Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013 - PubMed (original) (raw)

Hyeyeun Lim et al. JAMA. 2017.

Abstract

Importance: Thyroid cancer incidence has increased substantially in the United States over the last 4 decades, driven largely by increases in papillary thyroid cancer. It is unclear whether the increasing incidence of papillary thyroid cancer has been related to thyroid cancer mortality trends.

Objective: To compare trends in thyroid cancer incidence and mortality by tumor characteristics at diagnosis.

Design, setting, and participants: Trends in thyroid cancer incidence and incidence-based mortality rates were evaluated using data from the Surveillance, Epidemiology, and End Results-9 (SEER-9) cancer registry program, and annual percent change in rates was calculated using log-linear regression.

Exposure: Tumor characteristics.

Main outcomes and measures: Annual percent changes in age-adjusted thyroid cancer incidence and incidence-based mortality rates by histologic type and SEER stage for cases diagnosed during 1974-2013.

Results: Among 77 276 patients (mean [SD] age at diagnosis, 48 [16] years; 58 213 [75%] women) diagnosed with thyroid cancer from 1974-2013, papillary thyroid cancer was the most common histologic type (64 625 cases), and 2371 deaths from thyroid cancer occurred during 1994-2013. Thyroid cancer incidence increased, on average, 3.6% per year (95% CI, 3.2%-3.9%) during 1974-2013 (from 4.56 per 100 000 person-years in 1974-1977 to 14.42 per 100 000 person-years in 2010-2013), primarily related to increases in papillary thyroid cancer (annual percent change, 4.4% [95% CI, 4.0%-4.7%]). Papillary thyroid cancer incidence increased for all SEER stages at diagnosis (4.6% per year for localized, 4.3% per year for regional, 2.4% per year for distant, 1.8% per year for unknown). During 1994-2013, incidence-based mortality increased 1.1% per year (95% CI, 0.6%-1.6%) (from 0.40 per 100 000 person-years in 1994-1997 to 0.46 per 100 000 person-years in 2010-2013) overall and 2.9% per year (95% CI, 1.1%-4.7%) for SEER distant stage papillary thyroid cancer.

Conclusions and relevance: Among patients in the United States diagnosed with thyroid cancer from 1974-2013, the overall incidence of thyroid cancer increased 3% annually, with increases in the incidence rate and thyroid cancer mortality rate for advanced-stage papillary thyroid cancer. These findings are consistent with a true increase in the occurrence of thyroid cancer in the United States.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Hyeyeun Lim, Susan S. Devesa, David Check and Cari M. Kitahara declare no competing interests. Julie A. Sosa is on the Data Monitoring Committee of the Medullary Thyroid Cancer Consortium Registry, which is sponsored by Astra Zeneca, Eli Lilly, GlaxoSmithKline and Novo Nordisk.

Figures

Figure 1.

Figure 1.

Trends in annual thyroid cancer incidence rates (cases per 100,000 person-years). (A) Thyroid cancer incidence, overall and by histologic type (1974–2013) (B) Papillary thyroid cancer incidence by SEER Historic Stage A at diagnosis (1974–2013) (C) Papillary thyroid cancer incidence by tumor size at diagnosis (1983–2013). Tumor size was not recorded for cases diagnosed 1974–1982. Rates are age-adjusted to the 2000 U.S. standard population. Each line represents the annual percent change (APC).

Figure 2.

Figure 2.

Trends in annual thyroid cancer mortality rates (deaths per 100,000 person-years). (A) Observed total U.S. thyroid cancer mortality (1974–2013), observed SEER-9 thyroid cancer mortality (1974–2013), thyroid cancer incidence–based mortality, overall (1974–2013) and by histologic type (1994–2013), based on cases diagnosed during 1974–2013 (B) Thyroid cancer incidence-based mortality by SEER Historic Stage A at diagnosis (1994–2013), based on papillary thyroid cancer cases diagnosed during 1974–2013 C) Thyroid cancer incidence-based mortality by tumor size at diagnosis (1994–2013), based on papillary thyroid cancer cases diagnosed during 1983–2013. Tumor size was not recorded for cases diagnosed 1974–1982. Rates are age-adjusted to the 2000 U.S. standard population. Each line represents the annual percent change (APC). *APCs were not calculated if 0 deaths occurred in one or more years.

Comment in

Similar articles

Cited by

References

    1. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2013, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2013/, based on November 2015 SEER data submission, posted to the SEER web site, April 2016. Accessed June 1, 2016.
    1. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295(18):2164–2167. - PubMed
    1. Kent WD, Hall SF, Isotalo PA, Houlden RL, George RL, Groome PA. Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease. CMAJ 2007;177(11):1357–1361. - PMC - PubMed
    1. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg 2014;140(4):317–322. - PubMed
    1. Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis. N Engl J Med 2016;375(7):614–617. - PubMed

Publication types

MeSH terms

LinkOut - more resources