Department of Epidemiology of Lazio Region Health Service, Local Health Unit 1, Rome, Italy.
Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
Endocrine. 2024 Nov;86(2):510-514. doi: 10.1007/s12020-024-03995-x. Epub 2024 Aug 8.
Due to overdiagnosis, the incidence of thyroid cancer (TC) has increased in high-income countries, including Italy. Efforts have been made to address this issue since the mid-2010s, but more information is needed about how TC incidence has changed. We aim to examine the trend in TC incidence in the Lazio Region (central Italy) and assess the impact of the 2014 Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) to identify potential changes in TC diagnosis.
To identify TC cases, we conducted a population-based study (period 2007-2019) using the data from the Lazio Region Cancer Registry (5.8 million residents). We calculated the annual age-standardized incidence rates of TC for both sexes and analyzed the impact of ICCRTC on monthly incidence rates using segmented linear regression applied to interrupted time-series (ITS).
Throughout the 13 years, there was a significant decline in TC annual incidence rates, more pronounced in females. Our results are consistent with reports from outside Europe (United States and South Korea). Following ICCRTC implementation in 2014, a step-change reduction in both sexes was revealed.
Our study indicates a significant decrease in the incidence of TC, particularly among females. The ITS analysis highlights the possible role of ICCRTC in reducing overdiagnosis. As the Lazio Region reflects the Italian population in terms of various demographic, health, and lifestyle indicators, our findings can be applicable at the national level.
由于过度诊断,包括意大利在内的高收入国家的甲状腺癌(TC)发病率有所增加。自 21 世纪 10 年代中期以来,已经做出了一些努力来解决这个问题,但需要更多关于 TC 发病率变化的信息。我们旨在检查意大利拉齐奥地区(意大利中部)TC 发病率的趋势,并评估 2014 年意大利甲状腺细胞学分类和报告共识(ICCRTC)对潜在 TC 诊断变化的影响。
为了确定 TC 病例,我们进行了一项基于人群的研究(2007 年至 2019 年期间),使用拉齐奥地区癌症登记处(580 万居民)的数据。我们计算了男女 TC 的年标准化发病率,并使用分段线性回归应用于中断时间序列(ITS)分析 ICCRTC 对每月发病率的影响。
在 13 年期间,TC 的年发病率显著下降,女性更为明显。我们的结果与欧洲以外的报告(美国和韩国)一致。在 2014 年实施 ICCRTC 后,发现男女发病率均出现了明显的阶段性下降。
我们的研究表明 TC 的发病率显著下降,尤其是女性。ITS 分析突出了 ICCRTC 在减少过度诊断方面的可能作用。由于拉齐奥地区在人口统计学、健康和生活方式等方面反映了意大利人口的特点,我们的研究结果可以在全国范围内应用。