancerstats/types/thyroid/uk-thyroid-cancer-statistics

4. NHS Choices. Thyroid cancer 2012 [Internet]. Leeds: NHS Cchoices; 2012 [cited 2014 June 12]. Available from: http://www.nhs.uk/conditions/cancer-of-the-thyroid/Pages/Introduction.aspx

5. NYCRIS. Management of thyroid cancer in the Northern and Yorkshire region. Leeds:NYCRIS; 2004.

Fei Sun

Co-authors

E. Joseph

G. Gerrard