Jin Qianyun, Wu Jie, Huang Caiyun, Li Jingjing, Zhang Yunmeng, Ji Yuting, Liu Xiaomin, Duan Hongyuan, Feng Zhuowei, Liu Ya, Zhang Yacong, Lyu Zhangyan, Yang Lei, Huang Yubei
Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China.
J Glob Health. 2025 Apr 11;15:04113. doi: 10.7189/jogh.15.04113.
With rapid social-economic development and widespread screening, the surge in incidence and overdiagnosis of thyroid cancer is more worrying among the young than the general population. This problem, however, still lacks adequate attention.
We retrieved the original data of current, past and future burden of thyroid cancer from the Global Cancer Observatory (GLOBOCAN) 2022. We calculated the age-specific mortality-to-incidence ratio (MIR) by dividing age-specific mortality rates by incidence rates to quantify potential overdiagnosis, and used Segi's world standard population to calculate the age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). We then assessed the correlation between the human development index (HDI) and ASIR/ASMR using the linear correlation coefficient (r). Lastly, we characterised the temporal trend with the estimated annual percentage change (EAPC) and project the early-onset thyroid cancer burdens to 2050.
Globally, there were an estimated 239 362 (ASIR = 4.00 per 100 000 population) cases and 2409 (ASMR = 0.04 per 100 000 population) deaths from thyroid cancer among individuals aged <40 years in 2022. Compared to its ranking as the 7th most common cancer in the overall population, thyroid cancer rose to become the 2nd most common cancer among individuals <40 years. Nearly 99% of thyroid cancer cases in individuals <40 years of age (MIR = 0.01) may be potentially overdiagnosed, whereas 34% of cases in those >80 years (MIR = 0.66) were overdiagnosed. The ASIR of early-onset thyroid cancer varied widely (from 0.13 to 13.17 per 100 000 population), while the ASMR remains relatively similar and low across different regions. The ASIR of early-onset thyroid cancer increased with HDI (r = 0.69), while the ASMR decreased (r = -0.22). The ASIR of early-onset thyroid cancer had the fastest upward trend (EAPC in males vs. females: 9.88 vs. 9.28%) compared to early-onset cancers at other sites, while ASMR showed a downward trend (EAPC in males vs. females: -0.38% vs. -1.33%). The Republic of Korea experienced the highest EAPC for early-onset thyroid cancer ASIR (males vs. females: 29.95% vs. 23.04%). If national rates from 2022 remain stable, projected cases of early-onset thyroid cancer would decrease in high (-13.3%) and very high (-10.9%) HDI countries, but increase in low (96.5%) and medium HDI countries (11.7%).
The trend of early-onset thyroid cancer at the global level is more alarming than that of thyroid cancer overall. The younger age at diagnosis of thyroid cancer, the higher risk of potential overdiagnosis. Without timely interventions, the thyroid cancer burden will inevitably become a serious global public health issue, especially for the young population.
随着社会经济的快速发展和广泛筛查，甲状腺癌发病率的激增和过度诊断在年轻人中比在普通人群中更令人担忧。然而，这个问题仍未得到足够的关注。
我们从全球癌症观测站（GLOBOCAN）2022中检索了甲状腺癌当前、过去和未来负担的原始数据。我们通过将特定年龄死亡率除以发病率来计算特定年龄死亡率与发病率之比（MIR），以量化潜在的过度诊断，并使用世标人口计算年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）。然后，我们使用线性相关系数（r）评估人类发展指数（HDI）与ASIR/ASMR之间的相关性。最后，我们用估计的年度百分比变化（EAPC）来描述时间趋势，并预测2050年早发性甲状腺癌的负担。
2022年，全球40岁以下人群中估计有239362例甲状腺癌病例（ASIR = 每10万人口4.00例）和2409例死亡（ASMR = 每10万人口0.04例）。与在总体人群中作为第七大常见癌症的排名相比，甲状腺癌在40岁以下人群中升至第二大常见癌症。40岁以下人群中近99%的甲状腺癌病例（MIR = 0.01）可能被过度诊断，而80岁以上人群中34%的病例（MIR = 0.66）被过度诊断。早发性甲状腺癌的ASIR差异很大（每10万人口从0.13到13.17例），而不同地区的ASMR相对相似且较低。早发性甲状腺癌的ASIR随HDI升高（r = 0.69），而ASMR降低（r = -0.22）。与其他部位的早发性癌症相比，早发性甲状腺癌的ASIR上升趋势最快（男性与女性的EAPC：9.88%与9.28%），而ASMR呈下降趋势（男性与女性的EAPC：-0.38%与-1.33%）。韩国早发性甲状腺癌ASIR的EAPC最高（男性与女性：29.95%与23.04%）。如果2022年的国家发病率保持稳定，预计早发性甲状腺癌病例在高HDI国家（-13.3%）和非常高HDI国家（-10.9%）将减少，但在低HDI国家（96.5%）和中等HDI国家（11.7%）将增加。
全球早发性甲状腺癌的趋势比总体甲状腺癌的趋势更令人担忧。甲状腺癌诊断时年龄越小，潜在过度诊断的风险越高。如果不及时干预，甲状腺癌负担将不可避免地成为一个严重的全球公共卫生问题，尤其是对年轻人群而言。
