Trends in Prevalence of Thyroid Cancer Over Three Decades: A Retrospective Cohort Study of 17,526 Surgical Patients

Abstract

IntroductionThyroid cancer (TC) incidence has been increasing in recent years. The aim of this study was to investigate our institution-based estimates of operative volumes for TC over the last three decades.Materials and methodsThis was a retrospective cohort study of patients undergoing thyroid surgery at our institution. Patient characteristics were reviewed in three subgroups: Group I (treated in 1981–1986), Group II (treated in 1987–2002), and Group III (treated in 2003–2012).ResultsTC was diagnosed in 1578/17,526 (9.0 %) thyroid operations. Incidence of TC increased from 3.7 % in Group I to 10.4 % in Group III (p < 0.001). Incidence of papillary TC increased form 40.6 % in Group I to 81.3 % in Group III (p < 0.001). In the latter group, 23.5 % of all papillary TCs were diagnosed in patients with Hashimoto’s disease. Meanwhile, incidence of anaplastic TC decreased from 16.2 % in Group I to 2.1 % in Group III patients (p < 0.001). pT1 tumors were diagnosed in 8.1 % Group I and 54.8 % Group III (p < 0.001), whereas pT4 tumors were identified in 40.5 % Group I, 2.4 % Group II, and 0.84 % Group III subjects (p < 0.001). pT3 tumors were found in 51.6 % Group I, whereas multifocal papillary TCs were found in 15.7 % Group III patients, the latter with a higher prevalence of pN1 stage (p < 0.001).ConclusionsThe following trends in surgical volume for TC were identified throughout the study period: a fivefold increase of thyroid operations for TC, a threefold increase in incidence of papillary TC, and an eightfold decrease in incidence of anaplastic TC. It is of interest that a significant increase in incidence of multifocal papillary TC in young female patients with Hashimoto’s disease was found over time.

Racial/ethnic differences in thyroid cancer incidence in the United States, 2007‐2014

“…The etiology of increasing incidence in the United States is unknown . Worldwide risk factors for thyroid cancer include inadequate and excessive dietary iodine, thyroid problems (eg, goiter, benign nodules, adenomas), and radiation exposure …”

“…[6][7][8] Worldwide risk factors for thyroid cancer include inadequate and excessive dietary iodine, thyroid problems (eg, goiter, benign nodules, adenomas), and radiation exposure. 3,[7][8][9] Researchers have attributed the rising rates of thyroid cancer in the United States to the improvement of diagnostic techniques, specifically ultrasound (US)-guided fine needle aspiration (FNA) and computed tomography (CT). 3,10 The introduction of US-guided FNA into the United States health care system in the 1990s enabled the detection of tumors not easily discovered by palpation.…”

“…Although many researchers have suggested overdiagnosis is the cause of rising thyroid cancer incidence rates in the United States, epidemiologists have yet to rule out an actual increase in incidence rates, and furthermore have suggested alternate explanations for the rising rates, including biological or genetic factors, environmental exposure, comorbidity, and lack of treatment adherence. 3,4,9,[15][16][17][18][19][20] Thyroid cancer incidence varies by race/ethnicity. 18,20 According to the National Cancer Institute's Surveillance, Epidemiology, and End Results 18 Program database (SEER 18), from 2000-2014, whites had the highest estimated thyroid cancer incidence rate, followed by Hispanics, Asians, Native Americans, and African Americans.…”

Integrated analysis identifies DUSP5 as a novel prognostic indicator for thyroid follicular carcinoma

“…Thyroid carcinoma (TC) incidence has increased dramatically over the past decades . The public generally ascribes this increase to improved diagnostic accuracy .…”

Thyroid Surgeries in a Single Centre, 2010 - 2014

“…Through decades, thyroid cancer has remained the most common endocrine cancer worldwide and the most rapidly increasing cancer 1,2 . That could be due to a better diagnosis 3 .…”