Wu Jiun-Yan, Shyu Yuh-Kae, Lee Yu-Kwang, Wang Yu-Chiao, Chiang Chun-Ju, You San-Lin, Liao Li-Jen, Hsu Wan-Lun, Chen Yong-Chen
School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan.
Department of Nursing, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan.
Life (Basel). 2024 Jun 26;14(7):809. doi: 10.3390/life14070809.
Thyroid cancer incidence has increased globally in recent decades, especially in females, although its trends in Taiwan have not been studied extensively. This study aimed to investigate changes in female incidence and possible causes of thyroid cancer in Taiwan.
Using the Taiwan Cancer Registry (TCR) Database, age-standardized incidence rates, age-specific incidence rates and birth cohorts were calculated. Correlation between female thyroid cancer incidence and cohort fertility rates were examined.
Thyroid cancer incidence increased in Taiwanese female, with age-adjusted rates per 100,000 people increasing from 7.37 during 1995-1999 to 20.53 during 2015-2019; the annual percentage change (APC) was 5.9% (95% CI, 5.3-6.5). Age-specific incidence rates increased with age, with peak rates occurring at younger ages. The APCs in the 50-54 age group were the highest (6.8%, 95% CI, 6.1-7.5). Incidence rates also increased with later birth cohorts. We observed a significant negative correlation between thyroid cancer incidence and fertility rates in the same birth cohort.
We hypothesize that overdiagnosis may be a main reason for the rapidly increasing thyroid cancer incidence in Taiwanese females. Notably, we observed a strong negative correlation between fertility and thyroid cancer incidence. However, our study is limited by the absence of individual-level cancer data in the TCR database. These associations with fertility will be an important subject for future thyroid cancer research.
近几十年来，甲状腺癌的发病率在全球范围内有所上升，尤其是在女性中，尽管其在台湾地区的发病趋势尚未得到广泛研究。本研究旨在调查台湾地区女性甲状腺癌发病率的变化及可能原因。
利用台湾癌症登记数据库（TCR），计算年龄标准化发病率、年龄别发病率和出生队列。研究女性甲状腺癌发病率与队列生育率之间的相关性。
台湾女性甲状腺癌发病率上升，年龄调整后的发病率从1995 - 1999年的每10万人7.37例增至2015 - 2019年的每10万人20.53例；年增长率（APC）为5.9%（95%置信区间，5.3 - 6.5）。年龄别发病率随年龄增长而增加，发病率高峰出现在较年轻的年龄段。50 - 54岁年龄组的APC最高（6.8%，95%置信区间，6.1 - 7.5）。发病率也随出生队列的延后而增加。我们观察到同一出生队列中甲状腺癌发病率与生育率之间存在显著的负相关。
我们推测过度诊断可能是台湾女性甲状腺癌发病率快速上升的主要原因。值得注意的是，我们观察到生育率与甲状腺癌发病率之间存在很强的负相关。然而，我们的研究受限于TCR数据库中缺乏个体水平的癌症数据。这些与生育率的关联将是未来甲状腺癌研究的一个重要课题。
