Zhang Meng-Ni, Liang Xiao-Yu, Li Mao-Ting, Zhi Xin-Yue, Yan Qiu-Yu, Zhu Hong, Xie Juan
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
Asia Pac J Clin Oncol. 2023 Feb;19(1):196-205. doi: 10.1111/ajco.13800. Epub 2022 Jun 12.
Thyroid cancer has been an increasingly high-profile public health issue. Comprehensive assessment for its disease burden seems particularly important for understanding health priorities and hinting high-risk populations.
We estimated the age-sex-specific thyroid cancer burden and its temporal trend in China from 1990 to 2019 by following the general methods from the global burden of disease (GBDs) 2019 Study. And Joinpoint regression model, the Cox-Stuart trend test, and Cochran-Armitage test were applied for the analysis of temporal and age trend. The Mantel-Haenszel statistical method was used to compare the gender difference.
From 1990 to 2019, the age-standardized incidence rate of thyroid cancer in China has almost doubled to 2.05 per 100,000. Although the mortality rate and DALY rate kept leveling off, they presented a downtrend among females, while an upward trend in males. While the average annual percentage changes of those metrics all became deline since 2010 than the previous years. With age advancing, the rates of incidence, mortality, and DALYs for both sexes all presented linear fashion increases, which was particularly typical among males.
Given the serious trend and gender-age heterogeneity of Chinese thyroid cancer burden, male gender and advanced age may be related to poor prognosis of thyroid cancer, and strengthening primary prevention and exploring the underlying risk factors should be among the top priorities.
甲状腺癌已成为一个备受瞩目的公共卫生问题。对其疾病负担进行综合评估对于了解卫生重点和提示高危人群似乎尤为重要。
我们按照全球疾病负担（GBDs）2019研究的一般方法，估算了1990年至2019年中国特定年龄和性别的甲状腺癌负担及其时间趋势。并应用Joinpoint回归模型、Cox-Stuart趋势检验和Cochran-Armitage检验来分析时间和年龄趋势。采用Mantel-Haenszel统计方法比较性别差异。
1990年至2019年，中国甲状腺癌的年龄标准化发病率几乎翻了一番，达到每10万人2.05例。尽管死亡率和伤残调整生命年（DALY）率保持平稳，但在女性中呈下降趋势，而在男性中呈上升趋势。自2010年以来，这些指标的年均变化百分比均比前几年有所下降。随着年龄的增长，男女的发病率、死亡率和伤残调整生命年率均呈线性上升趋势，在男性中尤为典型。
鉴于中国甲状腺癌负担的严重趋势和性别年龄异质性，男性和高龄可能与甲状腺癌预后不良有关，加强一级预防和探索潜在危险因素应是首要任务。
