Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
Lancet Diabetes Endocrinol. 2021 Apr;9(4):225-234. doi: 10.1016/S2213-8587(21)00027-9. Epub 2021 Mar 1.
The incidence of thyroid cancer has increased in different populations worldwide in the past 30 years. We present here an overview of international trends of thyroid cancer incidence by major histological subtypes.
We did a population-based study with data for thyroid cancer incidence collected by the International Agency for Research on Cancer (IARC) for the period 1998-2012. Data were extracted from the Cancer Incidence in Five Continents plus compendium. We selected data for 25 countries that had a population of more than 2 million individuals covered by cancer registration (87 registries in total). Further criteria were that the selected registration areas had to have a proportion of unspecified thyroid cancer of less than 10% and analyses were restricted to individuals aged 20-84 years. We calculated age-specific incidence rates and age-standardised rates per 100 000 person-years for individuals aged 20 to 84 years, and assessed trends by country, sex, and major histological subtype (papillary, follicular, medullary, or anaplastic) based on absolute changes in age-standardised incidence rates between 1998-2002 and 2008-12.
Papillary thyroid cancer was the main contributor to overall thyroid cancer in all the studied countries, and was the only histological subtype that increased systematically in all countries, although with large variability between countries. In women, the age-standardised incidence rate of papillary thyroid cancer during 2008-12 ranged from 4·3-5·3 cases per 100 000 person-years in the Netherlands, the UK, and Denmark, to 143·3 cases per 100 000 women in South Korea. For men during the same period, the age-standardised incidence rates of papillary thyroid cancer per 100 000 person-years ranged from 1·2 cases per 100 000 in Thailand to 30·7 cases per 100 000 in South Korea. In many countries in Asia, the increase in papillary thyroid cancer rates in women was particularly pronounced after the year 2000; rates stabilised since around 2009 in the USA, Austria, Croatia, Germany, Slovenia, Spain, Lithuania, and Bulgaria. Temporal trends for follicular and medullary thyroid cancer did not show consistent patterns across countries, but slight decreases were seen for anaplastic thyroid cancer in 21 of 25 countries between 1998-2002, and 2008-12. In 2008-12, age-standardised rates for the follicular subtype ranged between 0·5 and 2·5 cases per 100 000 women (and between 0·3 and 1·5 per 100 000 men), while those for the medullary subtype were always less than 1 case per 100 000 women or men, and for anaplastic thyroid cancer less than 0·2 cases per 100 000 women or men.
In the period from 1998 to 2012, the rapid increases in thyroid cancer incidence were observed only for papillary thyroid cancer, the subtype more likely to be found in a subclinical form and therefore detected by intense scrutiny of the thyroid gland.
French Institut National du Cancer, Italian Association for Cancer Research, Italian Ministry of Health.
在过去的 30 年中，全世界不同人群的甲状腺癌发病率有所增加。我们在此概述了主要组织学亚型的国际甲状腺癌发病率趋势。
我们进行了一项基于人群的研究，使用国际癌症研究机构（IARC）收集的 1998-2012 年甲状腺癌发病率数据。数据来自《五大洲癌症发病率》第五卷。我们选择了 25 个人口超过 200 万的国家，这些国家的癌症登记覆盖了 87 个登记处。进一步的标准是，所选登记地区的未指明甲状腺癌比例必须低于 10%，并且分析仅限于 20-84 岁的个体。我们计算了 20-84 岁个体的年龄特异性发病率和每 100000 人年的年龄标准化发病率，并根据 1998-2002 年和 2008-12 年之间年龄标准化发病率的绝对变化，按国家、性别和主要组织学亚型（乳头状、滤泡状、髓样或间变性）评估趋势。
在所有研究的国家中，乳头状甲状腺癌是甲状腺癌的主要类型，并且是唯一一种在所有国家中系统性增加的组织学亚型，尽管各国之间的差异很大。在女性中，2008-12 年期间乳头状甲状腺癌的年龄标准化发病率在荷兰、英国和丹麦为每 100000 人年 4.3-5.3 例，而在韩国则为每 100000 名女性 143.3 例。同期男性的年龄标准化发病率每 100000 人年为泰国的 1.2 例，韩国的 30.7 例。在亚洲的许多国家，女性的乳头状甲状腺癌发病率在 2000 年后尤其明显增加；在美国、奥地利、克罗地亚、德国、斯洛文尼亚、西班牙、立陶宛和保加利亚，自 2009 年以来，这一趋势已经稳定下来。滤泡状和髓样甲状腺癌的时间趋势在各国之间没有一致的模式，但在 2008-12 年间，25 个国家中有 21 个国家的间变性甲状腺癌略有下降。2008-12 年，滤泡状亚型的年龄标准化发病率在每 100000 名女性 0.5-2.5 例之间（每 100000 名男性 0.3-1.5 例），而髓样亚型的年龄标准化发病率始终低于每 100000 名女性或男性 1 例，间变性甲状腺癌的年龄标准化发病率低于每 100000 名女性或男性 0.2 例。
在 1998 年至 2012 年期间，只有乳头状甲状腺癌的发病率迅速增加，这种亚型更有可能以亚临床形式出现，因此通过对甲状腺的仔细检查就能发现。
法国国家癌症研究所、意大利癌症研究协会、意大利卫生部。
