Increased trend of thyroid cancer in childhood over the last 30 years in EU countries: a call for the pediatric surgeon

Abstract

Given the increasing incidence of thyroid cancer cases affecting the pediatric population in Europe, an epidemiological analysis of the available data is essential in order to update standards of care and recommend diagnostic and therapeutic strategies coherent to the new epidemiological trend. An observational study was conducted, considering the time interval 1991–2012, acquiring data collected by the International Agency for Research on Cancer (IARC) through the “Cancer Incidence in 5 continents plus” (CI5 plus) project and dividing patients into four groups of age (0–4, 5–9, 10–14, 15–19 years old). Data retrieved were compared to the latest report from Global Cancer Observatory, collected through the GLOBOCAN 2020 project, dividing patients in two groups: age 10–14, 15–19. Our findings highlighted an increasing prevalence of thyroid cancer rates in patients aged from 10 to 15 years old and from 15 to 19 years old, mainly in the female population, in Belarus (from 1991 to 2007), Cyprus, and Italy (from 2008 to 2012). Moreover, a further increase in incidence was highlighted in Italy according to data from GLOBOCAN 2020, with respect to other European countries.Conclusion: An increasing prevalence of thyroid cancer is seen in age groups 10–19. Further research is required to understand the underlying cause and concomitantly identify the most proper screening and diagnostic techniques of thyroid nodules. Indeed, this is crucial to reach optimal surgical standards and better prognosis, possibly with more conservative approaches and maybe less postoperative complications. What is Known:• Thyroid cancer is the 4th most common malignancy in children. What is New:• In the last decades, an increasing pattern has been recorded.• In the US, it has outlined breast cancers as the most common cancer in females.

Global incidence and prevalence of differentiated thyroid cancer in childhood: systematic review and meta-analysis

“…More recently, an observational study compared data collected by the International Agency for Research on Cancer (IARC) through the “Cancer Incidence in 5 continents plus” (CI5 plus) project with those of the latest report from the Global Cancer Observatory (GLOBOCAN 2020 project). An overall increasing prevalence of thyroid cancer was found in the age groups 10–19, with female late adolescents presenting a much higher incidence with respect to girls aged 10–14 years old ( 43 ).…”

“…Possible explanations for the observed increased risk of DTC in postpubertal female subjects compared with their male counterparts include mechanisms involving female sex hormones, with estrogen and estrogen receptors (ERs) being the most investigated target of current research. Several in-vitro and animal studies have evaluated the influence of sex steroids on the proliferation of thyroid cells, although considerable discrepancies with respect to ER expression patterns in thyroid cancer tissues actually exist ( 43 , 45 , 46 ).…”

Risk of thyroid neoplasms in patients with 22q11.2 deletion and DiGeorge-like syndromes: an insight for follow-up

“…Epidemiological surveillance data described 1.2 cases per 100,000 patients under the age of 20 but 0.4 cases per 100,000 in patients aged under 15 ( 31 ). However, the incidence of pediatric thyroid nodules and cancer appears to be steadily increasing and associated with a worse prognosis ( 32 ), far higher than the expected value in the adult population (5%) ( 33 ). In clinical practice, the management of pediatric thyroid nodules largely follows the adult thyroid guidelines ( 25 ), with some peculiarities related to pediatric age.…”

Clinical Value of Ultrasonography and Serum Markers in Preoperative N Staging of Thyroid Cancer

“…However, this should not include children younger than 18, and we have too few data on pediatric patients to draw accurate conclusions. Spinelli et al [ 58 ] indicated that thyroidectomy can be associated with a considerable rate of complications such as hypoparathyroidism and recurrent laryngeal nerve injury. For all of these reasons, they underline the necessity to develop specific management strategies for the pediatric population, in order to face the increasing rates of thyroid cancers in the pediatric field and to offer optimal surgical treatment and avoid unnecessary invasive approaches.…”