Oh Chang-Mo, Jung Kyu-Won, Won Young-Joo, Shin Aesun, Kong Hyun-Joo, Lee Jin-Soo
The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea.
Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2015 Jul;47(3):362-9. doi: 10.4143/crt.2014.110. Epub 2014 Dec 2.
South Korea has the highest incidence rate of thyroid cancer in the world, and the incidence rate continues to increase. The aim of this study was to determine the age-period-cohort effects on the incidence of thyroid cancer in Korea.
Using the Korean National Cancer registry database, age-standardized incidence rates and annual percent changes (APCs) in thyroid cancer according to sex and histologic type were analyzed between 1997 and 2011. Age-period-cohort models were applied using an intrinsic estimator method according to sex.
In both men and women, the incidence of thyroid cancer showed a sharp increase from 1997 through 2011. Among the histologic types, papillary carcinoma showed the greatest increase, with APCs of 25.1% (95% confidence interval [CI], 22.7% to 27.5%) in men and 23.7% (95% CI, 21.9% to 25.5%) in women, whereas anaplastic carcinoma did not show a significant increase in either sex. An increase in overall thyroid cancer incidence over time was observed in all birth cohorts. An age-period-cohort model indicated a steeply increasing period effect, which increased prominently from 1997 to 2011 in both men and women. The age effect showed an inverted U-shaped trend. The cohort effect tended to show a slight increase or remain constant from 1952 to 1977, followed by a decrease.
The period effect can explain the sharp increase in thyroid cancer incidence, strongly suggesting the role of thyroid screening.
韩国是世界上甲状腺癌发病率最高的国家，且发病率持续上升。本研究的目的是确定年龄-时期-队列效应对韩国甲状腺癌发病率的影响。
利用韩国国家癌症登记数据库，分析了1997年至2011年间按性别和组织学类型划分的甲状腺癌年龄标准化发病率和年度百分比变化（APC）。根据性别，使用内在估计方法应用年龄-时期-队列模型。
在男性和女性中，甲状腺癌发病率从1997年到2011年都急剧上升。在组织学类型中，乳头状癌的增长最为显著，男性的APC为25.1%（95%置信区间[CI]，22.7%至27.5%），女性为23.7%（95%CI，21.9%至25.5%），而未分化癌在两性中均未显示出显著增加。在所有出生队列中都观察到甲状腺癌总体发病率随时间的增加。年龄-时期-队列模型显示出时期效应急剧增加，在男性和女性中从从1997年到2011年都显著增加。年龄效应呈倒U形趋势。队列效应在1952年至1977年期间倾向于略有增加或保持不变，随后下降。
时期效应可以解释甲状腺癌发病率的急剧上升，强烈表明甲状腺筛查的作用。
