Incidence and Histological Patterns of Thyroid Cancer in Tuzla Canton, Bosnia and Herzegovina: A Five-Year Retrospective Study, 2020–2024

Background: Thyroid cancer (TC) is the most common endocrine malignancy and is generally associated with a favorable prognosis. Its incidence has increased worldwide, whereas epidemiological data from Bosnia and Herzegovina, particularly Tuzla Canton, remain limited. Aim: The aim of this study is to determine the incidence, five-year period prevalence, histological distribution, and basic demographic characteristics of TC in Tuzla Canton between 2020 and 2024. Study design: This is a retrospective descriptive observational study. Methods: Records of 483 patients evaluated by the Council for Benign and Malignant Thyroid Diseases at the University Clinical Center Tuzla between January 1, 2020, and December 31, 2024, were retrospectively reviewed. Patients were included if they had histopathologically confirmed TC, were aged ≥15 years, and resided in Tuzla Canton. Incidence and five-year period prevalence were calculated using the latest available population estimates. Results: Of the 483 evaluated patients, 142 met the inclusion criteria. The cohort included 108 women (76%) and 34 men (24%), corresponding to a female-to-male ratio of 3.18:1. The median age at diagnosis was 56 years. Papillary TC was the most common type (n=105; 74%), followed by follicular (n=18; 13%), medullary (n=15; 10%), and anaplastic (n=4; 3%). The age-standardized average annual incidence was 6.99 per 100,000 population, while the five-year period prevalence was 32.98 per 100,000. Incidence was higher among women than among men and increased during the study period. The highest age-specific incidence was observed among women aged ≥75 years and men aged 65-74 years. Three deaths occurred during follow-up, of which two were directly attributable to TC; both TC-related deaths occurred in patients with anaplastic carcinoma. Conclusion: TC incidence in Tuzla Canton was lower than reported global and European estimates but increased during the five-year study period. Papillary carcinoma predominated, particularly among women. Longer-term population-based studies and the establishment of a national thyroid cancer registry are needed to improve epidemiological surveillance in Bosnia and Herzegovina.