Meng Ziang, Pan Ti, Yu Jingjing, Shi Chao, Liu Xuxu, Xue Dongbo, Wang Jing, Ma Biao
Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Front Endocrinol (Lausanne). 2024 Dec 6;15:1500926. doi: 10.3389/fendo.2024.1500926. eCollection 2024.
Thyroid cancer (TC) is a prevalent malignant tumor of the endocrine system in China. Current research primarily focuses on clinical diagnosis and treatment as well as underlying mechanisms, lacking epidemiological studies on the burden of the disease in China and worldwide.
The Global Burden of Disease Study 2021 was utilized to assess the incidence, prevalence, death, and disability-adjusted life years of TC in China and worldwide from 1990 to 2021 using the Joinpoint and R software.
From 1990 to 2021, the incidence and prevalence rates of TC in China have been consistently rising, and their growth rates are far higher than the global average. In China, TC usually occurs in patients aged 50-59, and the crude death rate generally increases with age. The burden of death among females has gradually declined, while that among males has continued to increase and surpassed females at the beginning of the 21st century. The burden of TC is heavy among middle-aged and elderly populations and the younger populations is also rapidly rising. The increased number of TC is mainly attributed to epidemiological changes, while the increase of deaths in China is primarily due to aging and population. Additionally, we predict that the age-standardized incidence rate of TC in China will continue to grow slowly over the next decade, while the age-standardized death rate will gradually decline among females and stabilize among males.
It is imperative to avoid over-screening and over-treatments for TC. Meanwhile, we should also avoid missing aggressive types of TC that may have an impact on overall survival. Additionally, understanding the mechanisms of metastasis and improving clinical treatments should be prioritized for further investigation. TC remains a significant public health challenge in China, necessitating a careful balance of the cost-benefit ratio.
甲状腺癌（TC）是中国内分泌系统中一种常见的恶性肿瘤。目前的研究主要集中在临床诊断、治疗以及潜在机制方面，缺乏关于中国和全球该疾病负担的流行病学研究。
利用2021年全球疾病负担研究，通过Joinpoint和R软件评估1990年至2021年中国和全球甲状腺癌的发病率、患病率、死亡率和伤残调整生命年。
1990年至2021年，中国甲状腺癌的发病率和患病率持续上升，且其增长率远高于全球平均水平。在中国，甲状腺癌通常发生在50 - 59岁的人群中，粗死亡率一般随年龄增长而增加。女性的死亡负担逐渐下降，而男性的死亡负担持续上升，并在21世纪初超过了女性。甲状腺癌在中老年人群中的负担较重，在年轻人群中的负担也在迅速上升。甲状腺癌病例数增加主要归因于流行病学变化，而中国死亡人数增加主要是由于老龄化和人口因素。此外，我们预测未来十年中国甲状腺癌的年龄标准化发病率将继续缓慢增长，而女性的年龄标准化死亡率将逐渐下降，男性的年龄标准化死亡率将趋于稳定。
必须避免对甲状腺癌进行过度筛查和过度治疗。同时，我们也应避免漏诊可能影响总体生存的侵袭性甲状腺癌类型。此外，应优先进一步研究转移机制并改善临床治疗。甲状腺癌在中国仍然是一项重大的公共卫生挑战，需要仔细权衡成本效益比。
