Introduction: Thyroid cancer (TC) is the most pervasive endocrine cancer worldwide. We examined the region-wise pattern of TC in India according to demographic, clinicopathological treatment and waiting-time distribution from diagnosis to treatment.

Methods: TC cases in India from 96 hospital-based cancer registries (HBCRs) (North 28, East 8, West 7, South 40, Central 4 and North-East 9) reported for 2012-2019 were included. Among the 31,678 newly diagnosed cases, those treated only at the respective HBCR’s (n = 10,521) were included in the detailed analysis. Statistical significance by region was obtained using the chi-square test for categorical variables, the t-test for continuous variables and Marascuilo procedure to compare multiple proportions.

Results: Among the 10,521 cases, 58% were from the South, the majority (68%) were females, with female-to-male ratio of 4.3:1, 3.8:1 and 3.5:1 in the north-east, central and southern regions, respectively, in the youngest (<35 years) age group (p < 0.001). The most familiar histological type was papillary carcinoma (69.0%). The female-to-male ratio for follicular carcinoma was 5:1 among <35 years, while the same for papillary carcinoma was 2.9:1. Distant metastasis at diagnosis was highest in the western region (19.0%), lowest in the South (13.4%). Radical intent-to-treat was highest in the South (92%) and lowest in the East (68.5%) (p < 0.001). Surgery alone or combined with other treatments was highest in the West (91.2%) compared to 48.9% in Central India. The waiting time from diagnosis to treatment was <7 days in 36% of cases from the North and the lowest proportion (19.0%) in both East and North-East regions (p < 0.001).

Conclusion: We observed considerable heterogeneity in demographic, clinic-pathological, treatment and waiting time from diagnosis to treatment for TC across the regions in India; this kind of region-wise hospital-based analysis would help to improve national and local cancer care programmes.