Department of Ear, Nose and Throat and Head & Neck Surgery, St George's University Hospitals NHS Foundation Trust, London, United Kingdom.
Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts.
JAMA Otolaryngol Head Neck Surg. 2022 Apr 1;148(4):350-359. doi: 10.1001/jamaoto.2021.4549.
IMPORTANCE: The global incidence of thyroid cancer has been increasing rapidly, and this increase has had an attendant burden on health systems. However, it is unclear how the burden of this disease differs among the pre-2004 countries of the European Union (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the UK), US, Australia, Canada, and Norway (EU15+). OBJECTIVE: To assess the trends in mortality, incidence, and disability-adjusted life-years (DALYs) associated with thyroid cancer between 1990 and 2019 in EU15+ nations. Data analysis was conducted from July 11 to October 11, 2021. DESIGN, SETTING, AND PARTICIPANTS: Observational cross-sectional analysis of the incidence of thyroid cancer was conducted using data obtained from the Global Burden of Disease Study database. Nineteen countries of the EU15+ were included. EXPOSURES: Thyroid cancer. MAIN OUTCOMES AND MEASURES: Age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs) and DALYs were extracted for individual EU15+ countries per sex for each of the years from 1990 to 2019, and mortality-to-incidence indexes were computed. Joinpoint regression analysis was used to describe the trends. RESULTS: Thirteen of 19 countries (68%) showed an average annual percentage change increase in ASIR across the study period (range, 0.2%-2.5%). Joinpoint regression analysis revealed largely plateauing ASIR trends in recent years across most EU15+ nations since 1990. Between 2011 and 2019, the estimated annual percentage change in the US was 0. Australia, Denmark, and the US were the only countries with increasing ASMR trends with positive average annual percentage changes: Australia, 0.6 (95% CI, 0.2-1.0); Denmark, 1.0 (95% CI, 0.8-1.3); and US, 0.4 (95% CI, 0.4-0.5); the remaining 16 countries showed negative trends (range, -0.2 to -2.1). Disability-adjusted life-years decreased in all EU15+ countries except Australia, Denmark, and the US. CONCLUSIONS AND RELEVANCE: This cross-sectional analysis found that overall, the burden of thyroid cancer across EU15+ countries appears to be decreasing, evidenced by plateauing incidence rates and reductions in mortality and DALYs over the 30-year study period. However, the US and Australia appear to have increasing ASMR and DALY trends. Ongoing observation is required to monitor how changes in international clinical practice guidelines affect thyroid cancer DALYs and mortality.
重要性:全球甲状腺癌的发病率一直在迅速上升,这给卫生系统带来了相应的负担。然而,目前尚不清楚这种疾病的负担在欧盟前 2004 个成员国(奥地利、比利时、丹麦、芬兰、法国、德国、希腊、爱尔兰、意大利、卢森堡、荷兰、葡萄牙、西班牙、瑞典和英国)、美国、澳大利亚、加拿大和挪威(欧盟 15 国+)之间有何不同。
目的:评估 1990 年至 2019 年期间欧盟 15 国+国家甲状腺癌死亡率、发病率和伤残调整生命年(DALYs)的变化趋势。数据分析于 2021 年 7 月 11 日至 10 月 11 日进行。
设计、地点和参与者:采用全球疾病负担研究数据库中的发病率数据进行了甲状腺癌发病率的观察性横断面分析。包括欧盟 15 国+的 19 个国家。
暴露:甲状腺癌。
主要结果和措施:为每个年份(1990 年至 2019 年)的每个性别分别提取了欧盟 15 国+每个国家的年龄标准化发病率(ASIR)、年龄标准化死亡率(ASMR)和 DALYs,并计算了死亡率与发病率的比值。采用联合点回归分析描述了趋势。
结果:19 个国家中有 13 个(68%)在研究期间表现出 ASIR 的平均年百分比变化增加(范围为 0.2%至 2.5%)。联合点回归分析显示,自 1990 年以来,欧盟 15 国+的大多数国家近年来的 ASIR 趋势基本趋于平稳。2011 年至 2019 年,美国的估计年百分比变化为 0.澳大利亚、丹麦和美国是唯一呈现 ASMR 趋势上升且平均年百分比变化为正的国家:澳大利亚,0.6(95%CI,0.2-1.0);丹麦,1.0(95%CI,0.8-1.3);美国,0.4(95%CI,0.4-0.5);其余 16 个国家呈现负趋势(范围为 0.2%至 2.1%)。除澳大利亚、丹麦和美国外,所有欧盟 15 国+国家的伤残调整生命年均下降。
结论和相关性:这项横断面分析发现,在 30 年的研究期间,欧盟 15 国+国家的总体甲状腺癌负担似乎在下降,这表明发病率趋于平稳,死亡率和 DALYs 有所下降。然而,美国和澳大利亚的 ASMR 和 DALY 趋势似乎在上升。需要持续观察国际临床实践指南的变化如何影响甲状腺癌的 DALYs 和死亡率。
JAMA Otolaryngol Head Neck Surg. 2022-4-1
Plast Reconstr Surg Glob Open. 2020-11-23
JAMA Netw Open. 2020-6-1
Cancers (Basel). 2025-2-20
Cancer Rep (Hoboken). 2025-3
Chin Med J (Engl). 2024-11-5
Eur J Prev Cardiol. 2021-9-20
Eur J Vasc Endovasc Surg. 2020-7-21
Nat Rev Endocrinol. 2019-10-15