Background
The incidence of thyroid cancer has more than doubled in recent decades. Debate continues
on whether the increasing incidence is a result of an increased detection of small
neoplasms or other factors.
Methods
Using the Surveillance, Epidemiology and End Results database, we examined the overall
incidence of thyroid cancer with variations based on tumor pathology, size, and stage,
as well as the current surgical and adjuvant therapy of thyroid carcinoma.
Results
Thyroid cancer incidence increased 2.6-fold from 1973 to 2006. This change can be
attributed primarily to an increase in papillary thyroid carcinoma, which increased
3.2-fold (P < .0001). The increase in papillary thyroid carcinoma also was examined based on
tumor size. Tumors ≤1 cm increased the most at a total of 441% between 1983 and 2006
or by 19.2% per year, the incidence of papillary thyroid carcinoma also increased
at 12.3%/year in 1.1–2-cm tumors, 10.3%/year in 2.1–5-cm tumors, and 12.0%/year for
>5-cm tumors (all P < .0001 by Cochran–Armitage trend test). We also demonstrated a positive correlation
between papillary thyroid carcinoma tumor size and stage of disease (Spearman, r =
0.285, P < .0001). Operative treatment for thyroid cancer also has shifted with total thyroidectomy
replacing partial thyroidectomy as the most common surgical procedure.
Conclusion
Contrary to other studies, our data indicate that the increasing incidence of thyroid
cancer cannot be accounted for fully by an increased detection of small neoplasms.
Other possible explanations for the increase in clinically significant (>1 cm) well-differentiated
thyroid carcinomas should be explored.
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References
- Increasing incidence of thyroid cancer in the United States, 1973–2002.JAMA. 2006; 295: 2164-2167
- Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease.CMAJ. 2007; 177: 1357-1361
- A time trend analysis of papillary and follicular cancers as a function of tumor size: a study of data from six cancer registries in France (1983–2000).Eur J Cancer. 2007; 43: 891-900
- Temporal trends for thyroid carcinoma in Australia: an increasing incidence of papillary thyroid carcinoma (1982–1997).Thyroid. 2002; 12: 141-149
- Care of the pregnant thyroid cancer patient.Curr Opin Oncol. 2010; 22: 1-5
- Cancer statistics, 2009.CA Cancer J Clin. 2010; 59: 225-249
- The prevalence of small papillary thyroid carcinomas in 100 consecutive autopsies in an American population.in: DeGroot L.J. Frohman L.A. Kaplan E.L. Refetoff S. Radiation-associated thyroid carcinoma. Grune & Stratton, New York1977: 123
- Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005.Cancer Epidemiol Biomarkers Prev. 2009; 18: 784-791
- The thyroid cancer epidemic: is it the dark side of the CT revolution?.Eur J Radiol. 2006; 60: 67-69
- A post-Chernobyl rise in thyroid cancer in Connecticut, USA.Eur J Cancer Prev. 1996; 5: 75-81
- Thyroid cancer.Cancer Lett. 2001; 163: 143-156
- The prognostic value of primary tumor size in papillary and follicular thyroid carcinoma.Cancer. 2005; 103: 2269-2273
- Primary tumor diameter as a risk factor for advanced disease features of differentiated thyroid carcinoma.Clin Endocrinol. 2009; 71: 291-297
- Increasing detection and increasing incidence in thyroid cancer.World J Surg. 2009; 33: 2567-2571
- Increasing incidence of differentiated thyroid cancer in the United States, 1988–2005.Cancer. 2009; 115: 3801-3807
- The WHO histologic classification of thyroid tumors: a commentary on the second edition.Cancer. 1989; 63: 908-911
- Body size and thyroid cancer in two million Norwegian men and women.Br J Cancer. 2006; 95: 366-370
- Risk of thyroid cancer after exposure to fertility drugs: results from a large Danish cohort study.Hum Reprod. 2008; 23: 451-456
- Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in native women in French Polynesia: a population-based case-control study.Am J Epidemiol. 2008; 167: 219-229
- Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.Thyroid. 2009; 19: 1167-1214
Article info
Publication history
Accepted:
October 19,
2010
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
