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Introduction: The new regulations called the “oncological package” were implemented in Poland on 1 January 2015. The issuance of the Diagnosis and Oncological Treatment Card initiates a path of rapid diagnosis and therapy. The new regulations also encompass the diagnostic process in suspected thyroid carcinoma, which is the leading endocrine gland cancer. In 2014, 162 new cases of thyroid cancer were noted in Świętokrzyskie Province in Poland. Before the rapid diagnostic procedure is implemented, the risk of malignancy must be evaluated, which is of particular importance in the case of suspected carcinoma of the thyroid gland due to the great prevalence of benign thyroid nodules. The risk of thyroid carcinoma is evaluated by the analysis of the medical history and proper interpretation of ultrasonographic images of focal lesions. Aim: The aim of this study was to analyse the knowledge of primary care physicians about clinical and ultrasonographic features of high-risk thyroid tumours and to assess whether the Diagnosis and Oncological Treatment Card is used correctly for initiation of a rapid diagnostic process in patients with suspected thyroid carcinoma. Material and methods: The analysis involved the results of thyroid ultrasound scans and medical history data collected during the first visit from all patients who, in the period from 1 January 2015 to 30 September 2016, were referred to the Department of Endocrinology of Świętokrzyskie Oncology Centre with the Diagnosis and Oncological Treatment Card issued by a primary care physician due to a suspicion of thyroid cancer. The authors evaluated the presence of clinical or ultrasonographic features of high-risk thyroid tumours. The analysis involved records of 95 patients. Results: None of the patients presented clinical features of thyroid carcinoma. The phenotype of focal lesions represented high-risk features in merely 21% of the patients; the most common ultrasonographic feature was hypoechogenicity (70% of patients). Oncological diagnostic procedures (fine-needle aspiration biopsy) confirmed a malignancy in only 1 case; it was a patient with high-risk ultrasonographic features (1/20 patients – 5%). None of the patients with a benign phenotype was diagnosed with thyroid carcinoma. Conclusions: 1) The Diagnosis and Oncological Treatment Card is not used properly by primary care physicians in the diagnosis of thyroid lesions. 2) When issuing the Diagnosis and Oncological Treatment Card, primary care physicians do not use the knowledge about clinical or ultrasonographic features that suggest a high risk of malignancy.

The aim of the study was to evaluate the 5-year relative survival rates of patients with all malignant cancers in the Swietokrzyskie Voivodeship who were diagnosed with cancer during the period 1995-2007, which is when the Swietokrzyskie Cancer Centre began and developed its comprehensive oncological care in the region. 41,104 patients from the Swietokrzyskie Voivodeship who were registered in the Swietokrzyskie Cancer Registry in that period of time were included in the analysis of the survival rates. Relative survival was calculated using the Hakulinen and Brenner methods. These methods are recommended by the European Network of Cancer Registries for the population-based cancer registries where cause of death is unknown. The results were referred to the European average of relative survival rates calculated for all malignant cancers combined, as well as selected cancers calculated within the EUROCARE-4 project. The survival rates of patients diagnosed from 2003 to 2007 do not differ significantly from the European average, and are even higher for both sexes combined (56.0% v. 48.3%), and cancers of cervix and corpus uteri, as well as lung cancer for men and women combined. The 5-year relative survival rates for all malignances of patients in the Swietokrzyskie Voivodeship diagnosed from 2003 to 2007 increased by 9.7 percentage points in comparison to previous years 1995-2002. A significant improvement was seen in prostate cancer (28.1 percentage points), rectum cancer (13.1) and colon cancer (11.0). The improvement of the survival rates reflects the improvement in curability due to the development of the Swietokrzyskie Cancer Centre.