Decreasing trends in thyroid cancer incidence in South Korea: What happened in South Korea?

Oh, Chang‐Mo; Lim, Jiwon; Jung, Yuh Seog; Kim, Yeol; Jung, Kyu‐Won; Hong, Seri; Won, Young‐Joo

doi:10.1002/cam4.3926

Cited by 27 publications

(29 citation statements)

References 29 publications

(37 reference statements)

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“…Overall, TERT promoter mutational status was significantly associated with old age, male sex, large tumor size, advanced histological type, advanced T and N stage, and presence of distant metastasis. In Korea, the incidence of thyroid carcinoma abruptly increased after the introduction of high-resolution ultrasonography and peaked in 2012, and then decreased [18]. Since the introduction of the Revised Korean Thyroid Association manage-ment guidelines, most thyroid tumors of 1 cm or less do not undergo cytologic examination, and active surveillance is selected as an optional method of treatment [19].…”

Section: Article In Pressmentioning

confidence: 99%

Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients

et al. 2022

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Background: Telomerase reverse transcriptase (TERT) promoter mutations are associated with increased recurrence and mortality in patients with thyroid carcinoma. Previous studies on TERT promoter mutations were retrospectively conducted on a limited number of patients. Methods: We prospectively collected data on all consecutive patients who underwent thyroid carcinoma surgery between January 2019 and December 2020 at the Samsung Medical Center, Seoul, Korea. We included 2,092 patients with thyroid carcinoma. Results: Of 2,092 patients, 72 patients (3.4%) had TERT promoter mutations. However, the frequency of TERT promoter mutations was 0.5% in papillary thyroid microcarcinoma (PTMC) ≤1 cm and it was 5.8% in papillary thyroid carcinoma (PTC) >1 cm. The frequency of TERT promoter mutations was significantly associated with older age at diagnosis (odds ratio [OR], 1.12; P<0.001), larger primary tumor size (OR, 2.02; P<0.001), and aggressive histological type (OR, 7.78 in follicular thyroid carcinoma; OR, 10.33 in poorly differentiated thyroid carcinoma; OR, 45.92 in anaplastic thyroid carcinoma; P<0.001). Advanced T stage, advanced N stage, and distant metastasis at diagnosis were highly prevalent in mutated thyroid cancers. However, initial distant metastasis was not present in patients with TERT promoter mutations in PTMC. Although the C228T mutation was more highly detected than the C250T mutation (64 cases vs. 7 cases), there were no significant clinicopathological differences. Conclusion:This study is the first attempt to investigate the frequency of TERT promoter mutations in a real-world setting. The frequency of TERT promoter mutations in PTC was lower than expected, and in PTMC, young patients, and female patients, the frequency was very low.

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Section: Article In Pressmentioning

confidence: 99%

Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients

et al. 2022

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“…However, it is unlikely that the results in this study will change significantly even if we considered recent information for the following reasons. Along with new guideline recommending not to use fine needle aspiration for thyroid cancer diagnosis in patient with thyroid nodule < 0.5 cm 38 and evidence supporting the overdiagnosis of thyroid cancer in Korea 2 , 3 , the incidence of thyroid cancer between 2012 and 2016 showed a decreasing trend 39 . However, the recent thyroid cancer incidence in Korea is still higher than that of 10 years ago 1 .…”

Section: Discussionmentioning

confidence: 99%

“…However, the recent thyroid cancer incidence in Korea is still higher than that of 10 years ago 1 . Furthermore, the facts that the evidences of overdiagnosis of thyroid cancer are steeply increased incidence restricted to papillary thyroid cancer and non-increasing mortality rate 14 , and the proportion of papillary thyroid cancer between 2012 and 2016 rather increased than that in the past indicate 39 that overdiagnosis still exists widely in Korea. In addition, it is unlikely that there will be a sharp regional difference in the acceptance of thyroid cancer guidelines by physicians or the recognition of thyroid cancer overdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

Spatial distribution and determinants of thyroid cancer incidence from 1999 to 2013 in Korea

Jang

Yoo

Chun

2021

Sci Rep

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We evaluated the spatial variation in thyroid cancer incidence and its determinants in Korea considering its importance in cancer prevention and control. This study was based on the ecological design with cancer incidence data by administrative district from the National Cancer Center and regional characteristics generated from the Korea Community Health Survey Data. We identified spatial clusters of thyroid cancer incidences based on spatial scan statistics. Determinants of regional variation in thyroid cancer incidence were assessed using the Besag-York-Mollie model with integrated nested Laplace approximations. Spatial clusters for low and high thyroid cancer incidences were detected in the northeastern and southwestern regions, respectively. Regional variations in thyroid cancer incidence can be attributed to the prevalence of recipients of basic livelihood security (coefficient, − 1.59; 95% credible interval [CI], − 2.51 to − 0.67), high household income (coefficient, 0.53; 95% CI, 0.31 to 0.76), heavy smoking (coefficient, − 0.91; 95% CI, − 1.59 to − 0.23), thyroid dysfunction (coefficient, 3.24; 95% CI, 1.47 to 5.00), and thyroid cancer screening (coefficient, 0.38; 95% CI, 0.09 to 0.67). This study presented the spatial variations in thyroid cancer incidence, which can be explained by the prevalence of socioeconomic factors, thyroid cancer screening, thyroid dysfunction, and smoking.

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“…If overscreening remains a major issue, other factors might have caused the decrease in thyroid cancer incidence (e.g., improved diagnostic efficiency, higher ultrasound resolution, greater expertise of physicians, and media effect). The revised KTA guidelines and K-TIRADS might have played a role in solving the problem of overdiagnosis to some extent [ 9 ]. Therefore, this study aimed to investigate the change in the diagnostic performance of thyroid cancer screening, especially the efficiency of FNA biopsies, before and after the K-TIRADS revision.…”

Section: Introductionmentioning

confidence: 99%

“…The revised KTA guidelines and K-TI-RADS might have played a role in solving the problem of overdiagnosis to some extent. 9) Therefore, this study aimed to investigate the change in the diagnostic performance of thyroid cancer screening, especially the efficiency of FNA biopsies, before and after the K-TIRADS revision.…”

Section: Introductionmentioning

confidence: 99%

Changes in Diagnostic Performance of Thyroid Cancer Screening before and after the Korean Thyroid Imaging Reporting and Data System Revision

et al. 2022

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Background: Since the era of “thyroid cancer epidemic,” many Korean academic societies discouraged the use of ultrasonography in healthy individuals and revised the Korean Thyroid Imaging Reporting and Data System to address the overscreening and overdiagnosis issues. This study aimed to evaluate the change in the diagnostic effectiveness of thyroid cancer screening over the last decade.Methods: This single-center, retrospective observational study analyzed the data of 125,962 thyroid nodules obtained during cancer screening at the health promotion center of Seoul National University Bundang Hospital from 2010 to 2019. Only 327 thyroid cancer cases pathologically confirmed by fine-needle aspiration (FNA) were included in the study. The strength of the association between the number of FNA and (1) the number of thyroid cancer diagnoses, (2) the positive predictive values (PPVs), and (3) the difference in PPV from the previous year were evaluated using Pearson’s correlation analysis.Results: The number of thyroid FNA biopsies as well as the thyroid cancer diagnoses decreased from 2010 to 2019 (166 to 48 [-71.1%] vs. 43 to 22 [-48.8%]). The PPV of FNA biopsies increased from 25.9% to 45.8% (+76.8%) and was negatively correlated with the number of FNA biopsies performed (R=-0.87, P<0.001). The difference in PPV from the previous year increased similarly but without statistical significance (R=-0.59, P=0.09).Conclusion: The diagnostic efficiency of thyroid cancer screening has increased over the last decade, as evidenced by the increasing PPV of FNA biopsies.

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Decreasing trends in thyroid cancer incidence in South Korea: What happened in South Korea?

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 27 publications

References 29 publications

Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients

Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients

Spatial distribution and determinants of thyroid cancer incidence from 1999 to 2013 in Korea

Changes in Diagnostic Performance of Thyroid Cancer Screening before and after the Korean Thyroid Imaging Reporting and Data System Revision

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