Mao Yushan, Xing Mingzhao
Laboratory for Cellular and Molecular Thyroid ResearchDivision of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Maryland, MD, USA.
Laboratory for Cellular and Molecular Thyroid ResearchDivision of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Maryland, MD, USA
Endocr Relat Cancer. 2016 Apr;23(4):313-22. doi: 10.1530/ERC-15-0445. Epub 2016 Feb 25.
The incidence rate of thyroid cancer has been rising rapidly in recent decades; however, its trend remains unclear. To investigate this, we analyzed the database of the Surveillance, Epidemiology and End Results (SEER) 13, 1992-2012 in the USA, particularly focusing on conventional papillary thyroid cancer (CPTC) and follicular variant of PTC (FVPTC). Of the 75,992 thyroid cancers, 61.3% were CPTC and 25.7% were FVPTC, and their incidence rates (IRs) were significantly increased from 1992 to 2012 (P all < 0.001), with CPTC being 2.4 times of FVPTC (P < 0.001) and the overall average annual percent change (AAPC) of incidence being 6.3% in the former and 5.3% in the latter. IRs were increased in all thyroid cancers, albeit most dramatically in PTC, in virtually all ethnic/demographic groups in recent two decades; however, the incidence trends varied among different thyroid cancers, particularly differentiable between CPTC and FVPTC. For example, Joinpoint analyses revealed that the APC of CPTC before 1996 was 1.5% (P > 0.05), which jumped to 6.8% (P < 0.05) after 1996, whereas the APC of FVPTC before 2000 was 6.6% (P < 0.05), which dropped to 4.8% (P < 0.05) after 2000. IRs and incidence trends of PTC were uneven among different ethnic/demographic groups, as exemplified by the lower IRs of both PTC variants in the Black females than in non-Hispanic White females but higher AAPCs of incidence in the former than in the latter. Interestingly, the data also suggest that the rise in the IRs of PTC is becoming plateaued in the most recent 2 years. These novel observations are helpful in understanding the incidence and incidence trends of thyroid cancer.
近几十年来,甲状腺癌的发病率一直在迅速上升;然而,其趋势仍不明朗。为了对此进行调查,我们分析了美国监测、流行病学和最终结果(SEER)13数据库(1992 - 2012年),特别关注传统乳头状甲状腺癌(CPTC)和乳头状甲状腺癌滤泡变体(FVPTC)。在75992例甲状腺癌中,61.3%为CPTC,25.7%为FVPTC,从1992年到2012年它们的发病率(IRs)显著增加(P均<0.001),CPTC是FVPTC的2.4倍(P<0.001),前者发病率的总体平均年变化百分比(AAPC)为6.3%,后者为5.3%。在近二十年里,几乎所有种族/人口群体中,所有甲状腺癌的IRs都有所增加,尽管在PTC中最为显著;然而,不同甲状腺癌的发病趋势有所不同,尤其是CPTC和FVPTC之间存在差异。例如,Joinpoint分析显示,1996年前CPTC的APC为1.5%(P>0.05),1996年后跃升至6.8%(P<0.05),而2000年前FVPTC的APC为6.6%(P<0.05),2000年后降至4.8%(P<0.05)。PTC的IRs和发病趋势在不同种族/人口群体中并不均匀,例如,黑人女性中两种PTC变体的IRs均低于非西班牙裔白人女性,但前者发病率的AAPCs高于后者。有趣的是,数据还表明,PTC的IRs在最近两年呈平稳趋势。这些新发现有助于了解甲状腺癌的发病率和发病趋势。