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Journal ArticleDOI

Thyroid cancer mortality and incidence: A global overview

TL;DR: The declines in thyroid cancer mortality reflect both variations in risk factor exposure and changes in the diagnosis and treatment of the disease, while the increases in the incidence are likely due to the increase in the detection of this neoplasm over the last few decades.
Abstract: In most areas of the world, thyroid cancer incidence has been appreciably increasing over the last few decades, whereas mortality has steadily declined. We updated global trends in thyroid cancer mortality and incidence using official mortality data from the World Health Organization (1970-2012) and incidence data from the Cancer Incidence in Five Continents (1960-2007). Male mortality declined in all the major countries considered, with annual percent changes around -2/-3% over the last decades. Only in the United States mortality declined up to the mid 1980s and increased thereafter. Similarly, in women mortality declined in most countries considered, with APCs around -2/-5% over the last decades, with the exception of the UK, the United States and Australia, where mortality has been declining up to the late 1980s/late 1990s to level off (or increase) thereafter. In 2008-2012, most countries had mortality rates (age-standardized, world population) between 0.20 and 0.40/100,000 men and 0.20 and 0.60/100,000 women, the highest rates being in Latvia, Hungary, the Republic of Moldova and Israel (over 0.40/100,000) for men and in Ecuador, Colombia and Israel (over 0.60/100,000) for women. In most countries, a steady increase in the incidence of thyroid cancer (mainly papillary carcinomas) was observed in both sexes. The declines in thyroid cancer mortality reflect both variations in risk factor exposure and changes in the diagnosis and treatment of the disease, while the increases in the incidence are likely due to the increase in the detection of this neoplasm over the last few decades.
Citations
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Journal ArticleDOI
TL;DR: There are concerns that hundreds of thousands of cases may be overdiagnoses — diagnosis of tumors that would not, if left alone, result in symptoms or death.
Abstract: Dramatic increases have been seen over recent decades in the reported incidence of thyroid cancer, but owing to new modes of screening, hundreds of thousands of cases may be overdiagnoses — diagnosis of tumors that would not, if left alone, result in symptoms or death.

716 citations

Journal ArticleDOI
24 Sep 2015-Thyroid
TL;DR: A large proportion of TC cases diagnosed in high-resource countries in the last two decades are likely to be due to diagnostic changes, and this proportion has progressively increased over time, and it is likely to grow further in the future.
Abstract: Background: Thyroid cancer (TC) incidence is rising in many countries, but the corresponding mortality is constant or declining. Incidence increases appear largely restricted to small papillary TC in young/middle-age individuals. We compared age-specific incidence rates across countries and time periods in order to estimate the fraction of TC possibly attributable to increased surveillance of the thyroid gland (diagnostic changes) following the introduction of neck ultrasonography in the 1980s. Methods: We focused on high-resource countries, including four Nordic countries, England and Scotland, France, Italy, the United States, Australia, Japan, and the Republic of Korea. Before the 1970s, TC incidence in Nordic countries increased proportionally to the second power of age, consistent with the multistage model of carcinogenesis. Using this historical observation for reference, we attributed the progressive departure from linearity of the age curves in each country to an increased detection of asymptomati...

255 citations


Cites background from "Thyroid cancer mortality and incide..."

  • ...In contrast, TC mortality trends have been stable or declining (1)....

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  • ...5 Introduction The incidence of thyroid cancer (TC) has been steadily increasing in the past three decades in many countries and regions worldwide (1,2) although to variable extent....

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  • ...Incidence rates, for instance, have increased rapidly in Southern European countries (3,4), the United States (5,6), and, most markedly, in the Republic of Korea (7), but only moderately in Northern European countries and Japan (1,2)....

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  • ...To compare trends in TC incidence rates, we selected seven among the largest high-resource countries from Europe (Denmark, Finland, Norway, Sweden, England and Scotland, France, and Italy) and four from other continents (the United States (US), Australia, Japan, and the Republic of Korea) for which: 1) cancer registration dated back at least to the early-1990s; and 2) at least one million person-years of observation was available annually over the most recent period (2003-2007)....

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  • ...The upward incidence trends and changes in the age-specific curves in the last two decades were accompanied by very low and stable TC mortality rates (1,5,6)....

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Journal ArticleDOI
TL;DR: The incidence of thyroid cancer worldwide has increased significantly over the past 3 decades, due predominantly to an increase in papillary thyroid cancer, but there also appears to be a true increase in new cases.

228 citations

Journal ArticleDOI
TL;DR: This Review highlights the epidemiology of thyroid cancer in high-income, middle-income and low-income countries and discusses the prevalence of modifiable individual risk factors and population-level exposures to environmental risk factors.
Abstract: The incidence of thyroid cancer is on the rise, and this disease is projected to become the fourth leading type of cancer across the globe. From 1990 to 2013, the global age-standardized incidence rate of thyroid cancer increased by 20%. This global rise in incidence has been attributed to several factors, including increased detection of early tumours, the elevated prevalence of modifiable individual risk factors (for example, obesity) and increased exposure to environmental risk factors (for example, iodine levels). In this Review, we explore proven and novel hypotheses for how modifiable risk factors and environmental exposures might be driving the worldwide increase in the incidence of thyroid cancer. Although overscreening and the increased diagnosis of possibly clinically insignificant disease might have a role in certain parts of the world, other areas could be experiencing a true increase in incidence due to elevated exposure risks. In the current era of personalized medicine, national and international registry data should be applied to identify populations who are at increased risk for the development of thyroid cancer.

213 citations

Journal ArticleDOI
TL;DR: The available evidence suggests iodine deficiency is a risk factor for TC, particularly for follicular TC and possibly, for anaplastic TC.
Abstract: Thyroid cancer (TC) is the most common endocrine malignancy and in most countries, incidence rates are increasing. Although differences in population iodine intake are a determinant of benign thyroid disorders, the role of iodine intake in TC remains uncertain. We review the evidence linking iodine intake and TC from animal studies, ecological studies of iodine intake and differentiated and undifferentiated TC, iodine intake and mortality from TC and occult TC at autopsy, as well as the case–control and cohort studies of TC and intake of seafood and milk products. We perform a new meta-analysis of pooled measures of effect from case–control studies of total iodine intake and TC. Finally, we examine the post-Chernobyl studies linking iodine status and risk of TC after radiation exposure. The available evidence suggests iodine deficiency is a risk factor for TC, particularly for follicular TC and possibly, for anaplastic TC. This conclusion is based on: a) consistent data showing an increase in TC (mainly follicular) in iodine deficient animals; b) a plausible mechanism (chronic TSH stimulation induced by iodine deficiency); c) consistent data from before and after studies of iodine prophylaxis showing a decrease in follicular TC and anaplastic TC; d) the indirect association between changes in iodine intake and TC mortality in the decade from 2000 to 2010; e) the autopsy studies of occult TC showing higher microcarcinoma rates with lower iodine intakes; and f) the case control studies suggesting lower risk of TC with higher total iodine intakes.

184 citations


Cites background or methods from "Thyroid cancer mortality and incide..."

  • ...The incidence of thyroid cancer has been rising steadily over the past few decades in most countries [1]....

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  • ...Italy has one of the highest incidence rates for thyroid cancer; in 2007, the age-standardized (world population) incidence rate in women was nearly 20 per 100,000 women [1]....

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  • ...[1], using data for thyroid cancer mortality and population size for countries in the period 1970–2012 from the WHO online database [106] estimated age-adjusted death rates from thyroid cancer at all ages in 2000 (1998–2002) and in 2010 (2008– 2012) and percentage changes between these periods (Additional file 1: Table S1)....

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  • ...In most areas of the world, while the incidence of thyroid cancer has been increasing over the past few decades, mortality has steadily declined [1]....

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References
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Journal ArticleDOI
TL;DR: The results for 20 world regions are presented, summarizing the global patterns for the eight most common cancers, and striking differences in the patterns of cancer from region to region are observed.
Abstract: Estimates of the worldwide incidence and mortality from 27 cancers in 2008 have been prepared for 182 countries as part of the GLOBOCAN series published by the International Agency for Research on Cancer. In this article, we present the results for 20 world regions, summarizing the global patterns for the eight most common cancers. Overall, an estimated 12.7 million new cancer cases and 7.6 million cancer deaths occur in 2008, with 56% of new cancer cases and 63% of the cancer deaths occurring in the less developed regions of the world. The most commonly diagnosed cancers worldwide are lung (1.61 million, 12.7% of the total), breast (1.38 million, 10.9%) and colorectal cancers (1.23 million, 9.7%). The most common causes of cancer death are lung cancer (1.38 million, 18.2% of the total), stomach cancer (738,000 deaths, 9.7%) and liver cancer (696,000 deaths, 9.2%). Cancer is neither rare anywhere in the world, nor mainly confined to high-resource countries. Striking differences in the patterns of cancer from region to region are observed.

21,040 citations

Journal ArticleDOI
TL;DR: The magnitude of the decline in cancer death rates from 1991 to 2010 varies substantially by age, race, and sex, ranging from no decline among white women aged 80 years and older to a 55% decline among black men aged 40 years to 49 years.
Abstract: Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data were collected by the National Center for Health Statistics. A total of 1,665,540 new cancer cases and 585,720 cancer deaths are projected to occur in the United States in 2014. During the most recent 5 years for which there are data (2006-2010), delay-adjusted cancer incidence rates declined slightly in men (by 0.6% per year) and were stable in women, while cancer death rates decreased by 1.8% per year in men and by 1.4% per year in women. The combined cancer death rate (deaths per 100,000 population) has been continuously declining for 2 decades, from a peak of 215.1 in 1991 to 171.8 in 2010. This 20% decline translates to the avoidance of approximately 1,340,400 cancer deaths (952,700 among men and 387,700 among women) during this time period. The magnitude of the decline in cancer death rates from 1991 to 2010 varies substantially by age, race, and sex, ranging from no decline among white women aged 80 years and older to a 55% decline among black men aged 40 years to 49 years. Notably, black men experienced the largest drop within every 10-year age group. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population.

10,829 citations

Journal ArticleDOI
TL;DR: Pancreas and liver cancers are projected to surpass breast, prostate, and colorectal cancers to become the second and third leading causes of cancer-related death by 2030, respectively.
Abstract: Cancer incidence and deaths in the United States were projected for the most common cancer types for the years 2020 and 2030 based on changing demographics and the average annual percentage changes in incidence and death rates. Breast, prostate, and lung cancers will remain the top cancer diagnoses throughout this time, but thyroid cancer will replace colorectal cancer as the fourth leading cancer diagnosis by 2030, and melanoma and uterine cancer will become the fifth and sixth most common cancers, respectively. Lung cancer is projected to remain the top cancer killer throughout this time period. However, pancreas and liver cancers are projected to surpass breast, prostate, and colorectal cancers to become the second and third leading causes of cancer-related death by 2030, respectively. Advances in screening, prevention, and treatment can change cancer incidence and/or death rates, but it will require a concerted effort by the research and healthcare communities now to effect a substantial change for the future.

4,973 citations


"Thyroid cancer mortality and incide..." refers background in this paper

  • ...In most countries, incidence rates have been appreciably increasing over the last few decades,2,3 and if recent trends are maintained, thyroid cancer may become the fourth most common cancer by 2030 in the United States.4 Such an increase is likely due to improved ascertainment, diagnosis and certification, and largely or totally reflects overdiagnosis of indolent disease, i.e., small papillary carcinomas.2,3,5 Conversely, mortality rates have been steadily declining in most areas of the world,6–8 likely due to improved diagnosis, management and treatment of the disease....

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  • ...Thus, the rise in thyroid cancer incidence does not appear to reflect a real increase in the occurrence of this neoplasm, but it is more likely due to a substantial increment in the detection of subclinical thyroid cancers (such as small papillary carcinomas) over the last decades, particularly in young women.(2,4,31) Indeed, diagnostic techniques for thyroid cancer have become more sensitive, particularly through the use of ultrasounds, ultrasoundguided fine-needle aspiration and computed tomography Figure 4....

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  • ...In most countries, incidence rates have been appreciably increasing over the last few decades,(2,3) and if recent trends are maintained, thyroid cancer may become the fourth most common cancer by 2030 in the United States.(4) Such an increase is likely due to improved ascertainment, diagnosis and certification, and largely or totally reflects overdiagnosis of indolent disease, i....

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Book
01 Jan 1981
TL;DR: Evidence that the various common types of cancer are largely avoidable diseases is reviewed, and it is suggested that, apart from cancer of the respiratory tract, the types of cancers that are currently common are not peculiarly modern diseases and are likely to depend chiefly on some long-established factor.
Abstract: My lecture spanned not only the hour allocated for it in the morning, but also the first half of the round table that afternoon, where it acted as an introduction to the round table discussion that followed. The break between the two sessions was determined only by administrative and not by scientific matters, and so in this published account, the two may be read as a unit.

4,211 citations