Increasing thyroid cancer incidence in <scp>Q</scp>ueensland, <scp>A</scp>ustralia 1982–2008 – true increase or overdiagnosis?

Pandeya, Nirmala; McLeod, Donald S A; Balasubramaniam, Kanchana; Baade, Peter D.; Youl, Philippa; Bain, Christopher; Allison, Roger; Jordan, Susan J.

doi:10.1111/cen.12724

Cited by 67 publications

(52 citation statements)

References 27 publications

(61 reference statements)

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“…8 11 Some investigators have, however, questioned the idea that overdiagnosis is the main cause of the current notable increase in cases of thyroid cancer. [12][13][14] In a registry based cancer study, 12 investigators observed that the incidence of both small and large thyroid tumours and the incidence of intrathyroidal and extrathyroidal cancers 12 substantially increased from 1983 to 2006 in the United States. The researchers concluded that improved detection does not fully explain…”

Section: Introductionmentioning

confidence: 99%

Association between screening and the thyroid cancer “epidemic” in South Korea: evidence from a nationwide study

Park

Cho

et al. 2016

BMJ

194

173

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Objective To investigate whether screening for thyroid cancer led to the current “epidemic” in South Korea.Design Review of the medical records of nationally representative samples of patients with a diagnosis of thyroid cancer in 1999, 2005, and 2008.Setting Sample cases were randomly selected from South Korea’s nationwide cancer registry, using a systematic sampling method after stratification by region.Participants 5796 patients with thyroid cancer were included (891 in 1999, 2355 in 2005, and 2550 in 2008).Main outcome measures The primary outcome was age standardised incidence of thyroid cancer and the changes in incidence between 1999 and 2008 according to the methods used to detect tumours (screen detection versus clinical detection versus unspecified).Results Between 1999 and 2008, the incidence of thyroid cancer increased 6.4-fold (95% confidence interval 4.9-fold to 8.4-fold), from 6.4 (95% confidence interval 6.2 to 6.6) per 100 000 population to 40.7 (40.2 to 41.2) per 100 000 population. Of the increase, 94.4% (34.4 per 100 000 population) were for tumours less than 20 mm, which were detected mainly by screening. 97.1% of the total increase was localised and regional tumours according to the Surveillance, Epidemiology, and End Results (SEER) summary stage. Where cases were clinically detected, 99.9% of the increased incidences (6.4 per 100 000 population) over the same period were tumours less than 20 mm.Conclusion The current “epidemic” of thyroid cancer in South Korea is due to an increase in the detection of small tumours, most likely as a result of overdetection. Concerted efforts are needed at a national level to reduce unnecessary thyroid ultrasound examinations in the asymptomatic general population.

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Section: Introductionmentioning

confidence: 99%

Association between screening and the thyroid cancer “epidemic” in South Korea: evidence from a nationwide study

Park

Cho

et al. 2016

BMJ

194

173

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“…In adults, the incidence of thyroid cancer has increased more rapidly than any other cancer in the last 20 years, and many studies have demonstrated factors contributing to the steep rise in the incidence of thyroid cancer [3,4,5]. Although improved detection with advanced imaging modalities is regarded as the main cause of the increasing incidence of small thyroid cancers [5], an increase in larger thyroid cancers indicates a rising occurrence of true thyroid cancer [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Although improved detection with advanced imaging modalities is regarded as the main cause of the increasing incidence of small thyroid cancers [5], an increase in larger thyroid cancers indicates a rising occurrence of true thyroid cancer [3,4]. Environmental and multiple other factors have been suggested [6]; however, the exact causes leading to the increase in thyroid cancer incidence are still unknown.…”

Section: Introductionmentioning

confidence: 99%

Trends in Thyroid Cancer Incidence in Korean Children (1999-2012) Based on Palpation and Nonpalpation Detection Methods

Cho¹,

Jang

Joung³

et al. 2015

Eur Thyroid J

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Background: The incidence of childhood thyroid cancer is increasing in several populations; however, contributing factors have not been adequately discussed. Objectives: Our aim was to identify trends of childhood thyroid cancer based on the Korea Central Cancer Registry (KCCR) database and to elucidate changes in detection methods of cancers using a single-center database. Methods: Data from the KCCR and Statistics Korea between 1999 and 2012 were used to calculate the crude incidence of thyroid cancer in children. To analyze detection methods for cancers, pediatric patients (aged 0-19 years, n = 126) who underwent thyroid surgery for thyroid cancers at our institution were identified. Subjects were divided into two groups by detection method: (1) palpation group and (2) screening group. Results: The crude incidence of childhood thyroid cancer increased from 0.5 per 100,000 in 1999 to 1.7 in 2012. The proportion of thyroid cancer among total cancers also increased from 4.4% in 1999 to 10.6% in 2012. Among 126 children from our institution, 91 cases (72%) were identified as palpable neck masses, and the remainder were discovered during imaging studies. The numbers in both groups gradually increased during the study period. Conclusions: The incidence of childhood thyroid cancer has steadily increased in Korea. Regarding the detection methods of cancers, most tumors are detected by palpation rather than screening, although the rate of masses identified during screening has increased.

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“…Specifically, increases in incidence have been reported in some European countries (La Vecchia et al, 2015), including Italy (Dal Maso et al, 2011), the Netherlands (Husson et al, 2013) and Wales (Amphlett et al, 2013). Worldwide, Australia (Pandeya et al, 2016) and the USA (Howlader et al, 2013) are among the countries with the largest increases in incidence (Kilfoy et al, 2009;La Vecchia et al, 2015), with APCs above five in both sexes, similar to the pattern of variation in incidence rates in Portugal. In the USA, the incidence of thyroid cancer has more than doubled over the last 30 years (from 3.6/100 000 in 1973 to 8.7/100 000 in 2002) and 87% of this increase is because of the diagnosis of small papillary cancers (≤ 1 cm) (Davies and Welch, 2006).…”

Section: Discussionmentioning

confidence: 70%

“…The increasing trend in the incidence of thyroid cancer in Portugal has surpassed the steady increase observed over the last few decades in various countries (Davies and Welch, 2006;Amphlett et al, 2013;Husson et al, 2013;La Vecchia et al, 2015;Pandeya et al, 2016) and an increase of over 30% for both sexes is expected by 2020 in the North (Castro et al, 2015). Specifically, increases in incidence have been reported in some European countries (La Vecchia et al, 2015), including Italy (Dal Maso et al, 2011), the Netherlands (Husson et al, 2013) and Wales (Amphlett et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Trends in thyroid cancer incidence and mortality in Portugal

Raposo

Morais

Oliveira

et al. 2017

European Journal of Cancer Prevention

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The objective was to quantify thyroid cancer incidence and mortality trends in Portugal. The number of thyroid cancer cases and incidence rates were retrieved from the Regional Cancer Registries for the period 1989-2011. The number of deaths and mortality rates were obtained from the WHO cancer mortality database (1988-2003 and 2007-2012) and Statistics Portugal (2004-2006; 1988-2012 by region). Joinpoint regression of the standardized incidence and mortality rates was performed. A significant, rapid and continued increase in incidence was observed for both sexes in each of the Regional Cancer Registries, with annual per cent changes (APCs) ranging between 2 and 9. Incidence in Portuguese women is higher than estimates for the world and Europe. Mortality decreased for women (APC: -1.5), with the greatest decrease in the North, and increased marginally for men (APC: +0.2), with a greater increase in the South. The significant increases in incidence in Portugal are predominantly because of the increase in incidence among women from the North. These trends, combined with an overall low mortality and high 5-year relative survival, raise concerns on the extent to which overdiagnosis may be taking place. Further research is needed, quantifying the importance of the most likely determinants of these trends as well as the extent and potentially deleterious effects of overdiagnosis and overtreatment in the Portuguese setting.

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Increasing thyroid cancer incidence in Queensland, Australia 1982–2008 – true increase or overdiagnosis?

Cited by 67 publications

References 27 publications

Association between screening and the thyroid cancer “epidemic” in South Korea: evidence from a nationwide study

Association between screening and the thyroid cancer “epidemic” in South Korea: evidence from a nationwide study

Trends in Thyroid Cancer Incidence in Korean Children (1999-2012) Based on Palpation and Nonpalpation Detection Methods

Trends in thyroid cancer incidence and mortality in Portugal

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