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Objective: To analyze thyroid cancer (TC) mortality rates from 1990 to 2016 in Ecuadorian men and women and compare their trends with Latin American and international trends. Design: A population-based temporal-trend study using the database of the Ecuadorian National Death Registry. Methods: Crude and age-adjusted mortality rates were calculated, and age-related mortality rates were standardized with the world population (WHO). Trends in age-standardized mortality rates were estimated by jointpoint regression analysis. The trends were expressed as annual percentage change (APC) and average annual percentage change (AAPC). Results: In total, TC caused 2,107 deaths (1,475 women and 632 men) in the selected period. The mortality in men showed a statistically non-significant decrease. The estimated APC was −0.4% (P = 0.70), and the AAPC was −0.4% (P = 0.70) without any identified jointpoint. In women, the mortality decreased significantly between 1990 and 1998, with the estimated APC being −6.6% (P < 0.05). However, it increased significantly from 1998 to 2016, with the estimated APC of 5.4% (P < 0.05), and a jointpoint was identified; the AAPC was 1.4 (P = 0.30). Conclusions: While TC mortality in Ecuadorian men showed a decrease, that in Ecuadorian women showed an initial decrease and a final increase. Our findings can be contrasted with the global data, which show decreases in TC mortality in both sexes.

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Background The incidence of thyroid cancer is increasing worldwide. This is not accompanied by a corresponding increase in mortality. In contrast, in most populations’ thyroid cancer mortality has been decreasing in recent decades, although there are some notable exceptions. Main body of the abstract Relatively few studies focus on mortality and in Latin America we do not find evidence on the temporal trend of mortality. The study of the epidemiology of the thyroid cancer should be approached with a suitable methodology and with data based on the population. Trends should be expressed as an annual percentage of change and/or average annual rate of change. An appropriate method for analyzing trends in thyroid cancer mortality rates is the Joinpoint regression analysis. Previously published findings are described, and the methodology used is compared . Short conclusion At the global level, Ecuador is one of the countries with the highest incidence rate of thyroid cancer. However, mortality data are scarce and not rigorous. It is important to raise awareness of updated and reliable population-based data on the trend of thyroid cancer mortality in Eccuador.