Dal Maso L, Tavilla A, Pacini F, Serraino D, van Dijk B A C, Chirlaque M D, Capocaccia R, Larrañaga N, Colonna M, Agius D, Ardanaz E, Rubió-Casadevall J, Kowalska A, Virdone S, Mallone S, Amash H, De Angelis R
Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy.
Eur J Cancer. 2017 May;77:140-152. doi: 10.1016/j.ejca.2017.02.023. Epub 2017 Apr 11.
Incidence rates of thyroid cancer (TC) increased in several countries during the last 30 years, while mortality rates remained unchanged, raising important questions for treatment and follow-up of TC patients. This study updates population-based estimates of relative survival (RS) after TC diagnosis in Europe by sex, country, age, period and histology.
Data from 87 cancer registries in 29 countries were extracted from the EUROCARE-5 dataset. One- and 5-year RS were estimated using the cohort approach for 86,690 adult TC patients diagnosed in 2000-2007 and followed-up to 12/31/2008. RS trends in 1999-2007 and 10-year RS in 2005-2007 were estimated using the period approach.
In Europe 2000-2007, 5-year RS after TC was 88% in women and 81% in men. Survival rates varied by country and were strongly correlated (Pearson ρ = 75%) with country-specific incidence rates. Five-year RS decreased with age (in women from >95% at age 15-54 to 57% at age 75+), from 98% in women and 94% in men with papillary TC to 14% in women and 12% in men with anaplastic TC. Proportion of papillary TC varied by country and increased over time, while survival rates were similar across areas and periods. In 1999-2007, 5-year RS increased by five percentage points for all TCs but only by two for papillary and by four for follicular TC. Ten-year RS in 2005-2007 was 89% in women and 79% in men.
The reported increasing TC survival trend and differences by area are mainly explained by the varying histological case-mix of cases.
在过去30年里，几个国家的甲状腺癌（TC）发病率有所上升，而死亡率保持不变，这引发了关于TC患者治疗和随访的重要问题。本研究更新了欧洲基于人群的TC诊断后按性别、国家、年龄、时期和组织学分类的相对生存率（RS）估计值。
从EUROCARE - 5数据集中提取了29个国家87个癌症登记处的数据。采用队列研究方法对2000年至2007年诊断出的86690例成年TC患者进行了1年和5年RS估计，并随访至2008年12月31日。采用时期研究方法估计了1999年至2007年的RS趋势以及2005年至2007年的10年RS。
在欧洲2000 - 2007年期间，TC诊断后的5年RS女性为88%，男性为81%。生存率因国家而异，并且与各国特定的发病率密切相关（Pearson相关系数ρ = 75%）。5年RS随年龄增长而降低（女性从15 - 54岁时的>95%降至75岁及以上时的57%），乳头状TC女性的5年RS从98%降至间变性TC女性的14%，男性从94%降至12%。乳头状TC的比例因国家而异且随时间增加，而各地区和时期的生存率相似。在1999 - 2007年期间，所有TC的5年RS提高了5个百分点，乳头状TC仅提高了2个百分点，滤泡状TC提高了4个百分点。2005 - 2007年的10年RS女性为89%，男性为79%。
所报道的TC生存率上升趋势及地区差异主要由病例的组织学构成不同所解释。
