1
|
Acosta GJ, Singh Ospina N, Brito JP. Epidemiologic changes in thyroid disease. Curr Opin Endocrinol Diabetes Obes 2024; 31:184-190. [PMID: 39087407 DOI: 10.1097/med.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE OF REVIEW To analyze the evolving epidemiologic trends in thyroid disease, focusing on risk factors, underlying drivers of these changes, and their implications on clinical practice and research priorities. RECENT FINDINGS Thyroid disease remains one of the most prevalent groups of disorders globally, and the shift in its frequency and distribution is multifactorial. The prevalence of hypothyroidism increases with age, although normal thyrotropin ranges appear to be age-dependent, raising concern for potentially inappropriate levothyroxine use. Hyperthyroidism and Graves' disease continue to be predominant in reproductive-age women but exhibit a milder phenotype at diagnosis. Thyroid nodules are increasingly found in asymptomatic patients, likely from more widespread use of neck and chest imaging. Thyroid cancer incidence has risen exponentially over the years, mostly driven by overdiagnosis of low-risk tumors; however, a small rise in incidence of higher risk tumors has been noted. Obesity appears to be a risk factor for thyroid cancer occurrence and more aggressive forms of the disease. SUMMARY Understanding epidemiologic trends in thyroid disease is crucial for guiding clinical practice and research efforts, aiming to optimize patient outcomes while preventing unnecessary and potentially harmful interventions.
Collapse
Affiliation(s)
- Gonzalo J Acosta
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, Florida
| | - Naykky Singh Ospina
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, Florida
| | - Juan P Brito
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine
- Department of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
2
|
Al-Ibraheem A, Abdlkadir AS, Al-Adhami DA, Lopci E, Al-Omari A, Al-Masri M, Yousef Y, Al-Hajaj N, Mohamad I, Singer S, Sykiotis GP. Comparative analysis through propensity score matching in thyroid cancer: unveiling the impact of multiple malignancies. Front Endocrinol (Lausanne) 2024; 15:1366935. [PMID: 38894738 PMCID: PMC11184125 DOI: 10.3389/fendo.2024.1366935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Background The incidence of thyroid cancer is on the rise worldwide, with childhood exposure to radiation being the sole acknowledged catalyst for its emergence. Nonetheless, numerous other factors that may pose risks are awaiting thorough examination and validation. This retrospective study aims to explore the malignancies linked to thyroid cancer and contrast the survival rates of those afflicted with a solitary tumor versus those with multiple primary neoplasms (MPN). Methods This retrospective study examined data from King Hussein Cancer Center (KHCC), Jordan. Among 563 patients diagnosed with thyroid cancer, 30 patients had thyroid malignancy as part of MPN. For a 1:3 propensity score-matched analysis, 90 patients with only a primary thyroid malignancy were also enrolled. Results Hematologic and breast malignancies were among the most frequent observed cancers alongside thyroid neoplasm. Patients who had MPN were diagnosed at older age, had higher body mass index and presented with higher thyroglobulin antibody levels (p < 0.05 for each). Additionally, MPN patient displayed a stronger family history for cancers (p= 0.002). A median follow-up duration of 135 months unveiled that MPN patients faced a worse 5-year survival compared to their counterparts with a singular neoplasm (87% vs 100% respectively; p < 0.01). However, no distinction emerged in the 5-year event-free survival between these two groups. Conclusion MPN correlates with a significantly altered survival outcome of thyroid cancer patients. The diagnosis of thyroid carcinoma at an older age, accompanied by elevated initial thyroglobulin antibody levels and a notable familial predisposition, may raise concerns about the potential occurrence of synchronous or metachronous tumors.
Collapse
Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, the University of Jordan, Amman, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Dhuha Ali Al-Adhami
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS– Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Amal Al-Omari
- Office of Scientific Affairs and Research (OSAR), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mahmoud Al-Masri
- Department of Surgery, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Yacoub Yousef
- Department of Surgery, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Nabeela Al-Hajaj
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Gerasimos P. Sykiotis
- Department of Endocrinology, Diabetology and Metabolism, Vaud University Hospital Center (CHUV), Lausanne, Switzerland
| |
Collapse
|
3
|
Girardi FM, Wagner VP, Martins MD. Thyroid Incidentalomas: Scrutinizing the Mode of Detection and Evaluating its Contribution to Thyroid Cancer Diagnosis. Indian J Otolaryngol Head Neck Surg 2024; 76:1733-1740. [PMID: 38566651 PMCID: PMC10982254 DOI: 10.1007/s12070-023-04392-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
There is an ongoing debate about the reasons behind the increasing incidence of thyroid cancer in the last two to three decades. Here, we investigate how thyroid nodules were detected in a large series of consultations for thyroid nodular pathology. METHODS In total, 576 patients were analyzed, with a total of 1014 nodules described. RESULTS In 347 (60.2%) cases, the diagnosis of a thyroid nodule was incidental, mostly during imaging tests for other reasons. Incidental diagnosis occurred among all ranges of nodule diameter and between palpable and non-palpable cases, even within a small proportion of symptomatic cases. In univariate analysis, incidental diagnosis was associated with smaller nodule diameter, non-palpable nodules, asymptomatic cases, older patient age, less advanced stages (T1-2), and conservative management. After multivariate analysis, older age, euthyroidism, and smaller diameter were statistically significant. Incidental diagnosis contributed to the diagnosis of 53.8% of the cases of cancer. Advanced T stages (T3-4) were more common in non-incidental diagnoses. CONCLUSION Our results indicate that incidental diagnosis of thyroid nodules is a significant contributor to thyroid cancer diagnosis in all ranges of nodule diameter, especially at earlier stages.
Collapse
Affiliation(s)
- Fábio Muradás Girardi
- Integrated Oncology Center of Ana Nery Hospital, Borges de Medeiros Street, 274, 503, Santa Cruz do Sul, RS 96810-034 Brazil
| | - Vivian P. Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
- Department of Oral Medicine, Porto Alegre Clinics Hospital (HCPA/UFRGS), Porto Alegre, RS Brazil
| |
Collapse
|
4
|
Ullmann TM, Papaleontiou M, Sosa JA. Current Controversies in Low-Risk Differentiated Thyroid Cancer: Reducing Overtreatment in an Era of Overdiagnosis. J Clin Endocrinol Metab 2023; 108:271-280. [PMID: 36327392 PMCID: PMC10091361 DOI: 10.1210/clinem/dgac646] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT Low-risk differentiated thyroid cancer (DTC) is overdiagnosed, but true incidence has increased as well. Owing to its excellent prognosis with low morbidity and mortality, balancing treatment risks with risks of disease progression can be challenging, leading to several areas of controversy. EVIDENCE ACQUISITION This mini-review is an overview of controversies and difficult decisions around the management of all stages of low-risk DTC, from diagnosis through treatment and follow-up. In particular, overdiagnosis, active surveillance vs surgery, extent of surgery, radioactive iodine (RAI) treatment, thyrotropin suppression, and postoperative surveillance are discussed. EVIDENCE SYNTHESIS Recommendations regarding the diagnosis of DTC, the extent of treatment for low-risk DTC patients, and the intensity of posttreatment follow-up have all changed substantially in the past decade. While overdiagnosis remains a problem, there has been a true increase in incidence as well. Treatment options range from active surveillance of small tumors to total thyroidectomy followed by RAI in select cases. Recommendations for long-term surveillance frequency and duration are similarly broad. CONCLUSION Clinicians and patients must approach each case in a personalized and nuanced fashion to select the appropriate extent of treatment on an individual basis. In areas of evidential equipoise, data regarding patient-centered outcomes may help guide decision-making.
Collapse
Affiliation(s)
- Timothy M Ullmann
- Division of General Surgery, Department of Surgery, Albany Medical College, 50 New Scotland Ave., MC-193, Albany, NY 12208, USA
| | - Maria Papaleontiou
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, Bldg. 16, Rm 453S, Ann Arbor, MI 48109, USA
| | - Julie Ann Sosa
- Section of Endocrine Surgery, Department of Surgery, University of California, San Francisco, 513 Parnassus Ave. Ste. S320, Box 0104, San Francisco, CA 94143, USA
| |
Collapse
|
5
|
Li Y, Huang Y, He X, Han C, Wu W, Shen H, Xu Y, Liu Y, Zhu Z. The global burden of thyroid cancer in high-income Asia-Pacific: a systematic analysis of the Global Burden of Disease study. Ther Adv Endocrinol Metab 2022; 13:20420188221090012. [PMID: 35464880 PMCID: PMC9019321 DOI: 10.1177/20420188221090012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/04/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Thyroid cancer has become increasingly prevalent and threatens human health. Few studies have explored the incidence of thyroid cancer in Asia and its relationship with social-progress factors. METHODS We analyzed Global Burden of Disease (GBD) Study 2019 data specific to thyroid cancer. Incidence, prevalence, mortality, and disability-adjusted life year (DALY) rates were used to evaluate the burden of thyroid cancer. RESULTS The age-standardized incidence, prevalence, and DALY rates per 100,000 population were 1.34% (95% UI, 2.44-3.07), 2.79% (95% UI, 18.82-23.77) and 16.49% (95% UI, 14.6-18), respectively, for all of Asia in 2019. In 2019, the DALY rate of thyroid cancer in the High-income Asia-Pacific region was the highest and mortality due to thyroid cancer in the High-income Asia-Pacific region was also the highest. The growth trend of DALYs in the High-income Asia-Pacific region was much steeper than those in other Asian regions. In all Asian regions and in the High-income Asia-Pacific region, the incidence, prevalence, mortality and DALY rates of thyroid cancer in female patients were drastically higher than those in male patients. Among Asian patients with thyroid cancer, the DALY rate was higher in men aged 80-89 years than in women. The DALY rate gradually increased with age. In the High-income Asia-Pacific region, the mortality rate of patients with thyroid cancer decreased with age. The prevalence was highest in those aged 40-79 years. CONCLUSION The disease burden of thyroid cancer in the High-income Asia-Pacific region was significantly higher than those in other regions, which may be due to overdiagnosis. The increasing incidence of thyroid cancer seems to indicate that thyroid cancer is still a public health problem in Asia. Therefore, some health policy adjustments will be meaningful.
Collapse
Affiliation(s)
| | | | | | - Cheng Han
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Wei Wu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, Shenyang, China
| | - Hui Shen
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yanbing Xu
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | | | - Zizhao Zhu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, No. 85 Heping South Street, Heping District, Shenyang 110006, Liaoning, China
| |
Collapse
|
6
|
Feletti F, Mellini L, Pironi F, Carnevale A, Parenti GC. Role of the cytopathologist during the procedure of fine-needle aspiration biopsy of thyroid nodules. Insights Imaging 2021; 12:111. [PMID: 34370089 PMCID: PMC8350303 DOI: 10.1186/s13244-021-01053-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/05/2021] [Indexed: 01/30/2023] Open
Abstract
Purpose This study aimed to conduct a diagnostic and cost-effective analysis of the cytopathology assistance in the ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) for characterising thyroid nodules. Materials and methods We reviewed the reports relative to 9061 US-guided FNABs for the histologic definition of the nature of thyroid nodules: 45.4% completed with the cytopathologist assistance and 54.6% by the radiologist alone. We also performed the cost-effectiveness analysis (CEA) of the procedure with and without the cytopathologist assistance. Results We found a significant positive correlation between the adoption/non-adoption of cytopathologist assistance and the number of indeterminate (TIR1) (Chi-square; z-score, Z = 10.22; critical value 5%, C = 1.96; p < 0.001). The cytopathologist's absence was correlated with the number of TIR 1 (Pearson correlation, product–moment correlation r = 0.059; critical value 5%, C = 0.008; p < 0.001). The total cost of the model's cytopathologist-assistance branch is 109.87€, while the total cost of the non-cytopathologist-assistance branch is 95.08€. Conclusion The cytopathologist assistance resulted in fewer nondiagnostic results, thus excluding the procedure's repetition but involved a higher expense, mainly due to the professional cost of the pathologist's participation. These data may provide decision-makers in healthcare with a practical evidence based on the opportunity to include the cytopathologist assistance in the thyroid nodule's FNAB depending on the available resources and the population's expectance. Supplementary information The online version contains supplementary material available at 10.1186/s13244-021-01053-y.
Collapse
Affiliation(s)
- F Feletti
- Department of Diagnostic Imaging Ausl Romagna, Unit of Radiology, S. Maria Delle Croci Hospital, Viale Randi 5, Ravenna, Italy.
| | - L Mellini
- Department of Diagnostic Imaging Ausl Romagna, Unit of Radiology, S. Maria Delle Croci Hospital, Viale Randi 5, Ravenna, Italy
| | - F Pironi
- DAMeTLab, Unit of Anatomical Pathology, S. M. Delle Croci Hospital, Ravenna, Italy
| | - A Carnevale
- Department of Radiology, University Radiology Unit, Sant'Anna University Hospital, Ferrara, Italy
| | - G C Parenti
- Department of Diagnostic Imaging Ausl Romagna, Unit of Radiology, S. Maria Delle Croci Hospital, Viale Randi 5, Ravenna, Italy
| |
Collapse
|
7
|
Ho J, Kim E, Han M, Jung I, Lee J, Jo YS. Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study. Ann Surg Oncol 2021; 28:4373-4384. [PMID: 33483844 DOI: 10.1245/s10434-020-09570-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Studies have shown that radioactive iodine therapy (RAIT) affects the development of second cancer in thyroid cancer patients. The impact of other factors, such as dyslipidemia are not clear. METHODS A retrospective analysis of thyroid cancer patients with a 1,251,913 person-year follow-up was conducted using data from the Health Insurance Review and Assessment database in South Korea from January 2008 to December 2018. We investigated factors related to second cancer development using a nested case-control analysis to avoid length bias. RESULTS The overall risk of developing second cancer was higher in thyroid cancer patients than in the general population [standardized incidence ratio, 3.34; 95% confidence interval (CI) 3.30-3.39]. Second cancer incidence was higher in patients who received RAIT than in those who did not [odds ratio (OR) 1.130; 95% CI 1.094-1.169]. Moreover, the risk of second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.265; 95% CI 1.223-1.309). After adjustment for RAIT, the incidence of a second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.262; 95% CI 1.221-1.306). CONCLUSIONS The risk of second cancer development in patients with thyroid cancer appears to be high. Dyslipidemia may be associated with an increased risk of several types of second cancers.
Collapse
Affiliation(s)
- Joon Ho
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunhwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jandee Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young Suk Jo
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
| |
Collapse
|
8
|
Changes in the Demographic and Clinicopathological Characteristics of Thyroid Cancer: A Population-Based Investigation in Algeria, 1993-2013. J Cancer Epidemiol 2020; 2020:7812791. [PMID: 33029144 PMCID: PMC7528096 DOI: 10.1155/2020/7812791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023] Open
Abstract
Over the last three decades, the incidence of thyroid cancer has increased worldwide. The reasons for this increase remain controversial. In Algeria, however, to date, information on thyroid cancer has been limited to a hospital-based case series. We analyzed data from a population-based cohort study in Oran District, Algeria, to describe demographic and clinicopathological characteristics of patients diagnosed with thyroid cancer between 1993 and 2013. Medical records and pathology reports of thyroid cancer patients who had surgery were reviewed. Changes in demographic and clinicopathological features over the 21-year period are described. During the study period, thyroid cancer was diagnosed in 1248 women (86.5%, mean age 43.7 ± 15.2 years) and 195 men (23.4%, mean age 48.1 ± 15.9 years). Most cases (83.1% for women and 69.8% for men) sought a diagnosis following a self-neck check. The most common histologic types were papillary (58.3%), follicular (29.7%), anaplastic (4.1%), and medullary (0.8%) carcinomas. The incidence of papillary carcinomas significantly increased (p < 0.001) while the incidence of other histologic types significantly decreased over time. Tumor size overall significantly decreased (p < 0.001) while the frequency of small (≤20 mm) and larger (>20 mm) carcinomas significantly increased (p < 0.05). The frequency of thyroid cancers with capsular effractions and angioinvasions also decreased over time. Thyroid cancer incidence in Algeria has increased substantially in line with international trends with changes in clinical practice being a possible contributing factor. However, the increasing papillary-to-follicular cancer ratio may be due to changes in iodine nutrition status in Algeria. Further research, including exploration of biological and molecular features of thyroid cancer, will enable a better understanding of risk factors and etiopathogenetic mechanisms.
Collapse
|
9
|
Al-Lawati NA, Shenoy SM, Al-Bahrani BJ, Al-Lawati JA. Increasing Thyroid Cancer Incidence in Oman: A Joinpoint Trend Analysis. Oman Med J 2020; 35:e98. [PMID: 32095279 PMCID: PMC7029156 DOI: 10.5001/omj.2020.16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/22/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives We sought to investigate the epidemiology of thyroid cancer and its trends in Oman over a 20-year period. Methods We analyzed all cases of primary thyroid cancer reported to the Oman National Cancer Registry between 1996 and 2015. Age-standardized incidence rates (ASR) were calculated using the World Standard Population. Joinpoint regression was used to assess trends and obtain annual percentage changes (APC) in incidence rates with 95% confidence intervals (95% CI) and p-values at the alpha = 0.050 level. Gender-specific APC was used to project thyroid cancer incidence rates in Oman over the next 20 years. Population attributable fraction was calculated for obesity and current non-smoking. Results A total of 1285 cases of primary thyroid cancer cases were registered in Oman between 1996 and 2015, with a female to male ratio of 4:1. In men, the ASR was 2.0 per 100 000 while in females it was 7.6 per 100 000 (p < 0.010). Over 80.0% of thyroid tumors were of a papillary type and 19.0% follicular type. Statistically significant trends for thyroid cancer were detected in women from 2008–2015 (APC = 14.3%, 95% CI: 8.0–20.9, p < 0.010) and among both genders (APC = 16.7%, 95% CI: 4.9–29.9, p < 0.010). If current trends continue, thyroid cancer incidence will increase to 3.1, 16.6, and 11.8 per 100 000 by 2040 in men, women, and both genders, respectively. Nearly 10.0% of thyroid cancer can be prevented by controlling obesity in the Omani population. Conclusions Oman has had moderate incidence rates of thyroid cancer with an increasing trend among women. Since projections estimate that the rates of this disease will double in women over the next 20 years, health authorities should consider providing sufficient resources to manage this condition and establish prevention programs that address obesity as part of the strategy for the prevention and control of noncommunicable diseases.
Collapse
Affiliation(s)
- Najla A Al-Lawati
- Department of Non-communicable Diseases Control, Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Sarooj M Shenoy
- Department of Non-communicable Diseases Control, Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Bassim J Al-Bahrani
- Department of Medical Oncology, National Oncology Centre, Royal Hospital, Muscat, Oman
| | - Jawad A Al-Lawati
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| |
Collapse
|
10
|
Zhang C, Li Y, Li J, Chen X. Total thyroidectomy versus lobectomy for papillary thyroid cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19073. [PMID: 32028431 PMCID: PMC7015547 DOI: 10.1097/md.0000000000019073] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis collected data for evaluating the effect of surgical extent on overall survival (OS) and recurrence-free survival (RFS) in patients with papillary thyroid cancer (PTC). METHODS We searched the PubMed, Embase, and Cochrane Library databases. The included studies compared two groups of patients with PTC: the total thyroidectomy (TT) group and the lobectomy (LT) group. The combined hazard ratio (HR) was calculated. RESULTS Thirteen studies were included in the present study. The TT and LT groups had similar OS results (HR = 1.04; 95% CI: 0.90-1.21; P = .60). In the subgroup analysis, the combined HR of the ≤1 cm group and the 1.0 to 2.0 cm group showed that TT had no advantage with regard to OS compared to LT. In the 2.0 to 4.0 cm group, TT provided better OS than LT (HR = 0.88; 95% CI: 0.79-0.99; P = .03). Patients who underwent TT had a better RFS outcome than those who underwent LT (HR = 0.56; 95% CI: 0.41-0.77; P < .0001). In the subgroup analysis, both the ≤1 cm group and >1 cm group that underwent TT were associated with better RFS. CONCLUSIONS Our meta-analysis suggested that LT increased the risk of recurrence in PTC patients with tumors ≤1.0 cm and in PTC patients with tumors >1.0 cm. More importantly, LT was associated with higher mortality in PTC patients with 2.0 to 4.0 cm tumors. Caution is warranted when LT is performed in this group of patients.
Collapse
Affiliation(s)
- Chi Zhang
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University
| | - Yanshuang Li
- Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jiyu Li
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University
| | - Xiao Chen
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University
| |
Collapse
|
11
|
Kim J, Gosnell JE, Roman SA. Geographic influences in the global rise of thyroid cancer. Nat Rev Endocrinol 2020; 16:17-29. [PMID: 31616074 DOI: 10.1038/s41574-019-0263-x] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2019] [Indexed: 12/11/2022]
Abstract
The incidence of thyroid cancer is on the rise, and this disease is projected to become the fourth leading type of cancer across the globe. From 1990 to 2013, the global age-standardized incidence rate of thyroid cancer increased by 20%. This global rise in incidence has been attributed to several factors, including increased detection of early tumours, the elevated prevalence of modifiable individual risk factors (for example, obesity) and increased exposure to environmental risk factors (for example, iodine levels). In this Review, we explore proven and novel hypotheses for how modifiable risk factors and environmental exposures might be driving the worldwide increase in the incidence of thyroid cancer. Although overscreening and the increased diagnosis of possibly clinically insignificant disease might have a role in certain parts of the world, other areas could be experiencing a true increase in incidence due to elevated exposure risks. In the current era of personalized medicine, national and international registry data should be applied to identify populations who are at increased risk for the development of thyroid cancer.
Collapse
Affiliation(s)
- Jina Kim
- University of California San Francisco, San Francisco, CA, USA
| | | | | |
Collapse
|
12
|
Memon A, Rogers I, Paudyal P, Sundin J. Dental X-Rays and the Risk of Thyroid Cancer and Meningioma: A Systematic Review and Meta-Analysis of Current Epidemiological Evidence. Thyroid 2019; 29:1572-1593. [PMID: 31502516 DOI: 10.1089/thy.2019.0105] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for thyroid cancer and brain and central nervous system tumors. Considering the high lifetime prevalence and frequency of exposure to dental X-rays, the most common source of diagnostic radiation exposure in the general population, even a small associated increase in cancer risk would be of considerable public health importance. With the objective to inform clinical practice and guidelines, we synthesized the current epidemiological evidence on the association between dental X-rays and the risk of thyroid cancer, meningioma, and other cancers of the head and neck region. Methods: The Medline, Embase, and Web of Science databases were searched to identify eligible studies. Summary odds ratio/relative risk estimates and confidence intervals were extracted, and pooled risk ratios (RRs) for each cancer were calculated using random effects meta-analysis. Results: The literature search identified 5537 publications; of these, 26 studies including 10,868 cancer patients were included in the synthesis. The random effects meta-analyses, based on seven studies of thyroid cancer (six case/control, one cohort) and eight studies of meningioma (all case/control), showed that multiple (or repeated) exposures to dental X-rays were significantly associated with an increased risk of thyroid cancer (pooled RR = 1.87 [95% confidence interval, CI 1.11-3.15]) and meningioma (pooled RR = 1.53 [CI 1.26-1.85]). There was no association with glioma, and there were too few studies of other cancers of the head and neck region to conduct a meaningful meta-analysis. Conclusions: Based on a meta-analysis of retrospective case/control studies, these findings provide some support to the hypothesis that multiple (or repeated) exposures to dental X-rays may be associated with an increased risk of thyroid cancer and meningioma. These studies did not include individual organ doses and ages at exposure, and are subject to recall bias and other limitations. Furthermore, the thyroid exposure has decreased dramatically over time from the use of thyroid shields and improved technology/equipment. Prospective studies, based on dental X-ray records and patient follow-up, are needed to test the hypothesis further and clarify the possible cancer risk associated with dental radiography, as although the risk at the individual level, particularly with improved technology/equipment, is likely to be very low, the proportion of the population exposed is high. Considering that about one-third of the general population in developed countries is routinely exposed to one or more dental X-rays per year, these findings manifest the need to reduce diagnostic radiation exposure as much as possible.
Collapse
Affiliation(s)
- Anjum Memon
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Priyamvada Paudyal
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Josefin Sundin
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| |
Collapse
|
13
|
Watanabe K, Igarashi T, Ashida H, Ogiwara S, Ohta T, Uchiyama M, Ojiri H. Diagnostic value of ultrasonography and TI-201/Tc-99m dual scintigraphy in differentiating between benign and malignant thyroid nodules. Endocrine 2019; 63:301-309. [PMID: 30276595 DOI: 10.1007/s12020-018-1768-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/19/2018] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the performance of ultrasonography (US) and TI-201/Tc-99m dual (Tl/Tc) scintigraphy in differentiating between benign and malignant thyroid nodules. METHODS Eighty-six patients diagnosed to have a thyroid tumor on postoperative histopathologic examination between June 2009 and February 2017 were included in this retrospective study. A radiologist reviewed the US and Tl/Tc scintigraphy reports along with all available clinical and histopathologic information. On Tl/Tc scintigraphy, a nodule in which uptake was higher in the delayed phase than in the surrounding parenchyma was defined as a delayed accumulation pattern and a nodule in which uptake was higher in the delayed phase than in the early phase was defined as a persistent pattern. The Tl/Tc scintigraphy images were evaluated in a blinded manner to assess reproducibility. A statistical analysis was performed to identify features associated with malignancy. Interobserver variability was calculated using the κ statistic. RESULTS US had higher sensitivity (81.2%), specificity (88.2%), and positive (96.6%) and negative (53.6%) predictive values than Tl/Tc scintigraphy. An ill-defined margin and microcalcification were independent predictors of a malignant thyroid nodule on multivariate logistic regression (P = 0.003 and P = 0.014, respectively). The persistent pattern had high specificity (85.7%) equivalent to that of US but had lower sensitivity (34.7%). The κ values for the delayed accumulation and persistent patterns were 0.66-0.78 and 0.32-0.50, respectively. CONCLUSIONS An ill-defined margin and microcalcification on US were independent predictors of a malignant thyroid nodule. A persistent pattern seen on Tl/Tc scintigraphy could contribute to the differential diagnosis.
Collapse
Affiliation(s)
- Ken Watanabe
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Takao Igarashi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hirokazu Ashida
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Sho Ogiwara
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tomoyuki Ohta
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mayuki Uchiyama
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| |
Collapse
|
14
|
Li F, Wu Y, Chen L, Hu L, Liu X. Evaluation of clinical risk factors for predicting insidious right central and posterior right recurrent laryngeal nerve lymph node metastasis in papillary thyroid microcarcinoma patients (cN0): experience of a single center. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:8. [PMID: 30788355 DOI: 10.21037/atm.2018.12.43] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Papillary thyroid microcarcinoma (PTMC), one specific subtype of papillary thyroid carcinoma (PTC) which measures less than 10 mm in maximum dimension, presents with a high risk of insidious lymph node metastasis escaping from preoperative examinations (cN0). Given the complications of lymph node dissection (LND) and metastasis risk, proper stratification of PTMC for performing prophylactic LND bears great importance. Methods From June 2015 to December 2017, 338 PTMC patients undergoing thyroidectomy were included in the present study. Potential risk factors, including age, gender, maximal tumor size, etc. were collected and analyzed for association with thyroid lymph node metastasis. Results Among the 338 patients, 87 patients (25.7%) presented with right central lymph node metastasis (CLNM) and 28 patients (8.3%) had posterior right recurrent laryngeal nerve lymph node metastasis (PRRLN-LNM). The maximal tumor was prone to occur at the middle part of the lower pole (35.3%) in patients with right CLNM, while the proportion of tumors located in the middle part of the upper pole (17.2%) was highest in PRRLN-LNM patients. Ages younger than 45 years old, male gender, and a tumor size of more than 0.5 cm were correlated independently with right CLNM and PRRLN-LNM. Presence of capsular invasion also had a significant association with the occurrence of PRRLN-LNM. Conclusions Ages younger than 45, male gender, and a maximal tumor size larger than 0.5 cm, in addition to capsular invasion, were independent risk factors for stratification of PTMC patients. PTMC patients with these clinical characteristics were suggested to receive prophylactic LND in their initial thyroid surgeries.
Collapse
Affiliation(s)
- Fuqiang Li
- Thyroid Disease Diagnosis and Treatment Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Yijun Wu
- Thyroid Disease Diagnosis and Treatment Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Liang Chen
- Thyroid Disease Diagnosis and Treatment Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Liang Hu
- Thyroid Disease Diagnosis and Treatment Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Xiaosun Liu
- Thyroid Disease Diagnosis and Treatment Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| |
Collapse
|
15
|
Salamanca-Fernández E, Rodriguez-Barranco M, Chang-Chan YL, Redondo-Sánchez D, Domínguez-López S, Bayo E, Narankiewicz D, Expósito J, Sánchez MJ. Thyroid Cancer Epidemiology in South Spain: a population-based time trend study. Endocrine 2018; 62:423-431. [PMID: 30043094 DOI: 10.1007/s12020-018-1681-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/09/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Thyroid cancer (TC) is the most common malignant disease of the endocrine system. The aim of this study was to analyze incidence and mortality trends of TC (C73 according to ICD-O-3) in Granada (Southern Spain) during the period 1985-2013, by sex, age, and histological type. METHODS This is a population-based cross-sectional study. Incidence data were obtained from the population-based Cancer Registry of Granada. All newly diagnosed cases of thyroid cancer over the period 1985-2013 were included. Joinpoint regression analysis with age-standardized rates were used to estimate annual percentage change (APC), CI 95% and turning points in trends. Results are presented by sex, age group, and histological type. RESULTS During the study period there were 1265 diagnosed cases of TC in Granada (72.6% in women). Incidence trends significantly increased in both men (APC: + 5.4%) and women (APC: + 4.7%). The most common histological types in both sexes were papillary (74.8%) and follicular (16.8%). The incidence has increased during the study period mainly due to papillary carcinoma, which has increased annually around 6% in both sexes. TC mortality trend during this period decreased in men (APC: -0.3%) and women (APC: -2.3%). CONCLUSION Our data showed an increasing trend in incidence of thyroid cancer in Granada, especially in women between 55-64 years. Mortality showed a slight decrease trend during the study period in both sexes. Papillary carcinoma was the most common histological type, with an increase of the relative weight of papillary microcarcinomas. Our study is in accordance with the European and worldwide trends in thyroid cancer incidence and mortality and sex differences.
Collapse
Affiliation(s)
- Elena Salamanca-Fernández
- Andalusian School of Public Health (EASP), Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | - Miguel Rodriguez-Barranco
- Andalusian School of Public Health (EASP), Granada, Spain.
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain.
- Biosanitary Investigation Institute ibs, Granada, Spain.
| | - Yoe-Ling Chang-Chan
- Andalusian School of Public Health (EASP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | - Daniel Redondo-Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | | | - Eloísa Bayo
- Radiation Oncology Department, University Hospital Virgen Macarena, Sevilla, Spain
| | - Dariusz Narankiewicz
- Preventive Medicine and Public Health Department, Hospital Virgen de la Victoria of Málaga, Málaga, Spain
| | - José Expósito
- Biosanitary Investigation Institute ibs, Granada, Spain
- Radiotherapy and Oncology Department, University Hospital Virgen de las Nieves Granada, Granada, Spain
| | - María José Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| |
Collapse
|
16
|
Gül N, Üzüm AK, Selçukbiricik ÖS, Yegen G, Tanakol R, Aral F. Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients. Radiol Oncol 2018; 52:257-262. [PMID: 30210035 PMCID: PMC6137358 DOI: 10.2478/raon-2018-0027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/12/2018] [Indexed: 01/03/2023] Open
Abstract
Background The association of subacute thyroiditis (SAT) and papillary thyroid carcinoma is a rare finding. In this study, we aimed to investigate the prevalence of differentiated thyroid cancer in a cohort of patients followed with the diagnosis of SAT. Patients and methods We retrospectively screened medical records of Endocrinology and Metabolism outpatient clinic in the past 20 years for patients with SAT. Patients with nodules and suspicious ultrasonography findings who underwent fine needle aspiration biopsy (FNAB) and operated due to malignancy risk were identified. Results We identified 137 (100 females, 37 males) patients with reliable records to confirm the diagnosis of SAT. The mean age of female patients was 41.1 ± 9.1 (range, 20-64) and of male patients was 43.0 ± 9.3 (range, 20-65). One or more FNAB was performed in 23 of the patients (16.8%) at the beginning and/or during the follow-up period when needed. Seven patients with suspicious FNAB findings were operated, and histopathological examination of the nodules confirmed the diagnosis of papillary thyroid carcinoma in 6 patients (4.4%). Conclusions Our observations suggesting a relatively higher prevalence of thyroid cancer in a small series of SAT patients warrant further studies to identify the real frequency of differentiated thyroid cancer and its association with inflammatory pathogenesis of SAT. This finding is compatible with the trend of increased thyroid cancer incidence all over the world. A repeat ultrasonography after resolution of clinical and inflammatory findings, and FNAB should be recommended to all patients with suspicious nodules.
Collapse
Affiliation(s)
- Nurdan Gül
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşe Kubat Üzüm
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Özlem Soyluk Selçukbiricik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gülçin Yegen
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Refik Tanakol
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ferihan Aral
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
17
|
Aljabri KS, Bokhari SA, Al MA, Khan PM. An 18-year study of thyroid carcinoma in the western region of Saudi Arabia: a retrospective single-center study in a community hospital. Ann Saudi Med 2018; 38:336-343. [PMID: 30284988 PMCID: PMC6180217 DOI: 10.5144/0256-4947.2018.336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/03/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Thyroid carcinoma (TC) is the ninth most common site of all cancers in women in the world and the second most common malignancy in Saudi Arabia. This reports updates data on the epidemiology of the disease in Saudi Arabia. OBJECTIVE Describe and interpret changes in the frequency of TC to compare with other populations and determine proportions of certain histological types of TC. DESIGN Medical record review. SETTING Military hospital in Jeddah, Saudi Arabia. PATIENTS AND METHODS We reviewed the pathological and clinical records from January 2000 to December 2017 of patients with TC. MAIN OUTCOME MEASURES Frequency and types of TC. SAMPLE SIZE 347 patients. RESULTS Over the 18-year period, out of 456 patients with TC, 347 patients had sufficiently complete records: 275 (79.3%) were female and 72 (20.7%) were male for a female to male ratio of 3.8:1. The mean (SD) age at surgery of all patients was 45.2 (16.0) years. There were 287 (82.7%) cases of papillary TC. The next common malignancy was follicular TC with 32 (9.2%) cases followed by Hurthle cell cancer with 11 (3.2%) cases. Lymphoma was found in only 7 (2%) cases. All TC types occurred at a younger age in females than males except for lymphoma. All TC types occurred with the greatest frequency in the fourth and fifth decades. There was a 2.3-fold increase in the number of TCs from 8 (2.3%) in 2000 to 26 (7.5%) in 2017. The rate per 100000 residents of Jeddah increased for the period from 2000 to 2002 from 1.6 to 3.4 for 2015-2017. Papillary TC cases in females accounted for most of the increase. CONCLUSION Our findings are consistent with similar studies worldwide. Etiological factors promoting the rise in TC must be investigated and may provide insight in developing suitable management strategies for the Saudi population. LIMITATION Small sample size and retrospective over a long period. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Khalid S Aljabri
- Dr. Khalid S. Aljabri, Department of Endocrinology,, King Fahd Armed Forces Hospital,, PO Box 6572, Jeddah 24361,, Saudi Arabia, T: +966-555-544919, khalidsaljabri@ yahoo.com, ORCID: http://orcid. org/0000-0001-5831-5935
| | | | - Muneera A Al
- Dr. Khalid S. Aljabri, Department of Endocrinology,, King Fahd Armed Forces Hospital,, PO Box 6572, Jeddah 24361,, Saudi Arabia, T: +966-555-544919, khalidsaljabri@ yahoo.com, ORCID: http://orcid. org/0000-0001-5831-5935
| | | |
Collapse
|
18
|
An update in international trends in incidence rates of thyroid cancer, 1973–2007. Cancer Causes Control 2018; 29:465-473. [DOI: 10.1007/s10552-018-1023-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 03/14/2018] [Indexed: 10/17/2022]
|
19
|
Shulin JH, Aizhen J, Kuo SM, Tan WB, Ngiam KY, Parameswaran R. Rising incidence of thyroid cancer in Singapore not solely due to micropapillary subtype. Ann R Coll Surg Engl 2018. [PMID: 29543059 DOI: 10.1308/rcsann.2018.0004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction The annual incidence of thyroid cancer is known to vary with geographic area, age and gender. The increasing incidence of thyroid cancer has been attributed to increase in detection of micropapillary subtype, among other factors. The aim of the study was to investigate time trends in the incidence of thyroid cancer in Singapore, an iodine-sufficient area. Materials and methods Data retrieved from the Singapore National Cancer Registry on all thyroid cancers that were diagnosed from 1974 to 2013 were reviewed. We studied the time trends of thyroid cancer based on gender, race, pathology and treatment modalities where available. Results The age-standardised incidence rate of thyroid cancer increased to 5.6/100,000 in 2013 from 2.5/100,000 in 1974. Thyroid cancer appeared to be more common in women, with a higher incidence in Chinese and Malays compared with Indians. Papillary carcinoma is the most common subtype. The percentage of papillary microcarcinoma has remained relatively stable at around 38% of all papillary cancers between 2007 and 2013. Although the incidence of thyroid cancer has increased since 1974, the mortality rate has remained stable. Conclusion This trend of increase in incidence of thyroid cancer in Singapore compares with other published series; however, the rise seen was not solely due to micropapillary type. Thyroid cancer was also more common in Chinese and Malays compared with Indians for reasons that needs to be studied further.
Collapse
Affiliation(s)
- J H Shulin
- Division of Endocrine Surgery, National University Hospital , Singapore
| | - J Aizhen
- National Registry of Disease Office, Health Promotion Board , Singapore
| | - S M Kuo
- National Registry of Disease Office, Health Promotion Board , Singapore
| | - W B Tan
- Division of Endocrine Surgery, National University Hospital , Singapore
| | - K Y Ngiam
- Division of Endocrine Surgery, National University Hospital , Singapore
| | - R Parameswaran
- Division of Endocrine Surgery, National University Hospital , Singapore
| |
Collapse
|
20
|
Zamora-Ros R, Béraud V, Franceschi S, Cayssials V, Tsilidis KK, Boutron-Ruault MC, Weiderpass E, Overvad K, Tjønneland A, Eriksen AK, Bonnet F, Affret A, Katzke V, Kühn T, Boeing H, Trichopoulou A, Valanou E, Karakatsani A, Masala G, Grioni S, de Magistris MS, Tumino R, Ricceri F, Skeie G, Parr CL, Merino S, Salamanca-Fernández E, Chirlaque MD, Ardanaz E, Amiano P, Almquist M, Drake I, Hennings J, Sandström M, Bueno-de-Mesquita HB, Peeters PH, Khaw KT, Wareham NJ, Schmidt JA, Perez-Cornago A, Aune D, Riboli E, Slimani N, Scalbert A, Romieu I, Agudo A, Rinaldi S. Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Int J Cancer 2018; 142:449-459. [PMID: 28688112 PMCID: PMC6198931 DOI: 10.1002/ijc.30880] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 05/29/2017] [Accepted: 06/20/2017] [Indexed: 12/21/2022]
Abstract
Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68-1.15; p-trend = 0.44), vegetables (HR: 0.89; 95% CI: 0.69-1.14; p-trend = 0.56), or fruit (HR: 1.00; 95% CI: 0.79-1.26; p-trend = 0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98-1.53; p-trend = 0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.
Collapse
Affiliation(s)
- Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Virginie Béraud
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | | | - Valerie Cayssials
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Konstantinos K. Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- School of Public Health, Imperial College London, London, UK
| | - Marie-Christine Boutron-Ruault
- CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, F-94805, Villejuif, France
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | | | | | - Fabrice Bonnet
- CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, F-94805, Villejuif, France
- CHU Rennes, Rennes 1 University, Rennes, France
| | - Aurélie Affret
- CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, F-94805, Villejuif, France
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Haidari, Greece
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
| | - Sara Grioni
- Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Italy
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway
| | - Christine L Parr
- Domain of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Elena Salamanca-Fernández
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Maria-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
| | - Pilar Amiano
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain
| | - Martin Almquist
- Department of Surgery, University Hospital Lund, Lund, Sweden
- Malmö Diet and Cancer Study, University Hospital Malmö, Malmö, Sweden
| | - Isabel Drake
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Joakim Hennings
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Maria Sandström
- Department for Radiation Sciences, Umeå University, Umeå, Sweden
| | - H. Bas Bueno-de-Mesquita
- School of Public Health, Imperial College London, London, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Petra H. Peeters
- School of Public Health, Imperial College London, London, UK
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kay-Thee Khaw
- Department of Public Health and Primary Care, University of Cambridge, UK
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | | | - Dagfinn Aune
- School of Public Health, Imperial College London, London, UK
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Bjørknes University College, Oslo, Norway
| | - Elio Riboli
- School of Public Health, Imperial College London, London, UK
| | - Nadia Slimani
- International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Sabina Rinaldi
- International Agency for Research on Cancer (IARC), Lyon, France
| |
Collapse
|
21
|
Raue F, Frank-Raue K. Thyroid Cancer: Risk-Stratified Management and Individualized Therapy. Clin Cancer Res 2018; 22:5012-5021. [PMID: 27742787 DOI: 10.1158/1078-0432.ccr-16-0484] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/24/2016] [Indexed: 11/16/2022]
Abstract
Thyroid cancer is the most common endocrine malignancy. Differentiated thyroid cancer (DTC) with the two subtypes, papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC), is the most frequent subtype of thyroid cancer; more rare subtypes are medullary thyroid cancer (MTC) and anaplastic thyroid cancer (ATC). The incidence of DTC has increased rapidly in recent years due to the more frequent use of imaging methods such as ultrasound of the neck and fine-needle aspiration (FNA) of thyroid nodules. After total thyroidectomy and radioiodine treatment, DTC remains an indolent and curable disease in most patients, whereas the cure rate in MTC is lower and depends on early diagnosis. Most ATCs are incurable. In recent years, there has been great progress in identifying genetic changes in thyroid cancer, and genetic testing of FNA samples or blood samples provides useful information for clinical decision making. Tumor staging, either postoperatively or by imaging, and measuring the tumor markers thyroglobulin for DTC and calcitonin for MTC, allow for dynamic risk-adapted stratification for follow-up procedures. In advanced metastatic thyroid cancer, molecular targeted therapy using tyrosine kinase receptor inhibitors, including sorafenib, lenvantinib, vandetanib, and cabozantinib, helps control tumor progression and prolongs progression-free survival. Using a dynamic risk-stratified approach to manage thyroid cancer, the outcomes for most thyroid cancer patients are excellent compared with those for other cancers. The major challenge in the future is to identify high-risk patients and to treat and monitor them appropriately. Clin Cancer Res; 22(20); 5012-21. ©2016 AACR SEE ALL ARTICLES IN THIS CCR FOCUS SECTION, "ENDOCRINE CANCERS REVISING PARADIGMS".
Collapse
Affiliation(s)
- Friedhelm Raue
- Molecular Laboratory, Endocrine Practice, Heidelberg, Germany.
| | | |
Collapse
|
22
|
Furuya-Kanamori L, Sedrakyan A, Onitilo AA, Bagheri N, Glasziou P, Doi SAR. Differentiated thyroid cancer: millions spent with no tangible gain? Endocr Relat Cancer 2018; 25:51-57. [PMID: 29042396 DOI: 10.1530/erc-17-0397] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/17/2017] [Indexed: 11/08/2022]
Abstract
The incidence of differentiated thyroid cancer (DTC) has rapidly increased worldwide over the last decades. It is unknown if the increase in diagnosis has been mirrored by an increase in thyroidectomy rates with the concomitant economic impact that this would have on the health care system. DTC and thyroidectomy incidence as well as DTC-specific mortality were modeled using Poisson regression in New South Wales (NSW), Australia per year and by sex. The incidence of 2002 was the point from which the increase in rates was assessed cumulatively over the subsequent decade. The economic burden of potentially avoidable thyroidectomies due to the increase in diagnosis was estimated as the product of the additional thyroidectomy procedures during a decade attributable to rates beyond those reported for 2002 and the national average hospital cost of an uncomplicated thyroidectomy in Australia. The following results were obtained. The incidence of both DTC and thyroidectomy doubled in NSW between 2003 and 2012, while the DTC-specific mortality rate remained unchanged over the same period. Based on the 2002 incidence, the projected increase over 10 years (2003-2012) in thyroidectomy procedures was 2196. This translates to an extra cost burden of over AUD$ 18,600,000 in surgery-related health care expenditure over one decade in NSW. Our findings suggest that, if this rise is solely attributable to overdetection, then the rising expenditure serves no additional purpose. Reducing unnecessary detection and a conservative approach to managing DTC are sensible and would lead to millions of dollars in savings and reduced harms to patients.
Collapse
Affiliation(s)
- Luis Furuya-Kanamori
- Department of Population MedicineCollege of Medicine, Qatar University, Doha, Qatar
| | - Art Sedrakyan
- Research School of Population HealthAustralian National University, Canberra, ACT, Australia
- Department of Healthcare Policy and ResearchWeill Cornell Medicine, New York, New York, USA
| | - Adedayo A Onitilo
- Department of Hematology/OncologyMarshfield Clinic Weston Center, Weston, Wisconsin, USA
| | - Nasser Bagheri
- Research School of Population HealthAustralian National University, Canberra, ACT, Australia
| | - Paul Glasziou
- Centre for Research in Evidence Based PracticeBond University, Gold Coast, QLD, Australia
| | - Suhail A R Doi
- Department of Population MedicineCollege of Medicine, Qatar University, Doha, Qatar
| |
Collapse
|
23
|
Sanabria A, Kowalski LP, Shah JP, Nixon IJ, Angelos P, Williams MD, Rinaldo A, Ferlito A. Growing incidence of thyroid carcinoma in recent years: Factors underlying overdiagnosis. Head Neck 2017; 40:855-866. [PMID: 29206325 DOI: 10.1002/hed.25029] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/24/2017] [Accepted: 10/25/2017] [Indexed: 01/03/2023] Open
Abstract
There is an increasing incidence of well-differentiated thyroid cancer worldwide. Much of the increase is secondary to increased detection of small, low-risk tumors, with questionable clinical significance. This review addresses the factors that contribute to the increasing incidence and considers environmental, and patient-based and clinician-led influences. Articles addressing the causes of the increased incidence were critically reviewed. A complex interplay of environmental, medical, and social pressures has resulted in increased awareness of the thyroid disease risk, increased screening of thyroid cancers, and increased diagnosis of thyroid cancers. Although there is evidence to suggest that the true disease incidence may be changing slightly, most of the increase is related to factors that promote early diagnosis of low-risk lesions, which is resulting in a significant phenomenon of overdiagnosis. An improved understanding of these pressures at a global level will enable healthcare policymakers to react appropriately to this challenge in the future.
Collapse
Affiliation(s)
- Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, Clinica Vida/Instituto de Cancerología Las Americas, Medellin, Colombia, South America
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, SP, Brazil
| | - Jatin P Shah
- Department of Head and Neck Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Peter Angelos
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Michelle D Williams
- Department of Pathology, Division of Pathology/Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
| |
Collapse
|
24
|
Lee JH, Hwang Y, Song RY, Yi JW, Yu HW, Kim SJ, Chai YJ, Choi JY, Lee KE, Park SK. Relationship between iodine levels and papillary thyroid carcinoma: A systematic review and meta-analysis. Head Neck 2017; 39:1711-1718. [DOI: 10.1002/hed.24797] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/17/2017] [Accepted: 02/23/2017] [Indexed: 01/31/2023] Open
Affiliation(s)
- Joon-Hyop Lee
- Department of Surgery; Seoul National University Bundang Hospital; 300 Gumi-dong Bundang-gu Seongnam-si Gyeonggi-do Korea
- Thyroid and Endocrine Surgery Section, Department of Surgery; Gachon University Gil Medical Center; Incheon Republic of Korea
| | - Yunji Hwang
- Department of Preventive Medicine; Seoul National University College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Ra-Yeong Song
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Jin Wook Yi
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Hyeong Won Yu
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Su-jin Kim
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Young Jun Chai
- Department of Surgery; Seoul National University Hospital Boramae Medical Center; Seoul Korea
| | - June Young Choi
- Department of Surgery; Seoul National University Bundang Hospital; 300 Gumi-dong Bundang-gu Seongnam-si Gyeonggi-do Korea
| | - Kyu Eun Lee
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Sue K. Park
- Department of Preventive Medicine; Seoul National University College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| |
Collapse
|
25
|
Abstract
During the past few decades, the incidence of thyroid cancer has increased substantially in many countries, including the USA. The rise in incidence seems to be attributable both to the growing use of diagnostic imaging and fine-needle aspiration biopsy, which has led to enhanced detection and diagnosis of subclinical thyroid cancers, and environmental factors. The latest American Thyroid Association (ATA) practice guidelines for the management of adult patients with thyroid nodules and differentiated thyroid cancer differ substantially from the previous ATA guidelines published in 2009. Specifically, the problems of overdiagnosis and overtreatment of a disease that is typically indolent, where treatment-related morbidity might not be justified by a survival benefit, now seem to be acknowledged. As few modifiable risk factors for thyroid cancer have been established, the specific environmental factors that have contributed to the rising incidence of thyroid cancer remain speculative. However, the findings of several large, well-designed epidemiological studies have provided new information about exposures (such as obesity) that might influence the development of thyroid cancer. In this Review, we describe the changing incidence of thyroid cancer, suggest potential explanations for these trends, emphasize the implications for patients and highlight ongoing and potential strategies to combat this growing clinical and public health issue.
Collapse
MESH Headings
- Adenocarcinoma, Follicular/diagnostic imaging
- Adenocarcinoma, Follicular/epidemiology
- Adenocarcinoma, Follicular/pathology
- Age Distribution
- Biopsy, Fine-Needle
- Carcinoma/diagnostic imaging
- Carcinoma/epidemiology
- Carcinoma/pathology
- Carcinoma, Neuroendocrine/diagnostic imaging
- Carcinoma, Neuroendocrine/epidemiology
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Papillary
- Humans
- Incidence
- Medical Overuse
- Obesity/epidemiology
- Radiation Exposure/statistics & numerical data
- Risk Factors
- Sex Distribution
- Smoking/epidemiology
- Thyroid Cancer, Papillary
- Thyroid Carcinoma, Anaplastic/diagnostic imaging
- Thyroid Carcinoma, Anaplastic/epidemiology
- Thyroid Carcinoma, Anaplastic/pathology
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/pathology
- Thyroid Nodule/diagnostic imaging
- Thyroid Nodule/epidemiology
- Thyroid Nodule/pathology
- United States/epidemiology
Collapse
Affiliation(s)
- Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 7E-536, Bethesda, Maryland 20892-9778, USA
| | - Julie A Sosa
- Section of Endocrine Surgery, Department of Surgery, Duke University, Seeley Mudd Building #484, 10 Searle Center Drive, DUMC #2945, Durham, North Carolina 27710, USA
- Duke Clinical Research Institute, North Pavilion, 2400 Pratt Street, Durham, North Carolina 27705, USA
| |
Collapse
|
26
|
Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP. Systematic Review of Trends in the Incidence Rates of Thyroid Cancer. Thyroid 2016; 26:1541-1552. [PMID: 27571228 DOI: 10.1089/thy.2016.0100] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND A large proportion of global increase in thyroid cancer (TC) incidence has been attributed to increased detection of papillary thyroid cancer (PTC). Nonetheless, some reports support a real increase in incidence. This study aimed to perform a systematic review to evaluate the changing trends in TC incidence and summarize potential risk factors predisposing to this trend. METHODS Literature published in the English language between 1980 and August 2014 was searched via PubMed (MEDLINE) and OvidSP (EMBASE). Original studies on changes in TC incidence in defined geographic areas that described clear methods of case selection and population estimates were included. Data on incidence rates and risk factors were collected. RESULTS Of 4719 manuscripts, 60 studies were included, of which 31 were from Europe, 13 from North America, and the rest from Asia (n = 9), Oceania (n = 4), and South America (n = 3). Fifty-three articles reported a significant increase in incidence (highest was a 10-fold increase in South Korea), six reported stable rates, and one noted a decrease. PTC was the commonest type reported to have increased in incidence (in 10 studies with relevant data). Follicular TC increased in incidence (in four studies), albeit at a lower rate compared with PTC. Data on risk factors were sparse; factors discussed included ionizing radiation, iodine deficiency, and supplementation. CONCLUSION This systematic review strongly supports a widespread and persistent increase in TC incidence. Evidence for over-detection of PTC as the predominant influence includes increased numbers of smaller size tumors and improved or unchanged survival.
Collapse
Affiliation(s)
| | - Thomas M Drake
- 1 Medical School, University of Sheffield , Sheffield, United Kingdom
| | - Lesley Uttley
- 2 School of Health and Related Research, University of Sheffield , Sheffield, United Kingdom
| | | |
Collapse
|
27
|
Walsh JP. Managing thyroid disease in general practice. Med J Aust 2016; 205:179-84. [DOI: 10.5694/mja16.00545] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/20/2016] [Indexed: 01/01/2023]
Affiliation(s)
- John P Walsh
- Sir Charles Gairdner Hospital, Perth, WA
- University of Western Australia, Perth, WA
| |
Collapse
|
28
|
Effect of different iodine concentrations on well-differentiated thyroid cancer cell behavior and its inner mechanism. Cell Biochem Biophys 2016; 71:299-305. [PMID: 25120024 DOI: 10.1007/s12013-014-0198-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
High iodine intake might be an important factor in the promotion of thyroid cancer and the incidence of thyroid carcinoma has increased obviously these years especially in area of high iodine intake, though the mechanism of which remains unknown. The aim of present study was to gain more insight into the influence of different iodine concentrations on cell behavior, such as proliferation and migration, and to further investigate its molecular mechanism using two well-differentiated thyroid cancer cell lines. Our study evaluated the effect of different iodine concentrations on cell behavior and investigated relevant molecules involved. The results indicated that iodine in vitro could promote the growth of thyroid cancer cells with the increase of iodine concentration in a specific range. Such effect may be related to signaling pathways as Akt and Erk and cytokine VEGF-A.
Collapse
|
29
|
Mahmood K, Zia KM, Zuber M, Salman M, Anjum MN. Recent developments in curcumin and curcumin based polymeric materials for biomedical applications: A review. Int J Biol Macromol 2015; 81:877-90. [PMID: 26391597 DOI: 10.1016/j.ijbiomac.2015.09.026] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/05/2015] [Accepted: 09/16/2015] [Indexed: 01/15/2023]
Abstract
Turmeric (Curcuma longa) is a popular Indian spice that has been used for centuries in herbal medicines for the treatment of a variety of ailments such as rheumatism, diabetic ulcers, anorexia, cough and sinusitis. Curcumin (diferuloylmethane) is the main curcuminoid present in turmeric and responsible for its yellow color. Curcumin has been shown to possess significant anti-inflammatory, anti-oxidant, anti-carcinogenic, anti-mutagenic, anticoagulant and anti-infective effects. This review summarizes and discusses recently published papers on the key biomedical applications of curcumin based materials. The highlighted studies in the review provide evidence of the ability of curcumin to show the significant vitro antioxidant, diabetic complication, antimicrobial, neuroprotective, anti-cancer activities and detection of hypochlorous acid, wound healing, treatment of major depression, healing of paracentesis, and treatment of carcinoma and optical detection of pyrrole properties. Hydrophobic nature of this polyphenolic compound along with its rapid metabolism, physicochemical and biological instability contribute to its poor bioavailability. To redress these problems several approaches have been proposed like encapsulation of curcumin in liposomes and polymeric micelles, inclusion complex formation with cyclodextrin, formation of polymer-curcumin conjugates, etc.
Collapse
Affiliation(s)
- Kashif Mahmood
- Institute of Chemistry, Government College University, Faisalabad, Pakistan
| | - Khalid Mahmood Zia
- Institute of Chemistry, Government College University, Faisalabad, Pakistan.
| | - Mohammad Zuber
- Institute of Chemistry, Government College University, Faisalabad, Pakistan
| | - Mahwish Salman
- Institute of Chemistry, Government College University, Faisalabad, Pakistan
| | | |
Collapse
|
30
|
Girardi FM, Barra MB, Zettler CG. Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010. Braz J Otorhinolaryngol 2015; 81:541-8. [PMID: 26277590 PMCID: PMC9449006 DOI: 10.1016/j.bjorl.2015.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/21/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION An ongoing discussion is found in medical literature about the reasons for changes in thyroid carcinoma incidence patterns over the last decades. OBJECTIVE To analyze the clinical and pathological characteristics of thyroid carcinoma cases over a decade. METHODS Cross-sectional study over an historical cohort. Medical records of 628 thyroid cancer cases in a single center were reviewed. 597 patients were included. Microcarcinoma cases were selected for a qualitative analysis phase, in which medical records were reviewed for better understanding of thyroid nodule and thyroid cancer diagnosis process. RESULTS An increase in the proportion of cases with thyroid cancer diagnosis was observed throughout the decade; new cases were predominantly tumors of less than 2 cm, with histopathological signs of low aggressiveness. There was an increase in proportion of cases with malignant cytological results among microcarcinomas. CONCLUSION There is a trend for increase in thyroidectomies due to cancer in this institution, with proportional increment of cases with histopathological characteristics indicative of early disease. Among microcarcinomas, there is an increasing group represented by cancer cases that were not incidentally diagnosed, related to an enhancement in preoperative diagnostic methods.
Collapse
Affiliation(s)
- Fábio Muradás Girardi
- Head and Neck Surgery Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil.
| | - Marinez Bizarro Barra
- Pathology Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
| | - Cláudio Galleano Zettler
- Pathology Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
| |
Collapse
|
31
|
O'Grady TJ, Gates MA, Boscoe FP. Thyroid cancer incidence attributable to overdiagnosis in the United States 1981-2011. Int J Cancer 2015; 137:2664-73. [DOI: 10.1002/ijc.29634] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/26/2015] [Accepted: 06/02/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Thomas J. O'Grady
- Department of Epidemiology and Biostatistics; School of Public Health, University at Albany; NY
- Department of Basic and Social Sciences; School of Arts and Sciences, Albany College of Pharmacy and Health Sciences; NY
| | - Margaret A. Gates
- Department of Epidemiology and Biostatistics; School of Public Health, University at Albany; NY
| | - Francis P. Boscoe
- New York State Department of Health, New York State Cancer Registry; NY
| |
Collapse
|
32
|
Zimmermann MB, Galetti V. Iodine intake as a risk factor for thyroid cancer: a comprehensive review of animal and human studies. Thyroid Res 2015; 8:8. [PMID: 26146517 PMCID: PMC4490680 DOI: 10.1186/s13044-015-0020-8] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 06/08/2015] [Indexed: 11/29/2022] Open
Abstract
Thyroid cancer (TC) is the most common endocrine malignancy and in most countries, incidence rates are increasing. Although differences in population iodine intake are a determinant of benign thyroid disorders, the role of iodine intake in TC remains uncertain. We review the evidence linking iodine intake and TC from animal studies, ecological studies of iodine intake and differentiated and undifferentiated TC, iodine intake and mortality from TC and occult TC at autopsy, as well as the case–control and cohort studies of TC and intake of seafood and milk products. We perform a new meta-analysis of pooled measures of effect from case–control studies of total iodine intake and TC. Finally, we examine the post-Chernobyl studies linking iodine status and risk of TC after radiation exposure. The available evidence suggests iodine deficiency is a risk factor for TC, particularly for follicular TC and possibly, for anaplastic TC. This conclusion is based on: a) consistent data showing an increase in TC (mainly follicular) in iodine deficient animals; b) a plausible mechanism (chronic TSH stimulation induced by iodine deficiency); c) consistent data from before and after studies of iodine prophylaxis showing a decrease in follicular TC and anaplastic TC; d) the indirect association between changes in iodine intake and TC mortality in the decade from 2000 to 2010; e) the autopsy studies of occult TC showing higher microcarcinoma rates with lower iodine intakes; and f) the case control studies suggesting lower risk of TC with higher total iodine intakes.
Collapse
Affiliation(s)
- Michael B Zimmermann
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zürich, Schmelzbergstrasse 7, LFV D21, CH-8092 Zürich, Switzerland
| | - Valeria Galetti
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zürich, Schmelzbergstrasse 7, LFV E14, CH-8092 Zürich, Switzerland
| |
Collapse
|
33
|
Lang BH, Wong CKH, TY Chan C. Initial attributable cost and economic burden of clinically-relevant differentiated thyroid cancer: A health care service provider perspective. Eur J Surg Oncol 2015; 41:758-65. [DOI: 10.1016/j.ejso.2015.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 01/23/2015] [Accepted: 01/26/2015] [Indexed: 12/24/2022] Open
|
34
|
Colonna M, Uhry Z, Guizard AV, Delafosse P, Schvartz C, Belot A, Grosclaude P. Recent trends in incidence, geographical distribution, and survival of papillary thyroid cancer in France. Cancer Epidemiol 2015; 39:511-8. [PMID: 26003877 DOI: 10.1016/j.canep.2015.04.015] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/23/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Over the past few decades, the incidence of thyroid cancer has dramatically increased in many countries. This increase was mainly seen in papillary cancer. The role of diagnostic practices and the effects of other risk factors were suggested to explain this increase. We provide a descriptive analysis in terms of changes in incidence, geographical distribution, and survival to check the relevance of assumptions about the increase. METHODS A detailed analysis of changes in incidence recorded in French cancer registries between 1982 and 2010 was performed taking into account age, period, and birth cohort. The geographical distribution of the incidence in the 2006-2010 period was estimated from the standardized incidence ratios. The net survival was estimated to evaluate the effects of sex, age, and period of diagnosis in patients diagnosed between 1989 and 2004 and followed-up until 2013. RESULTS The incidence of papillary cancer has increased sharply over the 1982-2010 period; the average annual rate of increase was 7.8% in men and 7.2% in women. The increase has slowed in the recent period in people aged less than 50 at the time of diagnosis. It has also slowed in the cohorts born 1945 and after. There was a strong geographic disparity in incidence between areas covered by cancer registries. Finally, the net survival was very high; the 10-year net survival was 96% and improved progressively from 82% in patients diagnosed between 1989 and 1993 to 95% in those diagnosed between 1999 and 2004. CONCLUSION The increased incidence results most probably from the effect of medical practice, although other risk factors seem also involved, but to a lesser extent. The increase seems to have slowed down in the recent years, especially in the youngest age groups. This observation suggests a recent trend towards saturation of the effects of medical practices in post-1945 cohorts associated with an effect of the gradual dissemination of the recommendations relative to the management of thyroid nodules.
Collapse
Affiliation(s)
- M Colonna
- Registre du cancer de l'Isère, CHU Grenoble, F-38043, Grenoble, France; FRANCIM, F-31073, Toulouse, France.
| | - Z Uhry
- Institut de Veille Sanitaire, Département des Maladies Chroniques et Traumatismes, F-94410, Saint-Maurice, France; Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, CNRS UMR5558, F-69100, Villeurbanne France
| | - A V Guizard
- Registre des tumeurs du Calvados, Centre François Baclesse, F-14076, Caen, France; FRANCIM, F-31073, Toulouse, France
| | - P Delafosse
- Registre du cancer de l'Isère, CHU Grenoble, F-38043, Grenoble, France; FRANCIM, F-31073, Toulouse, France
| | - C Schvartz
- Registre des cancers de la thyroïde de Marne-Ardennes, CLCC Jean Godinot, F-51100, Reims, France; FRANCIM, F-31073, Toulouse, France
| | - A Belot
- Institut de Veille Sanitaire, Département des Maladies Chroniques et Traumatismes, F-94410, Saint-Maurice, France; Hospices Civils de Lyon, Service de Biostatistique, F-69495, Pierre-Bénite, France; Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, CNRS UMR5558, F-69100, Villeurbanne France; Cancer Research UK Cancer Survival Group, Faculty of Epidemiology and Population Health, London, UK
| | - P Grosclaude
- Registre des Cancer du Tarn, Centre Hospitalier spécialisé, F-81000, Albi, France; FRANCIM, F-31073, Toulouse, France
| | | |
Collapse
|
35
|
Xiang D, Xie L, Xu Y, Li Z, Hong Y, Wang P. Papillary thyroid microcarcinomas located at the middle part of the middle third of the thyroid gland correlates with the presence of neck metastasis. Surgery 2014; 157:526-33. [PMID: 25433730 DOI: 10.1016/j.surg.2014.10.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/19/2014] [Accepted: 10/31/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Papillary thyroid microcarcinomas (PTMCs), located at upper poles of the thyroid, are associated with lateral neck metastasis (LNM) according to previous reports. Controversy remains regarding the correlation between the location of PTMCs and central neck metastasis (CNM). METHODS Medical records of 949 patients with PTMCs diagnosed between 2010 and 2013 were reviewed retrospectively. With a subdivision of the middle third of the thyroid gland, correlations between tumor location and CNM/LNM along with other clinicopathologic factors were analyzed by binary logistic regression. RESULTS PTMCs located in the middle part of the middle third of the thyroid gland (MPMT) showed the greatest rate of CNM (57.5%) among all locations. PTMCs located at isthmus showed the second greatest rate of CNM (44.3%). In the multivariate analysis, MPMT, tumor size >0.5 cm, young and middle age, male sex, multifocality within the affected lobe, and capsular invasion were correlated with CNM. PTMCs located at upper poles and MPMT showed comparatively high rates of LNM (8.6% and 8.3%). Consistent with previous reports, an upper pole location, MPMT, and a tumor size >0.5 cm greatly correlated with LNM in the multivariate analysis. Eleven patients had skip metastases, which only occurred with upper/lower pole locations and MPMT. CONCLUSION PTMCs located in the MPMT correlated with both CNM and LNM. Tumor location along with other clinicopathologic factors such as young and middle age, male sex, and tumor size >0.5 cm could facilitate preoperative stratification and guide operative management for patients with PTMC.
Collapse
Affiliation(s)
- Dapeng Xiang
- Department of General Surgery, Second Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Liangqi Xie
- Department of Molecular and Cellular Biology, UC Berkeley, Berkeley, CA
| | - Yuanliang Xu
- Department of General Surgery, Second Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhiyu Li
- Department of General Surgery, Second Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Yurong Hong
- Department of Ultrasonography, Second Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Ping Wang
- Department of General Surgery, Second Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
36
|
Enewold L, Harlan LC, Stevens JL, Sharon E. Thyroid cancer presentation and treatment in the United States. Ann Surg Oncol 2014; 22:1789-97. [PMID: 25361888 PMCID: PMC4417105 DOI: 10.1245/s10434-014-4209-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Thyroid cancer incidence is rising in the United States. Although overall thyroid cancer survival is high, prognostic stratification schemes have been developed to better delineate patients with poor prognoses. METHODS A random sample that included 1,003 adult papillary thyroid cancer patients diagnosed in 2006 and reported to the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program had their medical records re-abstracted and additional risk factor data collected. The distribution of patient demographics, medical histories, tumor characteristics and treatment modalities were assessed. Logistic regression was used to assess factors associated with total thyroidectomy (total, subtotal or near total) and radioiodine therapy. All analyses were conducted stratified by the Age, Metastases, Extent and Size (AMES) low/high-risk classification. RESULTS Receipt of total thyroidectomy was associated with family history of thyroid disease/cancer and larger tumor size among low-risk patients and smaller tumor size among high-risk patients. Among low-risk patients, the receipt of radioiodine was associated with family history of thyroid disease/cancer, larger tumor size, total thyroidectomy, and positive lymph nodes. Among high-risk patients, the receipt of radioiodine was associated with intermediate tumor and hospital sizes. CONCLUSIONS This study provides insight into the patterns of papillary thyroid cancer care in the general population. The findings from this study indicate adherence to guideline recommendations in that family history of thyroid disease/cancer, in addition to tumor characteristics, does appear to inform treatment practices, especially among low-risk patients.
Collapse
|
37
|
Cho YY, Lim J, Oh CM, Ryu J, Jung KW, Chung JH, Won YJ, Kim SW. Elevated risks of subsequent primary malignancies in patients with thyroid cancer: A nationwide, population-based study in Korea. Cancer 2014; 121:259-68. [DOI: 10.1002/cncr.29025] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/26/2014] [Accepted: 05/23/2014] [Indexed: 01/24/2023]
Affiliation(s)
- Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Jiwon Lim
- Cancer Registration and Statistics Branch; Division of Cancer Registration and Surveillance; National Cancer Center; Goyang Korea
| | - Chang-Mo Oh
- Cancer Registration and Statistics Branch; Division of Cancer Registration and Surveillance; National Cancer Center; Goyang Korea
| | - Junsun Ryu
- Department of Otolaryngology-Head and Neck Surgery; Head & Neck Oncology Clinic, Center for Thyroid Cancer, National Cancer Center; Goyang Korea
| | - Kyu-Won Jung
- Cancer Registration and Statistics Branch; Division of Cancer Registration and Surveillance; National Cancer Center; Goyang Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Young-Joo Won
- Cancer Registration and Statistics Branch; Division of Cancer Registration and Surveillance; National Cancer Center; Goyang Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| |
Collapse
|
38
|
Zafon C, Baena JA, Castellví J, Obiols G, Gonzalez O, Fort JM, Vilallonga R, Caubet E, Armengol M, Mesa J. Evolution of differentiated thyroid cancer: a decade of thyroidectomies in a single institution. Eur Thyroid J 2014; 3:197-201. [PMID: 25538902 PMCID: PMC4224230 DOI: 10.1159/000365416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/19/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Numerous studies have shown an increase in the incidence of thyroid cancer (TC) in recent years. OBJECTIVES In this paper, we reviewed the incidence of TC in a series of patients undergoing thyroid surgery at a single institution over a 10-year period. PATIENTS AND METHODS The cohorts were divided into two periods (2001-2005 and 2006-2010) with the purpose of comparing various clinicopathologic variables. RESULTS A total of 1,263 patients were included. A significant increase in the number of malignancies was shown in the second period, namely 90 cases in 2001-2005 (15.2% of all interventions) compared to 163 cases in 2006-2010 (24.3%) (p < 0.001). These differences were attributed to an increase in papillary thyroid carcinoma (PTC), as there were 66 PTC cases in the first period (11.13% of thyroidectomies performed) compared to 129 cases in the second period (19.25%). There were no clinicohistological differences among PTC cases in these two periods. CONCLUSIONS Over the last decade, there has been an increase in the incidence of TC in patients undergoing thyroid surgery. This increase is exclusively due to increases in PTC. Our study verifies the existence of this trend in our geographical area, similar to that noted in other parts of the world.
Collapse
Affiliation(s)
- Carles Zafon
- Department of Endocrinology, Universitat Autònoma de Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona and CIBERDEM (ISCIII), Barcelona, Spain
- *Dr. Carles Zafon, Department of Endocrinology Hospital Vall d'Hebron, Universitat Autonòma de Barcelona, Pg. Vall d'Hebron 119-129, ES-08035 Barcelona (Spain), E-Mail
| | - Juan Antonio Baena
- Endocrine, Bariatric and Metabolic Unit, Department of General Surgery, Universitat Autònoma de Barcelona, Spain
| | - Josep Castellví
- Department of Pathology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Gabriel Obiols
- Department of Endocrinology, Universitat Autònoma de Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona and CIBERDEM (ISCIII), Barcelona, Spain
| | - Oscar Gonzalez
- Endocrine, Bariatric and Metabolic Unit, Department of General Surgery, Universitat Autònoma de Barcelona, Spain
| | - José Manuel Fort
- Endocrine, Bariatric and Metabolic Unit, Department of General Surgery, Universitat Autònoma de Barcelona, Spain
| | - Ramon Vilallonga
- Endocrine, Bariatric and Metabolic Unit, Department of General Surgery, Universitat Autònoma de Barcelona, Spain
| | - Enric Caubet
- Endocrine, Bariatric and Metabolic Unit, Department of General Surgery, Universitat Autònoma de Barcelona, Spain
| | - Manuel Armengol
- Endocrine, Bariatric and Metabolic Unit, Department of General Surgery, Universitat Autònoma de Barcelona, Spain
| | - Jordi Mesa
- Department of Endocrinology, Universitat Autònoma de Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona and CIBERDEM (ISCIII), Barcelona, Spain
| |
Collapse
|
39
|
Curcumin inhibits the invasion of thyroid cancer cells via down-regulation of PI3K/Akt signaling pathway. Gene 2014; 546:226-32. [DOI: 10.1016/j.gene.2014.06.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/18/2014] [Accepted: 06/05/2014] [Indexed: 01/14/2023]
|
40
|
Horn-Ross PL, Lichtensztajn DY, Clarke CA, Dosiou C, Oakley-Girvan I, Reynolds P, Gomez SL, Nelson DO. Continued rapid increase in thyroid cancer incidence in california: trends by patient, tumor, and neighborhood characteristics. Cancer Epidemiol Biomarkers Prev 2014; 23:1067-79. [PMID: 24842625 PMCID: PMC4071298 DOI: 10.1158/1055-9965.epi-13-1089] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Thyroid cancer incidence is increasing worldwide. Incorporating 22 years of incidence data through 2009, we extend examination of these trends among a wide array of subgroups defined by patient (age, sex, race/ethnicity, and nativity), tumor (tumor size and stage), and neighborhood (socioeconomic status and residence in ethnic enclaves) characteristics, to identify possible reasons for this increase. METHODS Thyroid cancer incidence data on 10,940 men and 35,147 women were obtained from the California Cancer Registry for 1988-2009. Population data were obtained from the 1990 and 2000 U.S. Census. Incidence rates and 95% confidence intervals (CI) were calculated and incidence trends were evaluated using Joinpoint regression to evaluate the timing and magnitude of change [annual percentage change (APC) and rate ratios]. RESULTS The incidence of papillary thyroid cancer continues to increase in both men (APC, 5.4; 95% CI, 4.5-6.3 for 1998-2009) and women (APC, 3.8; 95% CI, 3.4-4.2 for 1998-2001 and APC, 6.3; 95% CI, 5.7-6.9 for 2001-2009). Increasing incidence was observed in all subgroups examined. CONCLUSIONS Although some variation in the magnitude or temporality of the increase in thyroid cancer incidence exists across subgroups, the patterns (i) suggest that changes in diagnostic technology alone do not account for the observed trends and (ii) point to the importance of modifiable behavioral, lifestyle, or environmental factors in understanding this epidemic. IMPACT Given the dramatic and continued increase in thyroid cancer incidence rates, studies addressing the causes of these trends are critical. Cancer Epidemiol Biomarkers Prev; 23(6); 1067-79. ©2014 AACR.
Collapse
Affiliation(s)
- Pamela L Horn-Ross
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Daphne Y Lichtensztajn
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Christina A Clarke
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Chrysoula Dosiou
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Ingrid Oakley-Girvan
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Peggy Reynolds
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Scarlett Lin Gomez
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CaliforniaAuthors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - David O Nelson
- Authors' Affiliations: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy and Division of Endocrinology, Department of Medicine; and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
41
|
Yildiz SY, Berkem H, Yuksel BC, Ozel H, Kendirci M, Hengirmen S. The rising trend of papillary carcinoma in thyroidectomies: 14-years of experience in a referral center of Turkey. World J Surg Oncol 2014; 12:34. [PMID: 24512315 PMCID: PMC3936813 DOI: 10.1186/1477-7819-12-34] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 01/28/2014] [Indexed: 11/24/2022] Open
Abstract
Background During the past 25 years, the incidence of thyroid papillary carcinoma (TPC), especially the micropapillary subtype, has been increasing in different countries worldwide. The rise in the rate of thyroid malignancies were also determined in Turkey in the last two decades. This fact was attributed to the Chernobyl accident because Turkey is one of the affected countries by the radioactive fallout. The aim of this study was to assess the changes in the parameters of the thyroid and put forth the reasons in a 14-year period. Methods The patient records, demographic and malignancy characteristics, and operations of 1,585 patients who had a thyroidectomy from 1996 to 2009 were reviewed retrospectively. The study was divided in two equal time periods for comparison of data. Results A total of 216 thyroid carcinomas (13.6%) were diagnosed in the study period. There was a significant increase in the frequency of papillary (P <0.023) and micropapillary (P <0.001) carcinomas when the two different time periods were compared. The rate of follicular, medullary and other types of malignancies did not change. In the second period (2003 to 2009) of analysis, the rate of micropapillary carcinoma (P = 0.001) and within male (P = 0.031) and female (P <0.001) genders, application of total thyroidectomy (p = 0.029), and multicentric disease (P = 0.015) increased significantly. A slight decrease in the mean age of the whole number of patients and patients with papillary and micropapillary carcinomas (P >0.05) was observed. The increased number of TPC >10 mm was insignificant. Geographic region and age specific malignancy increase was not determined. Conclusions Micropapillary carcinoma has become a dominant type of thyroid malignancy in Turkey. The main reasons of this transition were mandatory iodization and much higher application of total thyroidectomy in surgery. Improvement in healthcare and diagnostic techniques are the complementary factors. Due to its lack of molecular and genetic basis from the perspective of thyroid cancer, the Chernobyl disaster has lost its importance in Turkey.
Collapse
Affiliation(s)
- Selim Yigit Yildiz
- Department of Surgery, Kocaeli Derince Training and Research Hospital, 41100 Kocaeli, Turkey.
| | | | | | | | | | | |
Collapse
|
42
|
Zivaljevic V, Tausanovic K, Paunovic I, Diklic A, Kalezic N, Zoric G, Sabljak V, Vekic B, Zivic R, Marinkovic J, Sipetic S. Age as a prognostic factor in anaplastic thyroid cancer. Int J Endocrinol 2014; 2014:240513. [PMID: 25024703 PMCID: PMC4082884 DOI: 10.1155/2014/240513] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 05/19/2014] [Indexed: 11/17/2022] Open
Abstract
Background. Anaplastic thyroid cancer (ATC) is one of the tumors with the shortest survival in human medicine. Aim. The aim was to determine the importance of age in survival of patients with ATC. Material and Methods. We analyzed the data on 150 patients diagnosed with ATC in the period from 1995 to 2006. The Kaplan-Meier method and log-rank test were used to determine overall survival. Prognostic factors were identified by univariate and multivariate Cox regression analysis. Results. The youngest patient was 35 years old and the oldest was 89 years old. According to univariate regression analysis, age was significantly associated with longer survival in patients with ATC. In multivariate regression analysis, patients age, presence of longstanding goiter, whether surgical treatment is carried out or not, type of surgery, tumor multicentricity, presence of distant metastases, histologically proven preexistent papillary carcinoma, radioiodine therapy, and postoperative radiotherapy were included. According to multivariate analysis, besides surgery (P = 0.000, OR = 0.43, 95% CI = 0.29-0.63), only patients age (P = 0.023, OR = 0.68, 95% CI = 0.49-0.95) was independent prognostic factor of favorable survival in patients with ATC. Conclusion. Age is a factor that was independently associated with survival time in ATC. Anaplastic thyroid cancer has the best prognosis in patients younger than 50 years.
Collapse
Affiliation(s)
- Vladan Zivaljevic
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Katarina Tausanovic
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
- *Katarina Tausanovic:
| | - Ivan Paunovic
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Aleksandar Diklic
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Nevena Kalezic
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Goran Zoric
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Vera Sabljak
- Center for Endocrine Surgery, Clinical Center of Serbia, 11000 Belgrade, Serbia
| | | | - Rastko Zivic
- Surgical Clinic, KBC Dedinje, 11000 Belgrade, Serbia
| | | | - Sandra Sipetic
- School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| |
Collapse
|
43
|
Liu X, Zhu L, Cui D, Wang Z, Chen H, Duan Y, Shen M, Wu Y, Rong R, Zhang Z, Wang X, Chen J, Alexander EK, Yang T. Coexistence of Histologically Confirmed Hashimoto's Thyroiditis with Different Stages of Papillary Thyroid Carcinoma in a Consecutive Chinese Cohort. Int J Endocrinol 2014; 2014:769294. [PMID: 25505911 PMCID: PMC4255062 DOI: 10.1155/2014/769294] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 10/25/2014] [Accepted: 11/04/2014] [Indexed: 11/17/2022] Open
Abstract
Purpose. To determine the relationship between Hashimoto's thyroiditis (HT) and all stages of papillary thyroid carcinoma (PTC) with or without local lymph node metastasis (LNM). Methods. We conducted a retrospective study of thyroidectomies from 2008-2013 in First Affiliated Hospital of Nanjing Medical University. We categorized patients according to the presence of histopathologically proven HT. The prevalence of mPTC (maximum diameter ≤ 10 mm) and crPTC (clinical relevant PTC) and local LNM rates were compared. Results. We evaluated 6,432 consecutive thyroidectomies. In total, 1,328 specimens were confirmed as HT. The prevalence of PTC in this HT cohort was 43.8%, significantly higher than non-HT group. After adjustment of gender and age, the prevalence of PTC was still higher in HT group. HT was a risk factor for PTC in multivariate analysis with odds ratio 2.725 (95% CI, 2.390-3.109) (P < 0.001). However, no correlation was found between HT and LNM of PTC. Conclusion. HT was associated with an increased prevalence of all stages of PTC, independent of tumor size, gender, and age. In contrast, locally advanced disease defined by LNM was unrelated to HT. These data suggest an association of HT with low risk PTC and a potential protective immunologic effect from further disease progression.
Collapse
Affiliation(s)
- Xiaoyun Liu
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Lijun Zhu
- Department of Children's Health Care, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Dai Cui
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Zhixiao Wang
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Huanhuan Chen
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yu Duan
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Meiping Shen
- Department of Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yunsong Wu
- Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Rong Rong
- Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Zhihong Zhang
- Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xiaodong Wang
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jiawei Chen
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Erik K. Alexander
- Thyroid Unit, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Tao Yang
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- *Tao Yang:
| |
Collapse
|
44
|
Abstract
The incidence of thyroid cancer has been increasing all around the world in the past decades. Early detection is one of the keys to reduce the mortality. Currently, fine-needle aspiration (FNA) guides the management of patients with a thyroid nodule. The use of FNA can reduce unnecessary thyroid surgery by twenty-five percent. However, the prevalence of non-diagnostic and indeterminate cytology from FNA is still high, approximately thirty percent. Many biomarkers were developed to differentiate between the benign and malignant thyroid nodule. This review summarizes each diagnostic biomarker of differentiated thyroid cancer. Sensitivity, specificity, and positive and negative predictive values of individual cytological laboratory need to be considered before implementation of each biomarker. Moreover, follow-up is still mandatory in negative biomarker tests because all genomic and proteomic alterations in thyroid cancer are still unknown.
Collapse
Affiliation(s)
- Tada Kunavisarut
- Division of Endocrinology and Metabolism, Department of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkoknoi, Bangkok, 10700, Thailand,
| |
Collapse
|
45
|
Choi SW, Ryu SY, Han MA, Park J. The association between the socioeconomic status and thyroid cancer prevalence; based on the Korean National Health and Nutrition Examination Survey 2010-2011. J Korean Med Sci 2013; 28:1734-40. [PMID: 24339702 PMCID: PMC3857368 DOI: 10.3346/jkms.2013.28.12.1734] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/23/2013] [Indexed: 11/20/2022] Open
Abstract
The incidence of thyroid cancer has recently increased in most industrialized countries, including Korea. To date, few studies have examined the association between thyroid cancer and socioeconomic status (SES). The current study was based on data collected from a total of 12,276 subjects (5,277 men and 6,999 women) by the Korean National Health and Nutrition Examination Survey (KNHANES) between 2010 and 2011. Univariate and multivariate logistic regression analysis revealed that older age (odds ration [OR], 1.03; 95% confidence interval [CI], 1.00-1.05), being female (OR, 8.16; 95%CI, 2.99-22.24), being overweight (OR, 1.04; 95%CI, 1.01-1.06), monthly household income (OR, 3.27; 95%CI, 1.16-9.20 for medium-highest household income vs lowest household income; OR, 3.30; 95%CI, 1.16-9.34 for highest household income vs lowest household income), educational level (OR, 2.74; 95%CI, 1.16-6.46 for 10-12 yr vs < 7 yr) and alcohol consumption (OR, 1.89; 95%CI 1.08-3.32) were significant risk factors for thyroid cancer. Our results indicate that the recent increase in thyroid cancer is attributable to better early detection rather than to any increase in actual prevalence.
Collapse
Affiliation(s)
- Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Mi-ah Han
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Jong Park
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| |
Collapse
|
46
|
Wong CKH, Lang BHH. A Cost-Utility Analysis for Prophylactic Central Neck Dissection in Clinically Nodal-Negative Papillary Thyroid Carcinoma. Ann Surg Oncol 2013; 21:767-77. [DOI: 10.1245/s10434-013-3398-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Indexed: 01/08/2023]
|
47
|
Amphlett B, Lawson Z, Abdulrahman GO, White C, Bailey R, Premawardhana LD, Okosieme OE. Recent trends in the incidence, geographical distribution, and survival from thyroid cancer in Wales, 1985-2010. Thyroid 2013; 23:1470-8. [PMID: 23488941 DOI: 10.1089/thy.2012.0573] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Previous studies of thyroid cancer incidence in Wales have given varying results with suggestions of an excess of cases in geographic areas that were previously exposed to the radioactive fallout from the 1986 Chernobyl nuclear reactor incident. Our objective in this study was to provide an up-to-date comprehensive analysis of time trends in the incidence, geographical distribution, and survival from thyroid cancer in Wales. METHODS We identified thyroid cancer cases, registered from 1985 through 2010 in the Welsh Cancer Intelligence and Surveillance Unit (WCISU). Age standardized rates were determined from the European standard population. A Poisson regression model was fitted to assess temporal trends and rate ratios (RRs) and confidence intervals (CIs) were determined and compared across consecutive time periods: 1985-1997 and 1998-2010. Standardized incidence ratios were calculated for each of the 22 local authority areas. Relative survival and Kaplan-Meier curves were computed to analyze all cause and thyroid cancer-specific survival. RESULTS A total of 1747 thyroid cancer cases were registered from 1985 to 2010. Age standardized incidence rates were 2.8 and 1.2 per 100,000 population per year for females and males respectively. Incidence rates increased with time (RR 1.3 [CI 1.2-1.5], p < 0.001; 1998-2010 vs. 1985-1997). The incidence of papillary cancer increased progressively over the study period (RR 2.22 [CI 1.91-2.57], p < 0.001; 1998-2010 vs. 1985-1997), while rates for other (nonpapillary) histological subtypes remained static (RR 0.95 [CI 0.84-1.08], p = 0.45; 1998-2010 vs. 1985-1997). We identified two geographical areas of increased incidence, but the spatial distribution of cases was inconsistent with exposure to radioactive fallout. Five-year relative survival from all-cause mortality improved from 74.2 [CI 66.8-80.1] in 1985-1989 to 82.6 [CI 77.1-86.9] in 2000-2004, but remained poor for patients over the age of 65 years (p < 0.001, > 65 years vs. 15-64 years) and patients with anaplastic thyroid cancer (p < 0.001; anaplastic vs. other histological varieties). CONCLUSIONS The incidence of thyroid cancer has increased in Wales, predominantly due to an increase in papillary cancers. The current geographical distribution of cases does not support a radiation effect in the region. Survival has remained poor for patients over the age of 65 years and those with anaplastic carcinoma.
Collapse
Affiliation(s)
- Bethan Amphlett
- 1 Department of Endocrinology and Diabetes, Prince Charles Hospital , Merthyr Tydfil, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
48
|
Mai KT, Gulavita P, Lai C, Swift J, Levac J, Olberg B, Purgina B. Topographic Distribution of Papillary Thyroid Carcinoma by Mapping in Coronal Sections of 125 Consecutive Thyroidectomy Specimens. Int J Surg Pathol 2013; 22:303-15. [PMID: 24050958 DOI: 10.1177/1066896913503491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Mapping of different foci in multifocal papillary thyroid carcinoma (PTC) has previously not been done as it is difficult to do so when thyroid specimens are serially sectioned transversely (ie, parallel to the horizontal plane). In this study, thyroidectomy specimens were serially sectioned coronally (ie, parallel to the largest surface of the thyroid gland), which allows for panoramic and 3-dimensional visualization of PTC foci and their relationship to one another. MATERIALS AND METHODS A total of 125 consecutive total thyroidectomies or lobectomies followed by completion thyroidectomies were serially sectioned coronally and reviewed with identification and characterization of PTC foci. PTCs were grouped into either discrete, encapsulated nodule(s) (EN) of both follicular or papillary architecture, usual variant (UV), or tall cell variant (TCV). RESULTS The predominant tumor masses were identified in the right lobe, isthmus, and left lobe in 52%, 8%, and 40%, respectively. The largest tumor nodules ranged from 3 to 60 mm (18.8 ± 6.6) with the UV, EN, and TCV groups accounting for 58%, 24%, and 18% of cases, respectively. Three topographic patterns of PTC can be distinguished as follows: (a) single tumor nodule (37 cases), (b) main tumor nodule with satellite nodule(s) displaying no or varying degrees of fusion with the main one (30 cases), and (c) main tumor nodule with either a second large nodule or randomly occurring tumor nodules (58 cases). Bilaterality can be seen in all 3 patterns but was most prevalent in the group comprising the main tumor nodule with either a second large nodule or random tumor nodules. It was least frequent in the EN group without random tumor nodules. The difference in rates of bilaterality between tumors <10 mm and ≥10 mm was statistically significant (P < .01). For all 3 groups, satellite nodules displayed histopathological features that were similar or dissimilar to the main tumor mass. They may be of a different variant than that of the main tumor nodule. CONCLUSIONS With panaromic and 3-dimensional visualization, individual tumors/satellite or random nodules of multifocal PTC were readily identified in serial coronal sections of thyroidectomy specimens. Bilaterality was frequently observed in tumors associated with random PTC foci, whereas, the EN group tended to be unilateral and was not associated with random foci.
Collapse
Affiliation(s)
- Kien T Mai
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| | - Previn Gulavita
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| | - Chi Lai
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| | - Joanne Swift
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| | - Joelle Levac
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| | - Bernhard Olberg
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| | - Bibianna Purgina
- The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada
| |
Collapse
|
49
|
Harach HR, Galíndez M, Campero M, Ceballos GA. Undifferentiated (anaplastic) thyroid carcinoma and iodine intake in Salta, Argentina. Endocr Pathol 2013; 24:125-31. [PMID: 23666798 DOI: 10.1007/s12022-013-9248-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study was conducted to investigate the natural history of undifferentiated thyroid carcinoma (UTC) in the iodine-deficient province of Salta, Argentina, in relation to salt iodization and health care standards. Five hundred ninety-three thyroid cancers diagnosed from 1958 to2012 were reviewed based mainly on the WHO classification and grouped into three periods, one before and two after iodine prophylaxis. The incidence of UTC was analyzed in relation to changing concentrations of potassium iodide (KI) in salt during the prophylaxis period (from 40 to 33.3 mg KI/kg salt), establishment of primary health care centers throughout the region, and use of fine needle aspiration (FNA) cytology. Twenty-nine UTCs were found in the whole series. The frequency of UTC decreased from 15.2 % (9/59 cases) in the first period to 2.6 % (10/381 cases) well after salt iodination (x (2) Fisher's test, p < 0.0002), and the incidence from 1.4/10(6)/year to 0.1/10(6)/year (Student's t test, p < 0.06), respectively. The decline of UTC after iodine prophylaxis occurred even after decreasing concentrations of KI in salt and timely coincided with the establishment of primary health care centers throughout the region and routine use of FNA. The lower rate of UTC after iodine prophylaxis in the province of Salta is mostly related to earlier detection of more differentiated thyroid tumors rather than higher salt iodization.
Collapse
Affiliation(s)
- H R Harach
- Pathology Unit, Dr. A. Oñativia Hospital, Salta, Argentina.
| | | | | | | |
Collapse
|
50
|
Lang BHH, Wong CKH. A cost-minimization analysis comparing total thyroidectomy alone and total thyroidectomy with prophylactic central neck dissection in clinically nodal-negative papillary thyroid carcinoma. Ann Surg Oncol 2013; 21:416-25. [PMID: 23982258 DOI: 10.1245/s10434-013-3234-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Total thyroidectomy (TT) with prophylactic central neck dissection (pCND) remains controversial for clinically nodal-negative (cN0) papillary thyroid carcinoma (PTC), and the issue of cost rarely has been examined. We evaluated whether pCND at the time of TT is more cost-saving than TT alone in the medium- to long-term. METHODS For a hypothetical group of 50-year-old females with a 1.5-cm cN0 PTC, a decision-tree model using TreeAge Software was developed to simulate outcomes and compare the 20-year accumulative direct cost between TT alone and TT+pCND strategies. Baseline values and ranges were determined from a systematic review of the literature. Sensitivity analyses were conducted to test model strength. Cost estimate of surgical procedures, complications, and radioiodine (RAI) ablation was based on government gazette. RESULTS The cost accrued per patient for the primary operation under TT alone and TT+pCND strategies were USD 6,702.81 and USD 10,062.35, respectively, whereas the cost for the reoperative procedure were USD 12,981.40 and USD 12,509.09, respectively. The 20-year accumulative cost for TT alone and TT+pCND strategies were USD 19,888.36 and USD 22,760.86, respectively. The incremental cost per patient was USD 2,872.50. In the univariate and bivariate sensitivity analyses, no change in conclusion was seen by varying the rates of complications, annualized locoregional recurrences and RAI, or by extending the model to 50 years. CONCLUSIONS From a pure economic institution's perspective, TT+pCND is more expensive in the medium- and long-term and seems less justified compared with TT alone for cN0 PTC.
Collapse
Affiliation(s)
- Brian Hung-Hin Lang
- Division of Endocrine Surgery, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China,
| | | |
Collapse
|