ContextIncreasing cancer incidence is typically interpreted as an increase in the true occurrence of disease but may also reflect changing pathological criteria or increased diagnostic scrutiny. Changes in the diagnostic approach to thyroid nodules may have resulted in an increase in the apparent incidence of thyroid cancer.ObjectiveTo examine trends in thyroid cancer incidence, histology, size distribution, and mortality in the United States.MethodsRetrospective cohort evaluation of patients with thyroid cancer, 1973-2002, using the Surveillance, Epidemiology, and End Results (SEER) program and data on thyroid cancer mortality from the National Vital Statistics System.Main Outcome MeasuresThyroid cancer incidence, histology, size distribution, and mortality.ResultsThe incidence of thyroid cancer increased from 3.6 per 100 000 in 1973 to 8.7 per 100 000 in 2002—a 2.4-fold increase (95% confidence interval [CI], 2.2-2.6; P .20 for trend). Virtually the entire increase is attributable to an increase in incidence of papillary thyroid cancer, which increased from 2.7 to 7.7 per 100 000—a 2.9-fold increase (95% CI, 2.6-3.2; P<.001 for trend). Between 1988 (the first year SEER collected data on tumor size) and 2002, 49% (95% CI, 47%-51%) of the increase consisted of cancers measuring 1 cm or smaller; 87% (95% CI, 85%-89%) consisted of cancers measuring 2 cm or smaller. Mortality from thyroid cancer was stable between 1973 and 2002 (approximately 0.5 deaths per 100 000).ConclusionsThe increasing incidence of thyroid cancer in the United States is predominantly due to the increased detection of small papillary cancers. These trends, combined with the known existence of a substantial reservoir of subclinical cancer and stable overall mortality, suggest that increasing incidence reflects increased detection of subclinical disease, not an increase in the true occurrence of thyroid cancer.

https://jamanetwork.com/journals/jama/articlepdf/202835/JOC60052.pdf

Increasing incidence of thyroid cancer in the United States, 1973-2002.

The introduction of biodegradable implant materials as well as minimally invasive surgical procedures in medicine has substantially improved health care within the past few decades. This report describes a group of degradable thermoplastic polymers that are able to change their shape after an increase in temperature. Their shape-memory capability enables bulky implants to be placed in the body through small incisions or to perform complex mechanical deformations automatically. A smart degradable suture was created to illustrate the potential of these shape-memory thermoplastics in biomedical applications.

https://science.sciencemag.org/content/sci/296/5573/1673.full.pdf

Biodegradable, Elastic Shape Memory Polymers for Potential Biomedical Applications

/pdf/management-guidelines-for-patients-with-thyroid-nodules-and-33wjxjfqag.pdf

Management guidelines for patients with thyroid nodules and differentiated thyroid cancer.

European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium Furio Pacini, Martin Schlumberger, Henning Dralle, Rossella Elisei, Johannes W A Smit, Wilmar Wiersinga and the European Thyroid Cancer Taskforce Section of Endocrinology and Metabolism, University of Siena, Via Bracci, 53100 Siena, Italy, Service de Medicine Nucleaire, Institut Gustave Roussy, Villejuif, France, Department of General, Visceral and Vascular Surgery, University of Halle, Germany, Department of Endocrinology, University of Pisa, Italy, Department of Endocrinology and Metabolic Disease, Leiden University Medical Center, The Netherlands and Department of Endocrinology and Metabolism, University of Amsterdam, The Netherlands

/pdf/european-consensus-for-the-management-of-patients-with-dske0use4g.pdf

European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium

OBJECTIVE: The objective of this study was to determine the best treatment
 of incisional hernia, taking into account recurrence, complications,
 discomfort, cosmetic result, and patient satisfaction. BACKGROUND:
 Long-term results of incisional hernia repair are lacking. Retrospective
 studies and the midterm results of this study indicate that mesh repair is
 superior to suture repair. However, many surgeons are still performing
 suture repair. METHODS: Between 1992 and 1998, a multicenter trial was
 performed, in which 181 eligible patients with a primary or first-time
 recurrent midline incisional hernia were randomly assigned to suture or
 mesh repair. In 2003, follow-up was updated. RESULTS: Median follow-up was
 75 months for suture repair and 81 months for mesh repair patients. The
 10-year cumulative rate of recurrence was 63% for suture repair and 32%
 for mesh repair (P < 0.001). Abdominal aneurysm (P = 0.01) and wound
 infection (P = 0.02) were identified as independent risk factors for
 recurrence. In patients with small incisional hernias, the recurrence
 rates were 67% after suture repair and 17% after mesh repair (P = 0.003).
 One hundred twenty-six patients completed long-term follow-up (median
 follow-up 98 months). In the mesh repair group, 17% suffered a
 complication, compared with 8% in the suture repair group (P = 0.17).
 Abdominal pain was more frequent in suture repair patients (P = 0.01), but
 there was no difference in scar pain, cosmetic result, and patient
 satisfaction. CONCLUSIONS: Mesh repair results in a lower recurrence rate
 and less abdominal pain and does not result in more complications than
 suture repair. Suture repair of incisional hernia should be abandoned.

/pdf/long-term-follow-up-of-a-randomized-controlled-trial-of-1m0wy0j602.pdf

Long-term Follow-up of a Randomized Controlled Trial of Suture Versus Mesh Repair of Incisional Hernia

Background

The objective of this study was to define the incidence trends of Merkel cell carcinoma (MCC), a rare and aggressive cutaneous malignancy.



Materials and Methods

All cases of MCC of the skin between 1986 and 2001 were identified using the surveillance, epidemiology, and end results (SEER) program. Overall age-adjusted, gender-specific, age-specific, stage-specific, and regional incidence rates were calculated. All rates are per 100,000 and age-adjusted to the 2000 US standard population. Estimated annual percent change (EAPC) was calculated using a linear least squares model.



Results

A total of 1,124 cases of MCC were identified in the SEER registries. The rate of MCC increased from 0.15 cases per 100,000 in 1986 to 0.44 cases per 100,000 in 2001. The EAPC for the time period was 8.08%. This was statistically significant (95% CI: 6.29, 9.90, P-value < 0.05). Age-specific incidence (5-year age groups) were highest in the elderly, 4.28 per 100,000 in the 85+ age group.



Conclusions

MCC incidence rates have increased threefold over the 1986–2001 period. Rates are highest in the elderly population. Further etiologic studies and identification of high-risk populations are warranted. J. Surg. Oncol. 2005;89:1–4. © 2004 Wiley-Liss, Inc.

Merkel cell carcinoma: changing incidence trends.

Background and Objective
The ideal suture for abdominal fascial closure has yet to be determined. Surgical practice continues to rely largely on tradition rather than high-quality level I evidence. The authors conducted a systematic review and meta-analysis of randomized controlled trials to determine which suture material and technique reduces the odds of incisional hernia.

The search for an ideal method of abdominal fascial closure: a meta-analysis.

Background: The objective of this study was to define the epidemiology of thyroid cancer in our regional population and compare results with Surveillance, Epidemiology, and End Results (SEER) Program cancer registry trends. Methods: Thyroid cancer cases diagnosed between 1990 and 2000 were identified in the Florida Cancer Data System (FCDS). Overall, gender-specific, age-specific, and stage-specific incidence rates were calculated. All rates are per 100,000 and age-adjusted to the 2000 U.S. standard population. Estimated Annual Percent Change (EAPC) was calculated with a linear least-squares model. Results: Patients with thyroid cancer (n = 8603) were identified in the FCDS registry. Age-adjusted incidence rates increased from 4.2 per 100,000 to 7 per 100,000 in 2000. The EAPC for this period was 5.5% (P < .001). The SEER incidence rates increased from 7.9 to 10.2 per 100,000, and the EAPC was 3.7% (P < .05). Analysis of gender-specific incidence rates showed increases from 6 and 2.2 per 100,000 in 1990 to 10.1 and 3.8 per 100,000 in 2000 among females and males, respectively, with EAPCs of 5.9% (females) and 4.5% (males) (P < .001). With stratification by age group, the highest incidence rates were 9 per 100,000 in the group aged 65 to 84 years and 8.4 per 100,000 in the group aged 45 to 64 years. Conclusions: Thyroid cancer incidence rates in Florida almost doubled over the 1990–2000 period and are concordant with SEER trends. Etiologic studies addressing temporal changes in reproductive factors, more intensive diagnostic activities, and changes in histological criteria are warranted.

Thyroid cancer: Is the incidence still increasing

Background
Studies suggest radioguided seed localization (RSL) yields fewer positive margins than wire-guided localization (WL). The goal of this study is to determine whether RSL is superior to WL.

A Multicentered, Randomized, Controlled Trial Comparing Radioguided Seed Localization to Standard Wire Localization for Nonpalpable, Invasive and in situ Breast Carcinomas

Background Gastrointestinal stromal tumors (GISTs) have been recognized as the most common mesenchymal tumors of the gastrointestinal tract The most effective treatment for unresectable tumors is imatinib mesylate, based on two phase II trials Because no phase III clinical trial has been undertaken, we sought to determine both current population-based incidence and whether improved outcomes noted in both individual centers and clinical trials have also been observed in a large prospective cancer registry earlier and after the introduction of imatinib Study design The 13-center cumulative tumor registry (April 2005 release) from the Surveillance, Epidemiology, and End Results (SEER) database was queried from 1992 to 2002 to determine incidence and associated outcomes for patients diagnosed with GIST Confirmations of incidence trends using the incident Florida Cancer Data System (FCDS, 2005 release) were also determined Results A 25-fold age-adjusted increase in incidence of GIST, from 0028 per 100,000 in 1992 to 0688 per 100,000 in 2002, was observed This increase is mostly because smooth-muscle tumors have been reclassified as GISTs, but it also represents a 50% increase in population- and age-adjusted gastrointestinal mesenchymal tumor diagnosis since 1992 Despite rising GIST incidence rates, there has been a marked improvement in survival since 2000, coinciding with the introduction of the tyrosine kinase inhibitor imatinib into clinical practice Conclusions The diagnosis of GIST has dramatically increased since 1992 Survivals have greatly improved since 2000, when imatinib mesylate was FDA approved

https://www.journalacs.org/article/S1072-7515(06)00006-8/pdf

Nicole Hodgson

Papers

Merkel cell carcinoma: changing incidence trends.

The search for an ideal method of abdominal fascial closure: a meta-analysis.

Thyroid cancer: Is the incidence still increasing

A Multicentered, Randomized, Controlled Trial Comparing Radioguided Seed Localization to Standard Wire Localization for Nonpalpable, Invasive and in situ Breast Carcinomas

Current incidence and outcomes of gastrointestinal mesenchymal tumors including gastrointestinal stromal tumors.