Hospices Civils de Lyon, Registre Rhône Alpin des Cancers thyroïdiens, Fédération d'Endocrinologie et Centre de Médecine Nucléaire Groupement Hospitalier Est, 69677 Bron Cedex, France.
Eur J Endocrinol. 2010 Jan;162(1):127-35. doi: 10.1530/EJE-09-0570. Epub 2009 Sep 29.
To analyze, at a population level, the relation between the incidences of benign thyroid diseases in patients submitted to surgery and that of thyroid cancers based on their respective geographical distributions.
The study included 3169 cases (691 cancers and 2478 benign diseases) operated on in 2002 in the Rhône-Alpes région, which is subdivided into eight départements and 311 cantons.
The total thyroid intervention rate was 54.6/100 000 (23.4 and 86.4), and the annual cancer incidence was 11.9/100 000 (4.7 and 13.8) for men and women respectively. The prevalence of cancer among thyroid surgery was 21.8% and that of cancer discovered in goiters increased with age (44% at 60 years). Intervention rates varied from départment to département. In women, the incidence of microcancers was correlated to the thyroid intervention for benign pathologies rate. In men, the incidence of supracentimetric cancers was related to the TIBR. At the canton level, the relative risk of benign diseases was correlated to that of cancers. TIBR and incidence of cancers were higher in urban cantons than in nonurban ones. The density of endocrinologists influenced the prevalence of cancers among all the cases submitted to surgery.
In the Rhône-Alpes population with high rates of thyroid cancer incidence and of thyroid surgery, a number of correlations were found according to gender and tumor size. However, the general incidence of cancer was not directly related to surgical activity. Geographical variability may be related to the heterogeneous medical and pathological practices.
在人群水平上，根据甲状腺癌和良性甲状腺疾病的地理分布，分析接受手术治疗的患者中这两种疾病的发病率之间的关系。
本研究纳入了 2002 年在罗纳-阿尔卑斯地区接受手术治疗的 3169 例患者（691 例癌症和 2478 例良性疾病），该地区分为 8 个省和 311 个县。
甲状腺干预总发生率为 54.6/100000（男性为 23.4/100000，女性为 86.4/100000），男女年癌症发病率分别为 11.9/100000（4.7/100000 和 13.8/100000）。甲状腺手术中癌症的患病率为 21.8%，甲状腺肿中发现的癌症患病率随年龄增长而增加（60 岁时为 44%）。各省内的干预率存在差异。在女性中，微癌的发病率与良性病变的甲状腺干预率相关。在男性中，超径癌的发病率与 TIBR 相关。在县一级，良性疾病的相对风险与癌症的相对风险相关。城市县的 TIBR 和癌症发病率高于非城市县。内分泌科医生的密度影响所有接受手术的病例中癌症的患病率。
在罗纳-阿尔卑斯地区，甲状腺癌发病率和甲状腺手术率较高，根据性别和肿瘤大小发现了一些相关性。然而，癌症的总体发病率与手术活动并无直接关系。地理变异性可能与医疗和病理实践的异质性有关。
