Thyroid nodules (TN) are very frequent, with up to 8% of adults having palpable nodules and by using ultrasound we can detect up to 10 times more nodules (Yeung & Serpell, 2008) [1]. In the absence of any guidelines for thyroid nodule management in Morocco, our study aims to describe physicians’ practices in the Greater Casablanca Region regarding thyroid nodules. We conducted a descriptive cross-sectional study using a questionnaire issued to doctors who practice in the Greater Casablanca Region in both sectors public and private. Results show that half of the participants do a general exam for all patients and 72% of them include a routine palpation of thyroid. When they found a thyroid nodule, 97% and 99% demanded ultrasonography and TSH measure respectively. Furthermore, thirty percent refer patients for management regardless of the EU-TIRADS score. In brief, the management of thyroid nodules in Morocco needs a guideline based on the latest research advances and international guidelines, to improve diagnosis and management of thyroid nodules and avoid overdiagnosis and overtreatment.
Cite this paper
Tabiti, H. , Guensi, A. and Bendahhou, K. (2023). Physicians’ Practices toward Thyroid Nodules: Experience of the City of Casablanca, Morocco. Open Access Library Journal, 10, e143. doi: http://dx.doi.org/10.4236/oalib.1110143.
Yeung, M.J. and Serpell, J.W. (2008) Management of the Solitary Thyroid Nodule. The Oncologist, 13, 105-112. https://doi.org/10.1634/theoncologist.2007-0212
Haugen, B.R., Alexander, E.K., Bible, K.C., Doherty, G.M., Mandel, S.J., Nikiforov, Y.E., et al. (2006) 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 26, 1-133.
https://doi.org/10.1089/thy.2015.0020
Dean, D.S. and Gharib, H. (2008) Epidemiology of Thyroid Nodules. Best Practice & Research Clinical Endocrinology & Metabolism, 22, 901-911.
https://doi.org/10.1016/j.beem.2008.09.019
Brito, J.P., Gionfriddo, M.R., Al Nofal, A., Boehmer, K.R., Leppin, A.L., Reading, C., et al. (2014) The Accuracy of Thyroid Nodule Ultrasound to Predict Thyroid Cancer: Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology & Metabolism, 99, 1253-1263. https://doi.org/10.1210/jc.2013-2928
Elsevier Health Sciences (2019) Maladie C des enseignants d’endocrinologie diabète et. Endocrinologie, diabétologie et maladies métaboliques: Réussir les ECNi. 577 p.
Schneider, D.F. and Chen, H. (2013) New Developments in the Diagnosis and Treatment of Thyroid Cancer: New Developments in Thyroid Cancer. CA: A Cancer Journal for Clinicians, 63, 373-394. https://doi.org/10.3322/caac.21195
Nguyen, Q.T., Lee, E.J., Huang, M.G., Park, Y.I., Khullar, A. and Plodkowski, R.A. (2015) Diagnosis and Treatment of Patients with Thyroid Cancer. American Health & Drug Benefits, 8, 30-40.
Paajanen, I., Metso, S., Jaatinen, P. and Kholová, I. (2018) Thyroid FNA Diagnostics in a Real-Life Setting: Experiences of the Implementation of the Bethesda System in Finland. Cytopathology, 29, 189-195. https://doi.org/10.1111/cyt.12513
Campennì, A., Barbaro, D., Guzzo, M., Capoccetti, F. and Giovanella, L. (2020) Personalized Management of Differentiated Thyroid Cancer in Real Life—Practical Guidance from a Multidisciplinary Panel of Experts. Endocrine, 70, 280-291.
https://doi.org/10.1007/s12020-020-02418-x
Registre des Cancers de la Region du Grand Casablanca 2013-2017.
https://www.contrelecancer.ma/site_media/uploaded_files/Registre_des_Cancers_de_la_Region_du_Grand_Casablanca_2013-2017.pdf
Ahn, H.S., Kim, H.J. and Welch, H.G. (2014) Korea’s Thyroid-Cancer “Epidemic”—Screening and Overdiagnosis. The New England Journal of Medicine, 371, 1765-1767. https://doi.org/10.1056/NEJMp1409841
Davies, L., Morris, L.G.T., Haymart, M., Chen, A.Y., Goldenberg, D., Morris, J., et al. (2015) American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: The Increasing Incidence of Thyroid Cancer. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 21, 686-696. https://doi.org/10.4158/EP14466.DSCR
Gharib, H. and Papini, E. (2007) Thyroid Nodules: Clinical Importance, Assessment, and Treatment. Endocrinology and Metabolism Clinics of North America, 36, 707-735. https://doi.org/10.1016/j.ecl.2007.04.009
Miki, H., Inoue, H., Komaki, K., Uyama, T., Morimoto, T. and Monden, Y. (1998) Value of Mass Screening for Thyroid Cancer. World Journal of Surgery, 22, 99-102.
https://doi.org/10.1007/s002689900356
Bennedbæk, F.N. and Hegedüs, L. (2000) Management of the Solitary Thyroid Nodule: Results of a North American Survey. The Journal of Clinical Endocrinology & Metabolism, 85, 2493-2498. https://doi.org/10.1210/jcem.85.7.6672
Bonnema, S.J., Bennedbæk, F.N., Wiersinga, W.M. and Hegedüs, L. (2000) Management of the Nontoxic Multinodular Goitre: A European Questionnaire Study. Clinical Endocrinology (Oxford), 53, 5-12.
https://doi.org/10.1046/j.1365-2265.2000.01060.x
Burch, H.B., Burman, K.D., Cooper, D.S., Hennessey, J.V. and Vietor, N.O. (2016) A 2015 Survey of Clinical Practice Patterns in the Management of Thyroid Nodules. The Journal of Clinical Endocrinology & Metabolism, 101, 2853-2862.
https://doi.org/10.1210/jc.2016-1155
Führer, D., Mügge, C. and Paschke, R. (2005) Questionnaire on Management of Nodular Thyroid Disease (Annual Meeting of the Thyroid Section of the German Society of Endocrinology 2003). Experimental and Clinical Endocrinology & Diabetes, 113, 152-159. https://doi.org/10.1055/s-2005-837523
Bomeli, S.R., LeBeau, S.O. and Ferris, R.L. (2010) Evaluation of a Thyroid Nodule. Otolaryngologic Clinics of North America, 43, 229-238.
https://doi.org/10.1016/j.otc.2010.01.002
Bennedbæk, F.N., Perrild, H. and Hegedüs, L. (1999) Diagnosis and Treatment of the Solitary Thyroid Nodule. Results of a European Survey. Clinical Endocrinology, 50, 357-363. https://doi.org/10.1046/j.1365-2265.1999.00663.x
Davies, L., Ouellette, M., Hunter, M. and Welch, H.G. (2010) The Increasing Incidence of Small Thyroid Cancers: Where Are the Cases Coming from? The Laryngoscope, 120, 2446-2451. https://doi.org/10.1002/lary.21076
Vaccarella, S., Franceschi, S., Bray, F., Wild, C.P., Plummer, M. and Maso, L.D.
(2016) Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis.
The New England Journal of Medicine , 375, 614-617.
https://doi.org/10.1056/NEJMp1604412
