Evolving Understanding of the Epidemiology of Thyroid Cancer

Seib, Carolyn D.; Sosa, Julie Ann

doi:10.1016/j.ecl.2018.10.002

Cited by 344 publications

(295 citation statements)

References 61 publications

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“…We observed that the majority of thyroid cancer cases were of low risk of recurrence and mortality. Moreover, we found that more than half of thyroid cancers were diagnosed incidentally, and the minority of patients presented with symptoms resembling findings in countries where thyroid cancer overdiagnosis drives increasing incident trends [34][35][36][37] .…”

Section: Discussionsupporting

confidence: 63%

Incidental diagnosis and surgery outcomes of thyroid cancer in Ecuador

Solís-Pazmiño¹,

Salazar-Vega²,

Lincango-Naranjo³

et al. 2019

Preprint

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Background: In contrast to the rapid increase in thyroid cancer (TC) incidence, thyroid cancer mortality rates have remained low and stable over the last decades. In Ecuador, however, TC mortality has increased and to determine possible drivers, a retrospective analysis of all patients attending a thyroid cancer referral center in Ecuador was conducted. Methods: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo (HEEE), a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results: Among 452 patients, 74.8% were young adults and 94.2% (426) of patients were female. 13.7% had a family history of thyroid cancer, and median of tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score equal or less than 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin (sTg) value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma (DTC), 86% (n=375) received radioactive iodine (RAI). Conclusion: Thyroid cancer histological characteristics and method of diagnosis are like the ones described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Section: Discussionsupporting

confidence: 63%

Incidental diagnosis and surgery outcomes of thyroid cancer in Ecuador

Solís-Pazmiño¹,

Salazar-Vega²,

Lincango-Naranjo³

et al. 2019

Preprint

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“…Thyroid cancer incidence is rising considerably worldwide (+300% over the last 30 years) (1,2). The causes underpinning this huge increase are controversial and environmental factors may play a role (1) as well as an overdiagnosis effect due to the widespread use of imaging techniques and screening campaigns (3).…”

Section: Introductionmentioning

confidence: 99%

Follow-up of low risk thyroid cancer patients: can we stop follow-up after 5 years of complete remission?

Lamartina

Handkiewicz-Junak

2020

European Journal of Endocrinology

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Each year, the proportion of thyroid cancer patients presenting with low-risk disease is increasing. The shift in the landscape of thyroid cancer presentation is forcing clinicians to re-evaluate not only management but also surveillance paradigms. During the follow-up, patients are stratified considering their response to treatment and classified into one of the following response categories: excellent, biochemical incomplete, structural incomplete, or indeterminate. These categories reflect a real-time prognosis and thereby substantially influence and personalise disease management. Although at present, no guideline recommends stopping differentiated thyroid carcinoma (DTC) surveillance at any particular time point, the relatively low prevalence of treatment failures in low-risk patients may prompt early discontinuation of surveillance in this subgroup. Therefore, this debate will present an overview of the controversies surrounding the surveillance of low-risk patients with DTC.

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“…However, the patients with PMC had a female preponderance and the patients with diffuse sclerosing variant of PC had a higher mean age. prevalansı son üç yılda baskın olmak üzere küresel olarak artmaktadır (5)(6)(7)(8). Tiroid malignitelerinin çok büyük bir kısmını oluşturan PK hem tiroidin hem de endokrin sistemin en sık görülen malignitesidir (5,6,(9)(10)(11).…”

Section: Discussionunclassified