Department of Epidemiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Department of Head and Neck Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Cancer Sci. 2023 Oct;114(10):4052-4062. doi: 10.1111/cas.15909. Epub 2023 Jul 24.
We used data from 13 cancer registries in China, Japan, and South Korea to analyze time trends in overdiagnosis of thyroid cancer between 1998 and 2012. Age-standardized and age-specific incidence and annual percentage changes were calculated. The number of thyroid cancers diagnosed and the proportion attributable to overdiagnosis were estimated, with calculations stratified by sex and age group. The Spearman method was used to analyze the correlation between thyroid cancer incidence and overdiagnosis. From 1998 to 2012, both the incidence and proportions of overdiagnoses of thyroid cancer in China, Japan, and South Korea showed an increasing trend, with higher rates in women than men. South Korea had both the highest incidence for men (10.1/10 ) and women (46.7/10 ) and the highest proportions of overdiagnosis (men, 90.3%; women, 94.9%). The fastest growth in overdiagnosis was in Chinese men and women (annual percentage changes 6.1 and 4.6, respectively). We found significant positive correlations between age-standardized incidence and proportions of overdiagnosis for both men (Spearman r = 0.98, p < 0.05) and women (Spearman r = 0.99, p < 0.05) in the three countries. Age-specific incidence curves in Chinese and South Korean individuals were of an inverted U-shape. Overdiagnosis of thyroid cancer in Japan was mainly concentrated in middle-aged and older patients, whereas in China and South Korea, it occurred primarily in the middle-aged. The incidence and overdiagnosis of thyroid cancer in China, Japan, and South Korea are increasing, necessitating the implementation of comprehensive measures to reduce these overdiagnoses.
我们使用了来自中国、日本和韩国的 13 个癌症登记处的数据，分析了 1998 年至 2012 年期间甲状腺癌过度诊断的时间趋势。计算了年龄标准化和年龄特异性发病率以及年百分比变化。估计了诊断出的甲状腺癌数量和归因于过度诊断的比例，并按性别和年龄组进行分层计算。使用 Spearman 方法分析了甲状腺癌发病率与过度诊断之间的相关性。1998 年至 2012 年，中国、日本和韩国的甲状腺癌发病率和过度诊断比例均呈上升趋势，女性的发病率和比例均高于男性。韩国的男性（10.1/10）和女性（46.7/10）发病率均最高，过度诊断的比例也最高（男性为 90.3%，女性为 94.9%）。中国男性和女性的过度诊断增长最快（年百分比变化分别为 6.1%和 4.6%）。我们发现，三个国家的男性（Spearman r=0.98，p<0.05）和女性（Spearman r=0.99，p<0.05）的年龄标准化发病率与过度诊断比例之间存在显著的正相关关系。中国和韩国个体的年龄特异性发病率曲线呈倒 U 形。日本的甲状腺癌过度诊断主要集中在中年和老年患者，而中国和韩国则主要发生在中年。中国、日本和韩国的甲状腺癌发病率和过度诊断都在增加，需要采取综合措施来减少这些过度诊断。
