La Vecchia Carlo, Malvezzi Matteo, Bosetti Cristina, Garavello Werner, Bertuccio Paola, Levi Fabio, Negri Eva
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Int J Cancer. 2015 May 1;136(9):2187-95. doi: 10.1002/ijc.29251. Epub 2014 Oct 13.
In most areas of the world, thyroid cancer incidence has been appreciably increasing over the last few decades, whereas mortality has steadily declined. We updated global trends in thyroid cancer mortality and incidence using official mortality data from the World Health Organization (1970-2012) and incidence data from the Cancer Incidence in Five Continents (1960-2007). Male mortality declined in all the major countries considered, with annual percent changes around -2/-3% over the last decades. Only in the United States mortality declined up to the mid 1980s and increased thereafter. Similarly, in women mortality declined in most countries considered, with APCs around -2/-5% over the last decades, with the exception of the UK, the United States and Australia, where mortality has been declining up to the late 1980s/late 1990s to level off (or increase) thereafter. In 2008-2012, most countries had mortality rates (age-standardized, world population) between 0.20 and 0.40/100,000 men and 0.20 and 0.60/100,000 women, the highest rates being in Latvia, Hungary, the Republic of Moldova and Israel (over 0.40/100,000) for men and in Ecuador, Colombia and Israel (over 0.60/100,000) for women. In most countries, a steady increase in the incidence of thyroid cancer (mainly papillary carcinomas) was observed in both sexes. The declines in thyroid cancer mortality reflect both variations in risk factor exposure and changes in the diagnosis and treatment of the disease, while the increases in the incidence are likely due to the increase in the detection of this neoplasm over the last few decades.
在世界上大多数地区,过去几十年间甲状腺癌的发病率显著上升,而死亡率则稳步下降。我们利用世界卫生组织的官方死亡率数据(1970 - 2012年)以及《五大洲癌症发病率》的数据(1960 - 2007年),更新了全球甲状腺癌死亡率和发病率的趋势。在所考虑的所有主要国家中,男性死亡率均有所下降,过去几十年的年变化率约为-2%/-3%。只有美国的死亡率在20世纪80年代中期之前下降,此后上升。同样,在大多数所考虑的国家中,女性死亡率下降,过去几十年的年变化率约为-2%/-5%,英国、美国和澳大利亚除外,在这些国家,死亡率在20世纪80年代末/90年代末之前一直在下降,此后趋于平稳(或上升)。在2008 - 2012年期间,大多数国家的死亡率(年龄标准化,世界人口)在男性中为每10万人0.20至0.40例,在女性中为每10万人0.20至0.60例,男性中死亡率最高的是拉脱维亚、匈牙利、摩尔多瓦共和国和以色列(超过每10万人0.40例),女性中是厄瓜多尔、哥伦比亚和以色列(超过每10万人0.60例)。在大多数国家,男女两性的甲状腺癌(主要是乳头状癌)发病率均持续上升。甲状腺癌死亡率的下降既反映了危险因素暴露的变化,也反映了疾病诊断和治疗的变化,而发病率的上升可能是由于过去几十年该肿瘤检测率的提高。