Gao May Z, Omer Tariq M, Miller Katherine M, Simpson Matthew C, Bukatko Aleksandr R, Gedion Kalipa, Adjei Boakye Eric, Kost Karen M, Dickinson James A, Varvares Mark A, Osazuwa-Peters Nosayaba
Duke University School of Medicine, Durham, NC 27710, USA.
Department of Pediatric Otolaryngology, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Cancers (Basel). 2025 Apr 24;17(9):1429. doi: 10.3390/cancers17091429.
BACKGROUND/OBJECTIVES: Thyroid cancer incidence has risen in both the United States and Canada, despite differing healthcare systems. While overdiagnosis likely partly explains this trend in adults, its impact on younger populations is unclear. We used the North American Association of Central Cancer Registries, which included 133,808 thyroid cancer cases from the United States and Canada, to assess incidence trends among pediatric, adolescent, and young adult (PAYA) populations.
Age-adjusted incidence rates (AAIR) per 100,000 person-years (PY) were compared using rate ratios (RR), stratified by sex, age, race/ethnicity (United States only), and histology. Joinpoint regression estimated annual percentage changes (APC) and average APCs (AAPC) in AAIRs. From 1995 to 2014, thyroid cancer incidence increased by 137%. Significant increases occurred across all age groups (0-14, 15-24, 25-34, 35-39 years). The rate increase was highest for papillary thyroid cancer (AAPC = 5.50, 95% CI 5.06, 5.94), and among individuals aged 35-39 years (AAPC = 5.99, 95% CI 4.84, 7.15). Of racial/ethnic groups in the United States, non-Hispanic White individuals had the highest AAIR (6.22 per 100,000 PY). Mortality has changed minimally.
Over the past two decades, thyroid cancer incidence has increased in individuals under 40. While evidence suggests that overdiagnosis primarily accounts for this trend, other contributing factors cannot be ruled out. Further research and surveillance of the drivers of increased incidence are critical.
背景/目的：尽管美国和加拿大的医疗保健系统不同，但甲状腺癌的发病率在这两个国家均有所上升。虽然过度诊断可能部分解释了成年人中的这一趋势，但其对年轻人群的影响尚不清楚。我们利用北美中央癌症登记协会的数据，该协会纳入了来自美国和加拿大的133,808例甲状腺癌病例，以评估儿童、青少年和青年（PAYA）人群中的发病率趋势。
使用率比（RR）比较每10万人年（PY）的年龄调整发病率（AAIR），并按性别、年龄、种族/族裔（仅美国）和组织学进行分层。Joinpoint回归估计AAIR的年度百分比变化（APC）和平均APC（AAPC）。从1995年到2014年，甲状腺癌发病率增加了137%。所有年龄组（0-14岁、15-24岁、25-34岁、35-39岁）均出现显著增加。甲状腺乳头状癌的发病率上升最高（AAPC = 5.50，95%CI 5.06，5.94），在35-39岁的个体中发病率上升也最高（AAPC = 5.99，95%CI 4.84，7.15）。在美国的种族/族裔群体中，非西班牙裔白人的AAIR最高（每10万PY为6.22）。死亡率变化极小。
在过去二十年中，40岁以下人群的甲状腺癌发病率有所增加。虽然有证据表明过度诊断是这一趋势的主要原因，但其他促成因素也不能排除。进一步研究和监测发病率增加的驱动因素至关重要。
