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Tian T, Qi Z, Huang S, Wang H, Huang R. Radioactive Iodine Therapy Decreases the Recurrence of Intermediate-Risk PTC With Low Thyroglobulin Levels. J Clin Endocrinol Metab 2023; 108:2033-2041. [PMID: 36715264 DOI: 10.1210/clinem/dgad045] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023]
Abstract
CONTEXT Whether radioactive iodine therapy (RAIT) is necessary for intermediate-risk papillary thyroid cancer (PTC) after total thyroidectomy is still lacking reliable evidence, especially for patients with low postoperative thyroglobulin (Tg) levels. OBJECTIVE This study conducted a propensity score matching (PSM) analysis to investigate whether RAIT is effective in reducing the recurrence of intermediate-risk PTC with low Tg levels. METHODS In total, 1487 patients with intermediate-risk PTC with unstimulated Tg ≤ 1 ng/mL or stimulated Tg ≤ 10 ng/mL after total thyroidectomy were enrolled retrospectively. The clinicopathological characteristics were compared between the non-RAIT and RAIT groups before and after PSM (1:4 matching). The impact of RAIT on biochemical recurrence and structural recurrence was evaluated. RESULTS Overall, 1349 (90.7%) patients underwent RAIT, and 138 (9.3%) did not. After a median follow-up time of 51 months, 30 patients presented with recurrence, including 11 structural and 19 biochemical recurrences. After PSM, the non-RAIT group had a higher rate of structural recurrence (5/138 vs 5/552, P = .046) and biochemical recurrence (6/138 vs 4/552, P = .005) than the RAIT group. Multivariate analysis showed that not receiving RAIT was an independent risk factor for structural recurrence (hazard ratio [HR] 10.572, 95% CI 2.439-45.843, P = .002) and biochemical recurrence (HR 16.568, 95% CI 3.670-74.803, P < .001). Kaplan-Meier analysis showed that the non-RAIT group had more unfavorable recurrence-free survival (structural and biochemical, all P < .05). CONCLUSION RAIT could decrease the recurrence risk of intermediate-risk PTC in patients with unstimulated Tg ≤ 1 ng/mL or stimulated Tg ≤ 10 ng/mL. Further prospective randomized studies are needed to confirm these findings.
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Affiliation(s)
- Tian Tian
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 610000 Chengdu, China
| | - Zhibing Qi
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 610000 Chengdu, China
- Department of Nuclear Medicine, Jiujiang First People's Hospital, 332000 Jiujiang, China
| | - Shuhui Huang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 610000 Chengdu, China
| | - Hongxi Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 610000 Chengdu, China
| | - Rui Huang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 610000 Chengdu, China
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Mols F, Schoormans D, Netea-Maier R, Husson O, Beijer S, Van Deun K, Zandee W, Kars M, Wouters van Poppel PCM, Simsek S, van Battum P, Kisters JMH, de Boer JP, Massolt E, van Leeuwaarde R, Oranje W, Roerink S, Vermeulen M, van de Poll-Franse L. Determinants and mediating mechanisms of quality of life and disease-specific symptoms among thyroid cancer patients: the design of the WaTCh study. Thyroid Res 2023; 16:23. [PMID: 37424010 DOI: 10.1186/s13044-023-00165-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Thyroid cancer (TC) patients are understudied but appear to be at risk for poor physical and psychosocial outcomes. Knowledge of the course and determinants of these deteriorated outcomes is lacking. Furthermore, little is known about mediating biological mechanisms. OBJECTIVES The WaTCh-study aims to; 1. Examine the course of physical and psychosocial outcomes. 2. Examine the association of demographic, environmental, clinical, physiological, and personality characteristics to those outcomes. In other words, who is at risk? 3. Reveal the association of mediating biological mechanisms (inflammation, kynurenine pathway) with poor physical and psychological outcomes. In other words, why is a person at risk? DESIGN AND METHODS Newly diagnosed TC patients from 13 Dutch hospitals will be invited. Data collection will take place before treatment, and at 6, 12 and 24 months after diagnosis. Sociodemographic and clinical information is available from the Netherlands Cancer Registry. Patients fill-out validated questionnaires at each time-point to assess quality of life, TC-specific symptoms, physical activity, anxiety, depression, health care use, and employment. Patients are asked to donate blood three times to assess inflammation and kynurenine pathway. Optionally, at each occasion, patients can use a weighing scale with bioelectrical impedance analysis (BIA) system to assess body composition; can register food intake using an online food diary; and can wear an activity tracker to assess physical activity and sleep duration/quality. Representative Dutch normative data on the studied physical and psychosocial outcomes is already available. IMPACT WaTCh will reveal the course of physical and psychosocial outcomes among TC patients over time and answers the question who is at risk for poor outcomes, and why. This knowledge can be used to provide personalized information, to improve screening, to develop and provide tailored treatment strategies and supportive care, to optimize outcomes, and ultimately increase the number of TC survivors that live in good health.
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Affiliation(s)
- Floortje Mols
- CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
| | - Dounya Schoormans
- CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Romana Netea-Maier
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
- Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
| | - Katrijn Van Deun
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Wouter Zandee
- Department of Endocrinology, Groningen University, University Medical Center Groningen, Groningen, The Netherlands
| | - Marleen Kars
- Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
| | | | - Suat Simsek
- Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | | | | | - Jan Paul de Boer
- Antoni Van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Elske Massolt
- Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Rachel van Leeuwaarde
- Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | | | - Lonneke van de Poll-Franse
- CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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van Dijk SPJ, Coerts HI, Lončar I, Verhoef C, Kruijff S, Engelsman AF, Peeters RP, van Ginhoven TM. Deescalating Follow-up After Hemithyroidectomy for Patients With Low-risk Papillary Thyroid Microcarcinoma. JAMA Otolaryngol Head Neck Surg 2023; 149:42-48. [PMID: 36416850 PMCID: PMC9685547 DOI: 10.1001/jamaoto.2022.3686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Importance Structural recurrent disease (RD) after surgical treatment of papillary thyroid microcarcinoma (mPTC) is rare. We hypothesized that the RD rate after hemithyroidectomy in low-risk patients with mPTC is low. Objective To assess the occurrence of RD in Dutch patients with mPTC who received surgical treatment according to the Dutch guidelines. Design, Setting, and Participants This nationwide retrospective cohort study included all patients who had undergone surgery with a diagnosis of cN0/cNx mPTC in the Netherlands between January 2000 and December 2020 were identified from the Netherlands Cancer Registry database. Patients with preoperative lymph node metastases were excluded. Two groups were defined: group 1 (incidental), mPTC in pathology report after thyroid surgery for another indication; and group 2 (nonincidental), patients with a preoperative highly suspect thyroid nodule (Bethesda 5) or proven mPTC (Bethesda 6). Dutch guidelines state that a hemithyroidectomy is sufficient in patients with unifocal, intrathyroidal mPTC. Main Outcomes and Measures The occurrence of RD in patients with low-risk mPTC after hemithyroidectomy. Results In total, 1636 patients with mPTC were included. Patients had a median (IQR) follow-up time of 71 (32-118) months. Median (IQR) age at time of diagnosis was 51 (41-61) years and 1292 (79.0%) were women. Overall, RD after initial treatment was seen in 25 patients (1.5%). The median (IQR) time to RD was 8.2 (3.6-16.5) months and 22 of the 25 (88%) patients developed RD within 2 years. Recurrent disease was not significantly different between both groups (group 1, n = 15 [1.3%]; group 2, n = 10 [2.1%]; difference, 0.8%; 95% CI, -0.5% to 2.5%). Of the 484 patients with nonincidental mPTC (group 2), 246 (50.8%) patients were treated with a hemithyroidectomy and follow-up in accordance with Dutch guidelines. Lymph node metastases were found in 1 of 246 (0.4%) patients after hemithyreoidectomy, and new mPTC in the contralateral thyroid was detected in 3 of 246 (1.2%) patients. Median (IQR) follow-up of this patient group was 37 (18-71) months. The 10-year probability of RD was 1.3% for patients without vascular invasion and 24.4% for patients with vascular invasion. Conclusions and Relevance This nationwide cohort study found that overall, RD after hemithyroidectomy for patients with low-risk mPTC was rare (<2%). Based on these results, it seems reasonable to deescalate follow-up of patients with low-risk mPTC without vascular invasion after hemithyroidectomy. From a health care perspective, deescalation of follow-up may contribute to increased sustainability and accessibility to health care, both large challenges for the future.
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Affiliation(s)
- Sam P. J. van Dijk
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Hannelore I. Coerts
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Ivona Lončar
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Schelto Kruijff
- Department of Surgical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Anton F. Engelsman
- Department of Surgery, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | - Robin P. Peeters
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tessa M. van Ginhoven
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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Lončar I, van Dijk SPJ, Metman MJH, Lin JF, Kruijff S, Peeters RP, Engelsman AF, van Ginhoven TM. Active Surveillance for Papillary Thyroid Microcarcinoma in a Population with Restrictive Diagnostic Workup Strategies. Thyroid 2021; 31:1219-1225. [PMID: 33430696 DOI: 10.1089/thy.2020.0845] [Citation(s) in RCA: 7] [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] [Indexed: 12/29/2022]
Abstract
Background: The worldwide incidence of papillary thyroid carcinoma (PTC) has increased. Efforts to reduce overtreatment follow two approaches: limiting diagnostic workup of low-risk thyroid nodules and pursuing active surveillance (AS) after diagnosis of microscopic PTC (mPTC). However, most studies on AS have been performed in countries with a relatively high proportion of overdiagnosis and thus incidental mPTC. The role of AS in a population with a restrictive diagnostic workup protocol for imaging and fine-needle aspiration remains unknown. Therefore, the aim of this study was to describe the proportion and characteristics of patients with mPTC in the Netherlands and to describe the potential candidates for AS in a situation with restrictive diagnostic protocols since 2007. Methods: All operated patients with an mPTC in the Netherlands between 2005 and 2015 were identified from the Netherlands Cancer Registry database. Three groups were defined: (Group 1) mPTC with preoperative distant or lymph node metastases, (Group 2) mPTC in pathology report after thyroid surgery for another indication, and (Group 3) patients with a preoperative high suspicious thyroid nodule or proven mPTC (Bethesda 5 or 6). Only patients in Group 3 were considered potential candidates for AS. Results: A total of 1018 mPTC patients were identified. Group 1 consisted of 152 patients with preoperatively discovered metastases. Group 2 consisted of 667 patients, of whom 16 (2.4%) had lymph node metastases. There were 199 patients in Group 3, of whom 27 (13.6%) had lymph node metastases. After initial treatment in Group 3, 3.5% (7/199) of the patients had recurrence. Conclusions: Restrictive diagnostic workup strategies of patients with small thyroid nodules lead to limited patients eligible for AS and a higher incidence of lymph node metastases. We believe that there is limited additive value for AS in countries with restrictive diagnostic workup guidelines such as in the Netherlands. However, if an mPTC is encountered, AS can be offered on an individual basis.
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Affiliation(s)
- Ivona Lončar
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Sam P J van Dijk
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Madelon J H Metman
- Department of Surgical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Jia Feng Lin
- Department of Surgical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Schelto Kruijff
- Department of Surgical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Robin P Peeters
- Department of Internal medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anton F Engelsman
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Tessa M van Ginhoven
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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Park J, Kim K, Lim DJ, Bae JS, Kim JS. Male sex is not an independent risk factor for recurrence of differentiated thyroid cancer: a propensity score-matching study. Sci Rep 2021; 11:14908. [PMID: 34290341 PMCID: PMC8295365 DOI: 10.1038/s41598-021-94461-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
Male patients have a significantly higher prevalence of advanced-stage thyroid cancer. However, sex differences in the risk of differentiated thyroid carcinoma (DTC) recurrence have not been fully elucidated. Therefore, the present study aimed to investigate male sex as a prognostic factor for DTC. We assessed 5566 patients with DTC who underwent thyroid surgery between January 2009 and December 2015 at Seoul St. Mary’s Hospital (Seoul, Korea). Clinicopathological characteristics and long-term oncologic outcomes between female and male patients with DTC were compared using propensity score matching to reduce selection bias. The mean follow-up duration was 99.9 ± 18.7 months. The recurrence rate was significantly higher in male patients than female patients before matching (3.3% vs. 2.2%, p = 0.030), and there was no significant difference in recurrence rates between the matched groups after matching (3.0% vs. 2.5%, p = 0.591). Based on Kaplan–Meier analysis, the two groups did not significantly differ in disease-free survival after matching. Multivariate analysis revealed that male sex was not an independent prognostic factor of DTC recurrence. Male sex did not have a significant effect on DTC recurrence. Further studies with larger cohorts are required to validate the findings of this study.
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Affiliation(s)
- Joonseon Park
- Department of Surgery, College of Medicine, The Catholic University of Korea, 06591, Seoul, Republic of Korea
| | - Kwangsoon Kim
- Department of Surgery, College of Medicine, The Catholic University of Korea, 06591, Seoul, Republic of Korea.
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 06591, Seoul, Republic of Korea
| | - Ja Seong Bae
- Department of Surgery, College of Medicine, The Catholic University of Korea, 06591, Seoul, Republic of Korea
| | - Jeong Soo Kim
- Department of Surgery, College of Medicine, The Catholic University of Korea, 06591, Seoul, Republic of Korea
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Gajowiec A, Chromik A, Furga K, Skuza A, Gąsior-Perczak D, Walczyk A, Pałyga I, Trybek T, Mikina E, Szymonek M, Gadawska-Juszczyk K, Kuchareczko A, Suligowska A, Jaskulski J, Orłowski P, Chrapek M, Góźdź S, Kowalska A. Is Male Sex A Prognostic Factor in Papillary Thyroid Cancer? J Clin Med 2021; 10:jcm10112438. [PMID: 34072690 PMCID: PMC8199349 DOI: 10.3390/jcm10112438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 12/30/2022] Open
Abstract
Identifying risk factors is crucial for predicting papillary thyroid cancer (PTC) with severe course, which causes a clinical problem. The purpose of this study was to assess whether male sex can be such a predictive factor and to verify whether including it as a predictive factor of high initial risk of recurrence/persistence would help to enhance the value of the American Thyroid Association initial risk stratification system (ATA). We retrospectively analyzed 1547 PTC patients (1358 females and 189 males), treated from 1986 to 2018. The relationship between sex and clinicopathological features, response to therapy, and disease status was assessed. Men with PTC showed some adverse clinicopathological features more often than women, including angioinvasion, lymph node metastases, and tumor size > 40 mm. There were sex-related disparities with respect to response to initial therapy and final follow-up. Male sex is associated with some unfavorable clinicopathological features of PTC, which may affect response to initial therapy or final disease status. In our study, modification of the ATA system by including male sex as a risk factor does not enhance its value. Thus, further studies are needed to assess whether males require treatment modalities or oncological follow-up protocols that are different from those of females.
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Affiliation(s)
- Aleksandra Gajowiec
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
- Correspondence: ; Tel.: +48-663-961-210
| | - Anna Chromik
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
| | - Kinga Furga
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
| | - Alicja Skuza
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
| | - Danuta Gąsior-Perczak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Agnieszka Walczyk
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Iwona Pałyga
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Tomasz Trybek
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Estera Mikina
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Monika Szymonek
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Klaudia Gadawska-Juszczyk
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Artur Kuchareczko
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Agnieszka Suligowska
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Jarosław Jaskulski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Paweł Orłowski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Magdalena Chrapek
- Faculty of Natural Sciences, Jan Kochanowski University, 25-406 Kielce, Poland;
| | - Stanisław Góźdź
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Clinical Oncology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland
| | - Aldona Kowalska
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
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7
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van Beek DJ, Almquist M, Bergenfelz AO, Musholt TJ, Nordenström E. Complications after medullary thyroid carcinoma surgery: multicentre study of the SQRTPA and EUROCRINE® databases. Br J Surg 2021; 108:691-701. [PMID: 34157081 PMCID: PMC10364906 DOI: 10.1093/bjs/znaa195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Surgery is the curative therapy for patients with medullary thyroid carcinoma (MTC). In determining the extent of surgery, the risk of complications should be considered. The aim of this study was to assess procedure-specific outcomes and risk factors for complications after surgery for MTC. METHODS Patients who underwent thyroid surgery for MTC were identified in two European prospective quality databases. Hypoparathyroidism was defined by treatment with calcium/active vitamin D. Recurrent laryngeal nerve (RLN) palsy was diagnosed on laryngoscopy. Complications were considered at least transient if present at last follow-up. Risk factors for at-least transient hypoparathyroidism and RLN palsy were identified by logistic regression analysis. RESULTS A total of 650 patients underwent surgery in 69 centres at a median age of 56 years. Hypoparathyroidism, RLN palsy and bleeding requiring reoperation occurred in 170 (26·2 per cent), 62 (13·7 per cent) and 17 (2·6 per cent) respectively. Factors associated with hypoparathyroidism were central lymph node dissection (CLND) (odds ratio (OR) 2·20, 95 per cent c.i. 1·04 to 4·67), CLND plus unilateral lateral lymph node dissection (LLND) (OR 2·78, 1·20 to 6·43), CLND plus bilateral LLND (OR 2·83, 1·13 to 7·05) and four or more parathyroid glands observed (OR 4·18, 1·46 to 12·00). RLN palsy was associated with CLND plus LLND (OR 4·04, 1·12 to 14·58) and T4 tumours (OR 12·16, 4·46 to 33·18). After compartment-oriented lymph node dissection, N0 status was achieved in 248 of 537 patients (46·2 per cent). CONCLUSION Complications after surgery for MTC are procedure-specific and may relate to the unavoidable consequences of radical dissection needed in some patients.
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Affiliation(s)
- D-J van Beek
- Departments of Endocrine and Sarcoma Surgery, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Department of Endocrine Surgical Oncology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - M Almquist
- Departments of Endocrine and Sarcoma Surgery, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - A O Bergenfelz
- Surgery, Skåne University Hospital, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - T J Musholt
- Section of Endocrine Surgery, Clinic of General, Visceral and Transplantation Surgery, University Medical Centre Mainz, Mainz, Germany
| | - E Nordenström
- Departments of Endocrine and Sarcoma Surgery, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Pham DX, Nguyen HD, Phung AHT, Bui TD, Tran TS, Tran BNH, Ho-Pham LT, Nguyen TV. Trends in incidence and histological pattern of thyroid cancer in Ho Chi Minh City, Vietnam (1996-2015): a population-based study. BMC Cancer 2021; 21:296. [PMID: 33743620 PMCID: PMC7981942 DOI: 10.1186/s12885-021-08023-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The burden and trend of thyroid cancer in Vietnam have not been well documented. This study aimed to investigate the trends in incidence and histological pattern of thyroid cancer in Ho Chi Minh City from 1996 to 2015. METHODS A population-based study retrieved data from the Ho Chi Minh City Cancer Registry during 1996-2015. Trends in the incidence of thyroid cancer were investigated based on age, gender, and histology for each 5-year period. Annual percentage change (APC) in incidence rates was estimated using Joinpoint regression analysis. RESULTS In the study period, there were 5953 thyroid cancer cases (men-to-women ratio 1:4.5) newly diagnosed in Ho Chi Minh City with the mean age of 42.9 years (±14.9 years). The age-standardized incidence rate of thyroid cancer increased from 2.4 per 100,000 during 1996-2000 (95% confidence interval [95% CI]: 2.2-2.6) to 7.5 per 100,000 during 2011-2015 (95% CI: 7.3-7.9), corresponded to an overall APC of 8.7 (95% CI 7.6-9.9). The APC in men and women was 6.2 (95% CI: 4.2-8.2) and 9.2 (95% CI: 8.0-10.4), respectively. The incidence rate in the < 45 years age group was the highest diagnosed overall and increased significantly in both men (APC 11.0) and women (APC 10.1). Both genders shared similar distribution of subtype incidences, with papillary thyroid cancer constituted the most diagnosed (73.3% in men and 85.2% in women). The papillary thyroid cancer observed a markedly increase overall (APC of 10.7 (95% CI 9.3-12.0)). CONCLUSIONS There were appreciable increases in the age-standardized incidence rate of thyroid cancer in both genders, mainly contributed by the papillary subtype. The age of patients at diagnosis decreased gradually. The widespread utilization of advanced diagnostic techniques and healthcare accessibility improvement might play a potential role in these trends. Further investigations are needed to comprehend the risk factors and trends fully.
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Affiliation(s)
- Dung X. Pham
- Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam
- Department of Oncology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Hien D. Nguyen
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - An H. T. Phung
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Tung D. Bui
- Department of Healthcare Directions, Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam
| | - Thach S. Tran
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
| | - Bich N. H. Tran
- Bureau of Health Information, St Leonards, Sydney, New South Wales Australia
| | - Lan T. Ho-Pham
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Tuan V. Nguyen
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia
- School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia
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9
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Sondorp LH, Ogundipe VM, Groen AH, Kelder W, Kemper A, Links TP, Coppes RP, Kruijff S. Patient-Derived Papillary Thyroid Cancer Organoids for Radioactive Iodine Refractory Screening. Cancers (Basel) 2020; 12:E3212. [PMID: 33142750 PMCID: PMC7692469 DOI: 10.3390/cancers12113212] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 12/23/2022] Open
Abstract
Patients with well-differentiated thyroid cancer, especially papillary thyroid cancer (PTC), are treated with surgical resection of the thyroid gland. This is followed by post-operative radioactive iodine (I131), resulting in total thyroid ablation. Unfortunately, about 15-33% of PTC patients are unable to take up I131, limiting further treatment options. The aim of our study was to develop a cancer organoid model with the potential for pre-treatment diagnosis of these I131-resistant patients. PTC tissue from thirteen patients was used to establish a long-term organoid model. These organoids showed a self-renewal potential for at least five passages, suggesting the presence of cancer stem cells. We demonstrated that thyroid specific markers, a PTC marker, and transporters/receptors necessary for iodine uptake and thyroid hormone production were expressed on a gene and protein level. Additionally, we cultured organoids from I131-resistant PTC material from three patients. When comparing PTC organoids to radioactive iodine (RAI)-refractory disease (RAIRD) organoids, a substantial discordance on both a protein and gene expression level was observed, indicating a treatment prediction potential. We showed that patient-derived PTC organoids recapitulate PTC tissue and a RAIRD phenotype. Patient-specific PTC organoids may enable the early identification of I131-resistant patients, in order to reduce RAI overtreatment and its many side effects for thyroid cancer patients.
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Affiliation(s)
- Luc H.J. Sondorp
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (L.H.J.S.); (A.H.G.)
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
| | - Vivian M.L. Ogundipe
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Andries H. Groen
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (L.H.J.S.); (A.H.G.)
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
| | - Wendy Kelder
- Department of Surgery, Martini Hospital, 9728 NT Groningen, The Netherlands;
| | - Annelies Kemper
- Department of Surgery, Treant Hospital, 7909 AA Hoogeveen, The Netherlands;
| | - Thera P. Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
| | - Robert P. Coppes
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (L.H.J.S.); (A.H.G.)
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10
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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.
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11
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Rare thyroid malignancies in Europe: Data from the information network on rare cancers in Europe (RARECAREnet). Oral Oncol 2020; 108:104766. [DOI: 10.1016/j.oraloncology.2020.104766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023]
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12
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Hugen N, Sloot YJE, Netea-Maier RT, van de Water C, Smit JWA, Nagtegaal ID, van Engen-van Grunsven ICH. Divergent Metastatic Patterns Between Subtypes of Thyroid Carcinoma Results From the Nationwide Dutch Pathology Registry. J Clin Endocrinol Metab 2020; 105:5602698. [PMID: 31641763 PMCID: PMC7112975 DOI: 10.1210/clinem/dgz078] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 10/14/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Metastatic disease is the main cause of cancer-related mortality in thyroid carcinoma (TC) patients. Clinical studies have suggested differences in metastatic patterns between the different subtypes of TC. This study systematically evaluates the metastatic patterns of different subtypes in TC patients. METHODS A nationwide review of pathological records of all 650 patients diagnosed with a primary malignancy in the thyroid who underwent an autopsy between 1991 and 2010 was performed. Patients were selected from the Dutch pathology registry (PALGA). RESULTS Metastatic disease was present in 228 (35.1%) patients and was found in 38.7%, 17.3%, 75.4%, and 47.8% of patients with follicular, papillary, anaplastic, and medullary types of TC, respectively (P < .0001). The majority of patients had more than 1 metastasis. The most common site of metastatic disease was the lung for papillary (79.7%), follicular (72.9%), and anaplastic (92.1%) carcinoma but not for medullary carcinoma (56.3%), P < .0001. Medullary carcinoma patients most frequently had metastases to the liver (81.3%). The combination of metastases also differed between subtypes. CONCLUSION There are major differences in metastatic patterns between different subtypes of TC. The patterns and frequencies identified in this autopsy study may reflect the underlying biology of metastatic thyroid cancer and have potential to influence future monitoring and treatment strategies depending on clinical correlations.
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Affiliation(s)
- Niek Hugen
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
- Correspondence and Reprint Requests: Niek Hugen, Department of Surgery, Radboud University Medical Center, P.O. Box 9101, HP690, 6500 HB Nijmegen, the Netherlands. E-mail:
| | - Yvette J E Sloot
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Romana T Netea-Maier
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carlijn van de Water
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan W A Smit
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Iris D Nagtegaal
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
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13
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997-2014: A Nationwide Study. Thyroid 2019; 29:368-377. [PMID: 30618340 PMCID: PMC6437622 DOI: 10.1089/thy.2018.0564] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Survival of medullary thyroid carcinoma (MTC) subgroups in relation to the general population is poorly described. Data on the factors predicting long-term biochemical cure in MTC patients are nonexistent at a population level. A nationwide retrospective cohort study of MTC in Denmark from 1997 to 2014 was conducted, aiming to detect subgroups with survival similar to that of the general population and to identify prognostic factors for disease-specific survival and long-term biochemical cure. METHODS The study included 220 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. As a representative sample of the general population, a reference population matched 50:1 to the MTC cohort was used. RESULTS Patients diagnosed with hereditary MTC by screening (hazard ratio [HR] = 1.5 [confidence interval (CI) 0.5-4.3]), patients without regional metastases (HR = 1.4 [CI 0.9-2.3]), and patients with stage I (HR = 1.3 [CI 0.6-3.1]), stage II (HR = 1.1 [CI 0.6-2.3]), and III (HR = 1.3 [CI 0.4-4.2]) disease had an overall survival similar to the reference population. On multivariate analysis, the presence of distant metastases (HR = 12.3 [CI 6.0-25.0]) predicted worse disease-specific survival, while the absence of regional lymph node metastases (odds ratio = 40.1 [CI 12.0-133.7]) was the only independent prognostic factor for long-term biochemical cure. CONCLUSIONS Patients with hereditary MTC diagnosed by screening, patients without regional metastases, and patients with stages I, II, and III disease may have similar survival as the general population. The presence of distant metastases predicted worse disease-specific survival, while the absence of regional metastases predicted long-term biochemical cure.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL—Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Address correspondence to: Jes Sloth Mathiesen, MD, Department of ORL—Head & Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløvs Vej 4, DK-5000 Odense, Denmark
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Jutland, Gentofte, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Center for Rare Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL—Head & Neck Surgery and Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL—Head & Neck Surgery, and Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Bentzen
- Department of Oncology, Herlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anja Lisbeth Frederiksen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL—Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
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14
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Nettore IC, Colao A, Macchia PE. Nutritional and Environmental Factors in Thyroid Carcinogenesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081735. [PMID: 30104523 PMCID: PMC6121258 DOI: 10.3390/ijerph15081735] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/05/2018] [Accepted: 08/05/2018] [Indexed: 02/06/2023]
Abstract
Several epidemiological studies suggest an increased incidence of thyroid carcinoma (TC) in recent years, especially for the papillary histotype (PTC), suggesting that specific carcinogens might promote molecular abnormalities that are typical of PTC. The increased incidence is probably attributed to more intensive and sensitive diagnostic procedures, even if recent data suggest that various toxic elements could explain the phenomenon. Ionizing radiation exposure represents the most accepted risk factor for differentiated thyroid cancer that includes both the follicular and papillary histotypes. In this review, we examined the other environmental carcinogens that play a role in TC, such as eating habits, living in volcanic areas, and xenobiotic elements. Among eating habits, iodine intake represents one of the more discussed elements, because its deficiency is associated with follicular thyroid carcinomas (FTCs), while its progressive increment seems to be responsible for PTC. The gas, ash, and lava emissions of volcanoes are composed of various toxic compounds that pollute ground water, vegetables, and animals, contaminating humans via the food chain. Finally, the risk of developing PTC has also been associated with exposure of the population to xenobiotics in the environment or in the home. Their carcinogenic effects are probably caused by their accumulation, but additional studies are necessary to better understand the mechanisms of action.
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Affiliation(s)
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
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15
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Djurhuus BD, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960-2014: a nationwide study. Endocr Connect 2018; 7:829-839. [PMID: 29760189 PMCID: PMC6000757 DOI: 10.1530/ec-18-0157] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022]
Abstract
Recent studies have shown a significant increase in the temporal trend of medullary thyroid carcinoma (MTC) incidence. However, it remains unknown to which extent sporadic medullary thyroid carcinoma (SMTC) and hereditary MTC (HMTC) affect the MTC incidence over time. We conducted a nationwide retrospective study using previously described RET and MTC cohorts combined with review of medical records, pedigree comparison and relevant nationwide registries. The study included 474 MTC patients diagnosed in Denmark between 1960 and 2014. In the nationwide period from 1997 to 2014, we recorded a mean age-standardized incidence of all MTC, SMTC and HMTC of 0.19, 0.13 and 0.06 per 100,000 per year, respectively. The average annual percentage change in incidence for all MTC, SMTC and HMTC were 1.0 (P = 0.542), 2.8 (P = 0.125) and -3.1 (P = 0.324), respectively. The corresponding figures for point prevalence at January 1, 2015 were 3.8, 2.5 and 1.3 per 100,000, respectively. The average annual percentage change in prevalence from 1998 to 2015 for all MTC, SMTC and HMTC was 2.8 (P < 0.001), 3.8 (P < 0.001) and 1.5 (P = 0.010), respectively. We found no significant change in the incidence of all MTC, SMTC and HMTC possibly due to our small sample size. However, due to an increasing trend in the incidence of all MTC and opposing trends of SMTC (increasing) and HMTC (decreasing) incidence, it seems plausible that an increase for all MTC seen by others may be driven by the SMTC group rather than the HMTC group.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Center for Rare DiseasesAarhus University Hospital, Aarhus N, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head & Neck SurgeryAarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck SurgeryCopenhagen University Hospital, Copenhagen, Denmark
| | | | - Jens Bentzen
- Department of OncologyHerlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN)Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular MedicineAarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Anja Lisbeth Frederiksen
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Department of Clinical GeneticsOdense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
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16
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Mols F, Schoormans D, Smit JWA, Netea-Maier RT, Links TP, van der Graaf WTA, Husson O. Age-related differences in health-related quality of life among thyroid cancer survivors compared with a normative sample: Results from the PROFILES Registry. Head Neck 2018; 40:2235-2245. [DOI: 10.1002/hed.25325] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 01/09/2018] [Accepted: 04/09/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Floortje Mols
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology; Tilburg University; Tilburg The Netherlands
- Department of Research; Netherlands Comprehensive Cancer Organisation; Utrecht The Netherlands
| | - Dounya Schoormans
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology; Tilburg University; Tilburg The Netherlands
| | - Jan W. A. Smit
- Radboud University Medical Center, Department of Internal Medicine; Nijmegen The Netherlands
| | - Romana T. Netea-Maier
- Radboud University Medical Center, Department of Internal Medicine, Division of Endocrinology; Nijmegen The Netherlands
| | - Thera P. Links
- University of Groningen, University Medical Center Groningen, Department of Endocrinology; Groningen The Netherlands
| | - Winette T. A. van der Graaf
- Radboud University Medical Center, Department of Medical Oncology; Nijmegen The Netherlands
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust; London UK
| | - Olga Husson
- Department of Medical Psychology; Radboud University Medical Centre; Nijmegen The Netherlands
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17
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Dal Maso L, Panato C, Franceschi S, Serraino D, Buzzoni C, Busco S, Ferretti S, Torrisi A, Falcini F, Zorzi M, Cirilli C, Mazzucco W, Magoni M, Collarile P, Pannozzo F, Caiazzo AL, Russo AG, Gili A, Caldarella A, Zanetti R, Michiara M, Mangone L, Filiberti RA, Fusco M, Gasparini F, Tagliabue G, Cesaraccio R, Tumino R, Gatti L, Tisano F, Piffer S, Sini GM, Mazzoleni G, Rosso S, Fanetti AC, Vaccarella S. The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012. Eur J Cancer 2018; 94:6-15. [PMID: 29502036 DOI: 10.1016/j.ejca.2018.01.083] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 01/08/2023]
Abstract
AIMS In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis. METHODS Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology. TC overdiagnosis was estimated by sex, period, age, and Italian region. RESULTS In Italy between 1998-2002 and 2008-2012, TC ASR increased of 74% in women (from 16.2 to 28.2/100,000) and of 90% in men (from 5.3 to 10.1/100,000). ASR increases were nearly exclusively due to papillary TC (+91% in women, +120% in men). In both sexes, more than three-fold differences emerged between regions with highest and lowest ASR. Among TC cases diagnosed in 1998-2012 in Italy, we estimated that overdiagnosis accounted for 75% of cases in women and 63% in men and increased over the study period leading to overdiagnosis of 79% in women and 67% in men in 2008-2012. Notably, overdiagnosis was over 80% among women aged <55 years, and substantial variations were documented across Italian regions, in both genders. CONCLUSION(S) Incidence rates of TC are steadily increasing in Italy and largely due to overdiagnosis. These findings call for an update of thyroid gland examination practices in the asymptomatic general population, at national and regional levels.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
| | - Chiara Panato
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy; AIRTUM Database, Florence, Italy
| | - Susanna Busco
- Cancer Registry of Latina Province, ASL Latina, Italy
| | - Stefano Ferretti
- Ferrara Cancer Registry, University of Ferrara, Azienda USL Ferrara, Italy
| | - Antonietta Torrisi
- Registro Tumori Integrato Catania-Messina-Siracusa-Enna, Università Degli Studi di Catania, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì), Italy-Azienda Usl della Romagna, Forlì, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Veneto Region, Padua, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, AUSL Modena, Italy
| | - Walter Mazzucco
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", University of Palermo, Italy
| | - Michele Magoni
- Brescia Cancer Registry, Epidemiology Unit, Brescia Health Protection Agency, Italy
| | - Paolo Collarile
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | | | | | - Alessio Gili
- Public Health Section, Dept. of Experimental Medicine, University of Perugia, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, City of Torino, Ospedale S. Giovanni Battista-CPO, Torino, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, Italy
| | - Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Italy
| | - Rosa Angela Filiberti
- Liguria Region Cancer Registry, Epidemiologia Clinica, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Mario Fusco
- Cancer Registry of ASL Napoli 3 Sud, Napoli, Italy
| | | | - Giovanna Tagliabue
- Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosaria Cesaraccio
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, Sassari, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Luciana Gatti
- Mantova Cancer Registry, Epidemilogy Unit, Agenzia di Tutela Della Salute (ATS) Della Val Padana, Mantova, Italy
| | - Francesco Tisano
- Cancer Registry of the Province of Siracusa, Local Health Unit of Siracusa, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | | | | | - Stefano Rosso
- Piedmont Cancer Registry, Biella Province, Biella, Italy
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Abstract
The objective was to quantify thyroid cancer incidence and mortality trends in Portugal. The number of thyroid cancer cases and incidence rates were retrieved from the Regional Cancer Registries for the period 1989-2011. The number of deaths and mortality rates were obtained from the WHO cancer mortality database (1988-2003 and 2007-2012) and Statistics Portugal (2004-2006; 1988-2012 by region). Joinpoint regression of the standardized incidence and mortality rates was performed. A significant, rapid and continued increase in incidence was observed for both sexes in each of the Regional Cancer Registries, with annual per cent changes (APCs) ranging between 2 and 9. Incidence in Portuguese women is higher than estimates for the world and Europe. Mortality decreased for women (APC: -1.5), with the greatest decrease in the North, and increased marginally for men (APC: +0.2), with a greater increase in the South. The significant increases in incidence in Portugal are predominantly because of the increase in incidence among women from the North. These trends, combined with an overall low mortality and high 5-year relative survival, raise concerns on the extent to which overdiagnosis may be taking place. Further research is needed, quantifying the importance of the most likely determinants of these trends as well as the extent and potentially deleterious effects of overdiagnosis and overtreatment in the Portuguese setting.
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19
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Faugeras L, Pirson AS, Donckier J, Michel L, Lemaire J, Vandervorst S, D'Hondt L. Refractory thyroid carcinoma: which systemic treatment to use? Ther Adv Med Oncol 2018; 10:1758834017752853. [PMID: 29399055 PMCID: PMC5788129 DOI: 10.1177/1758834017752853] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/01/2017] [Indexed: 12/21/2022] Open
Abstract
The incidence of thyroid cancer has increased markedly in recent decades, but has been stable in terms of mortality rates. For the most part, these cancers are treated with surgery, which may or may not be followed by radioactive iodine depending on the tumor subtype. Still, many of these cancers will recur and may be treated with radioactive iodine or another surgery. It is unclear what treatment is best for cases of locally advanced or metastatic thyroid cancer that are refractory to radioactive iodine. Chemotherapy has a very low response rate. However, in the past few years, several systemic therapies, primarily targeted, have emerged to improve the overall survival of these patients. Alternative treatments are also of interest, namely peptide receptor radionuclide therapy or immunotherapy.
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Affiliation(s)
- Laurence Faugeras
- Oncology Department, CHU UCL Namur, 1 rue Therasse, 5530 Yvoir, Belgium
| | | | | | - Luc Michel
- Department of General Surgery, CHU UCL Namur, Yvoir, Belgium
| | - Julien Lemaire
- Department of General Surgery, CHU UCL Namur, Yvoir, Belgium
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20
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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.
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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
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21
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Jegerlehner S, Bulliard JL, Aujesky D, Rodondi N, Germann S, Konzelmann I, Chiolero A. Overdiagnosis and overtreatment of thyroid cancer: A population-based temporal trend study. PLoS One 2017; 12:e0179387. [PMID: 28614405 PMCID: PMC5470703 DOI: 10.1371/journal.pone.0179387] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/28/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The increase in incidence of thyroid cancer during the last decades without concomitant rise in mortality may reflect the growing detection of indolent forms of thyroid cancer, and may have fueled unnecessary thyroidectomies. Our aim was therefore, to compare recent secular trends in surgical intervention rate for thyroid cancer with the incidence and mortality of thyroid cancer to assess overdiagnosis and resulting overtreatment. METHODS We conducted a population-based temporal trend study in Switzerland from 1998 to 2012. All cases of invasive thyroid cancer, deaths from thyroid cancer, and cancer-related thyroidectomies were analyzed. We calculated changes in age-standardized thyroid cancer incidence rates, stratified by histologic subtype and tumor stage, thyroid cancer-specific mortality, and thyroidectomy rates. RESULTS Between 1998 and 2012, the age-standardized annual incidence of thyroid cancer increased from 5.9 to 11.7 cases/100,000 among women (annual mean absolute increase: +0.43/100,000/year) and from 2.7 to 3.9 cases/100,000 among men (+0.11/100,000/year). The increase was limited to the papillary subtype, the most indolent form of thyroid cancer. The incidence of early stages increased sharply, the incidence of advanced stages increased marginally, and the mortality from thyroid cancer decreased slightly. There was a three- to four-fold increase in the age-standardized annual thyroidectomy rate in both sexes. CONCLUSIONS We observed a large increase in the incidence of thyroid cancer, limited to papillary and early stage tumors, with a three- to four-fold parallel increase in thyroidectomy. The mortality slightly decreased. These findings suggest that a substantial and growing part of the detected thyroid cancers are overdiagnosed and overtreated. IMPACT Targeted screening and diagnostic strategies are warranted to avoid overdetection and unnecessary treatment of thyroid cancers.
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Affiliation(s)
- Sabrina Jegerlehner
- Division of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jean-Luc Bulliard
- Division of Chronic Diseases, IUMSP, Lausanne University Hospital, Lausanne, Switzerland
| | - Drahomir Aujesky
- Division of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Division of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Simon Germann
- Division of Chronic Diseases, IUMSP, Lausanne University Hospital, Lausanne, Switzerland
- Observatoire valaisan de la santé (OVS), Sion, Switzerland
| | | | - Arnaud Chiolero
- Division of Chronic Diseases, IUMSP, Lausanne University Hospital, Lausanne, Switzerland
- Observatoire valaisan de la santé (OVS), Sion, Switzerland
- Department of Epidemiology, McGill University, Montreal, Canada
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22
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Dal Maso L, Tavilla A, Pacini F, Serraino D, van Dijk BAC, Chirlaque MD, Capocaccia R, Larrañaga N, Colonna M, Agius D, Ardanaz E, Rubió-Casadevall J, Kowalska A, Virdone S, Mallone S, Amash H, De Angelis R. Survival of 86,690 patients with thyroid cancer: A population-based study in 29 European countries from EUROCARE-5. Eur J Cancer 2017; 77:140-152. [PMID: 28410490 DOI: 10.1016/j.ejca.2017.02.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Incidence rates of thyroid cancer (TC) increased in several countries during the last 30 years, while mortality rates remained unchanged, raising important questions for treatment and follow-up of TC patients. This study updates population-based estimates of relative survival (RS) after TC diagnosis in Europe by sex, country, age, period and histology. METHODS Data from 87 cancer registries in 29 countries were extracted from the EUROCARE-5 dataset. One- and 5-year RS were estimated using the cohort approach for 86,690 adult TC patients diagnosed in 2000-2007 and followed-up to 12/31/2008. RS trends in 1999-2007 and 10-year RS in 2005-2007 were estimated using the period approach. RESULTS In Europe 2000-2007, 5-year RS after TC was 88% in women and 81% in men. Survival rates varied by country and were strongly correlated (Pearson ρ = 75%) with country-specific incidence rates. Five-year RS decreased with age (in women from >95% at age 15-54 to 57% at age 75+), from 98% in women and 94% in men with papillary TC to 14% in women and 12% in men with anaplastic TC. Proportion of papillary TC varied by country and increased over time, while survival rates were similar across areas and periods. In 1999-2007, 5-year RS increased by five percentage points for all TCs but only by two for papillary and by four for follicular TC. Ten-year RS in 2005-2007 was 89% in women and 79% in men. CONCLUSIONS The reported increasing TC survival trend and differences by area are mainly explained by the varying histological case-mix of cases.
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Affiliation(s)
- L Dal Maso
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
| | - A Tavilla
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy
| | - F Pacini
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - D Serraino
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - B A C van Dijk
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - M D Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain; CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - R Capocaccia
- Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - N Larrañaga
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain; Basque Cancer Registry, Public Health Division of Gipuzkoa, Basque Health Department, Spain
| | - M Colonna
- Isere Cancer Registry (Grenoble), France; Francim Network (Toulouse), France
| | - D Agius
- Malta National Cancer Registry, Lecturer Public Health and Family Medicine, University of Malta, Malta
| | - E Ardanaz
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - J Rubió-Casadevall
- Medical Oncology Department, Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - A Kowalska
- Department of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | - S Virdone
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - S Mallone
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy
| | - H Amash
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R De Angelis
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy
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23
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Singer S, Jordan S, Locati LD, Pinto M, Tomaszewska IM, Araújo C, Hammerlid E, Vidhubala E, Husson O, Kiyota N, Brannan C, Salem D, Gamper EM, Arraras JI, Ioannidis G, Andry G, Inhestern J, Grégoire V, Licitra L. The EORTC module for quality of life in patients with thyroid cancer: phase III. Endocr Relat Cancer 2017; 24:197-207. [PMID: 28223365 DOI: 10.1530/erc-16-0530] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 12/23/2022]
Abstract
The purpose of the study was to pilot-test a questionnaire measuring health-related quality of life (QoL) in thyroid cancer patients to be used with the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire EORTC QLQ-C30. A provisional questionnaire with 47 items was administered to patients treated for thyroid cancer within the last 2 years. Patients were interviewed about time and help needed to complete the questionnaire, and whether they found the items understandable, confusing or annoying. Items were kept in the questionnaire if they fulfilled pre-defined criteria: relevant to the patients, easy to understand, not confusing, few missing values, neither floor nor ceiling effects, and high variance. A total of 182 thyroid cancer patients in 15 countries participated (n = 115 with papillary, n = 31 with follicular, n = 22 with medullary, n = 6 with anaplastic, and n = 8 with other types of thyroid cancer). Sixty-six percent of the patients needed 15 min or less to complete the questionnaire. Of the 47 items, 31 fulfilled the predefined criteria and were kept unchanged, 14 were removed, and 2 were changed. Shoulder dysfunction was mentioned by 5 patients as missing and an item covering this issue was added. To conclude, the EORTC quality of life module for thyroid cancer (EORTC QLQ-THY34) is ready for the final validation phase IV.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI)University Medical Center Mainz, Mainz, Germany
- University Cancer CentreMainz, Germany
| | - Susan Jordan
- QIMR Berghofer Medical Research InstituteHerston, Australia
| | - Laura D Locati
- Head & Neck Medical Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Pinto
- Rehabilitation UnitDepartment of Quality of Life, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione Giovanni Pascale' - IRCCS, Naples, Italy
| | - Iwona M Tomaszewska
- Department of Medical EducationJagiellonian University Medical College, Krakow, Poland
| | - Cláudia Araújo
- Service of Surgical OncologyInstituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Eva Hammerlid
- Department of Otolaryngology and Head and Neck SurgerySahlgrenska University Hospital, Gothenburg, Sweden
| | - E Vidhubala
- Department of Psycho-OncologyResource Centre for Tobacco Control, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Olga Husson
- Department of Medical PsychologyRadboud University Medical Center, Nijmegen, The Netherlands
| | - Naomi Kiyota
- Department of Medical Oncology and HematologyKobe University Hospital, Kobe, Japan
| | - Christine Brannan
- Mount Vernon Cancer CentreEast & North Herts NHS Trust, Northwood, London, UK
| | - Dina Salem
- Clinical OncologyFaculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eva M Gamper
- Department of Nuclear MedicineMedical University of Innsbruck, Innsbruck Institute of Patient-Centred Outcome Research, Innsbruck, Austria
| | | | | | - Guy Andry
- Surgery DepartmentJules Bordet Institute, Brussels, Belgium
| | - Johanna Inhestern
- Clinic of OtorhinolaryngologyJena University Hospital, Jena, Germany
| | - Vincent Grégoire
- Department of Radiation OncologyInstitut de Recherche Experimentale et Clinique, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium
| | - Lisa Licitra
- Head & Neck Medical Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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24
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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.
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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
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25
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Singer S, Husson O, Tomaszewska IM, Locati LD, Kiyota N, Scheidemann-Wesp U, Hofmeister D, Winterbotham M, Brannan C, Araújo C, Gamper EM, Kulis D, Rimmele H, Andry G, Licitra L. Quality-of-Life Priorities in Patients with Thyroid Cancer: A Multinational European Organisation for Research and Treatment of Cancer Phase I Study. Thyroid 2016; 26:1605-1613. [PMID: 27605136 DOI: 10.1089/thy.2015.0640] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). METHODS A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer-specific QoL module. RESULTS The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at least some of the patients. The most frequently selected issues were sudden attacks of tiredness, exhaustion, quality of sleep, employment, social support, fear of cancer progression, fear of second operation, difficulties swallowing, and globus sensation. CONCLUSIONS Thyroid cancer patients cross-culturally rate fatigue-related issues as highly important for their QoL, calling for increased efforts to find successful treatments for this problem. Vocational rehabilitation is also highly relevant for them and should therefore be an important aim of multidisciplinary care. The third important area of concern is psychological issues, especially fear of progression and of additional treatments.
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MESH Headings
- Adenocarcinoma, Follicular/pathology
- Adenocarcinoma, Follicular/rehabilitation
- Adenocarcinoma, Follicular/therapy
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Medullary/pathology
- Carcinoma, Medullary/therapy
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/rehabilitation
- Carcinoma, Papillary/therapy
- Combined Modality Therapy/adverse effects
- Cross-Cultural Comparison
- Europe
- Fatigue/etiology
- Fatigue/prevention & control
- Female
- Humans
- Internationality
- Male
- Middle Aged
- Neoplasm Staging
- Quality of Life
- Rehabilitation, Vocational
- Self Report
- Thyroid Cancer, Papillary
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/rehabilitation
- Thyroid Neoplasms/therapy
- Voluntary Health Agencies
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Affiliation(s)
- Susanne Singer
- 1 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz , Mainz, Germany
| | - Olga Husson
- 2 CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University , Tilburg, The Netherlands
| | - Iwona M Tomaszewska
- 3 Department of Medical Education, Jagiellonian University Medical College , Krakow, Poland
| | - Laura D Locati
- 4 Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan, Italy
| | - Naomi Kiyota
- 5 Department of Medical Oncology and Hematology, Kobe University Hospital , Kobe, Japan
| | - Ulrike Scheidemann-Wesp
- 1 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz , Mainz, Germany
| | - Dirk Hofmeister
- 6 Department of Medical Psychology and Medical Sociology, University Medical Centre , Leipzig, Germany
| | | | | | - Cláudia Araújo
- 8 Service of Surgical Oncology, Instituto Português de Oncologia do Porto Francisco Gentil , Porto, Portugal
| | - Eva M Gamper
- 9 Department of Nuclear Medicine and Department of Psychiatry and Psychotherapy, Medical University of Innsbruck , Innsbruck, Austria
| | - Dagmara Kulis
- 10 Translation Unit, European Organisation for Research and Treatment of Cancer (EORTC) Headquarters , Brussels, Belgium
| | - Harald Rimmele
- 11 National Association of Thyroid Cancer Patients "Bundesverband Schilddrüsenkrebs-Ohne Schilddrüse leben e.V.," Berlin, Germany
| | - Guy Andry
- 12 Surgery Department, Jules Bordet Institute , Brussels, Belgium
| | - Lisa Licitra
- 4 Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan, Italy
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26
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Carlberg M, Hedendahl L, Ahonen M, Koppel T, Hardell L. Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data. BMC Cancer 2016; 16:426. [PMID: 27388603 PMCID: PMC4937579 DOI: 10.1186/s12885-016-2429-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 06/10/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Radiofrequency radiation in the frequency range 30 kHz-300 GHz was evaluated to be Group 2B, i.e. 'possibly' carcinogenic to humans, by the International Agency for Research on Cancer (IARC) at WHO in May 2011. Among the evaluated devices were mobile and cordless phones, since they emit radiofrequency electromagnetic fields (RF-EMF). In addition to the brain, another organ, the thyroid gland, also receives high exposure. The incidence of thyroid cancer is increasing in many countries, especially the papillary type that is the most radiosensitive type. METHODS We used the Swedish Cancer Register to study the incidence of thyroid cancer during 1970-2013 using joinpoint regression analysis. RESULTS In women, the incidence increased statistically significantly during the whole study period; average annual percentage change (AAPC) +1.19 % (95 % confidence interval (CI) +0.56, +1.83 %). Two joinpoints were detected, 1979 and 2001, with a high increase of the incidence during the last period 2001-2013 with an annual percentage change (APC) of +5.34 % (95 % CI +3.93, +6.77 %). AAPC for all men during 1970-2013 was +0.77 % (95 % CI -0.03, +1.58 %). One joinpoint was detected in 2005 with a statistically significant increase in incidence during 2005-2013; APC +7.56 % (95 % CI +3.34, +11.96 %). Based on NORDCAN data, there was a statistically significant increase in the incidence of thyroid cancer in the Nordic countries during the same time period. In both women and men a joinpoint was detected in 2006. The incidence increased during 2006-2013 in women; APC +6.16 % (95 % CI +3.94, +8.42 %) and in men; APC +6.84 % (95 % CI +3.69, +10.08 %), thus showing similar results as the Swedish Cancer Register. Analyses based on data from the Cancer Register showed that the increasing trend in Sweden was mainly caused by thyroid cancer of the papillary type. CONCLUSIONS We postulate that the whole increase cannot be attributed to better diagnostic procedures. Increasing exposure to ionizing radiation, e.g. medical computed tomography (CT) scans, and to RF-EMF (non-ionizing radiation) should be further studied. The design of our study does not permit conclusions regarding causality.
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Affiliation(s)
- Michael Carlberg
- />Department of Oncology, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Lena Hedendahl
- />Independent Environment and Health Research Luleå, Östra Skolgatan 12, SE-972 53 Luleå, Sweden
| | - Mikko Ahonen
- />Institute of Environmental Health and Safety, Jaama 14-3, 11615 Tallinn, Estonia
| | - Tarmo Koppel
- />Department of Labour Environment and Safety, Tallinn University of Technology, SCO351 Ehitajate tee 5, 19086 Tallinn, Estonia
| | - Lennart Hardell
- />Department of Oncology, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
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Pandeya N, McLeod DS, Balasubramaniam K, Baade PD, Youl PH, Bain CJ, Allison R, Jordan SJ. Increasing thyroid cancer incidence in Queensland, Australia 1982-2008 - true increase or overdiagnosis? Clin Endocrinol (Oxf) 2016; 84:257-264. [PMID: 25597380 DOI: 10.1111/cen.12724] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 12/15/2014] [Accepted: 01/13/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Thyroid cancer incidence has been increasing worldwide. Some suggest greater ascertainment of indolent tumours is the only driver, but others suggest there has been a true increase. Increases in Australia appear to have been among the largest in the world, so we investigated incidence trends in the Australian state of Queensland to help understand reasons for the rise. METHODS Thyroid cancers diagnoses in Queensland 1982-2008 were ascertained from the Queensland Cancer Registry. We calculated age-standardized incidence rates (ASR) and used Poisson regression to estimate annual percentage change (APC) in thyroid cancer incidence by socio-demographic and tumour-related factors. RESULTS Thyroid cancer ASR in Queensland increased from 2·2 to 10·6/100 000 between 1982 and 2008 equating to an APC of 5·5% [95% confidence interval (CI) 4·7-6·4] in men and 6·1% (95% CI 5·5-6·6) in women. The rise was evident, and did not significantly differ, across socio-economic and remoteness-of-residence categories. The largest increase seen was in the papillary subtype in women (APC 7·9%, 95% CI 7·3-8·5). Incidence of localized and more advanced-stage cancers rose over time although the increase was greater for early-stage cancers. CONCLUSION There has been a marked increase in thyroid cancer incidence in Queensland. The increase is evident in men and women across all adult age groups, socio-economic strata and remoteness-of-residence categories as well as in localized and more advanced-stage cancers. Our results suggest 'overdiagnosis' may not entirely explain rising incidence. Contemporary aetiological data and individual-level information about diagnostic circumstances are required to further understand reasons for rising thyroid cancer incidence.
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Affiliation(s)
- N Pandeya
- School of Population Health, The University of Queensland, Herston, Brisbane, Qld, Australia
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Qld, Australia
| | - D S McLeod
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Qld, Australia
- Department of Endocrinology and Diabetes, Royal Brisbane & Women Hospital, Brisbane, Qld, Australia
| | - K Balasubramaniam
- School of Population Health, The University of Queensland, Herston, Brisbane, Qld, Australia
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Qld, Australia
| | - P D Baade
- Cancer Council Queensland, Brisbane, Qld, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia
- Griffith Health Institute, Griffith University, Gold Coast, Qld, Australia
| | - P H Youl
- Cancer Council Queensland, Brisbane, Qld, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia
- Griffith Health Institute, Griffith University, Gold Coast, Qld, Australia
| | - C J Bain
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Qld, Australia
| | - R Allison
- Cancer Care Services, Royal Brisbane & Women Hospital, Brisbane, Qld, Australia
| | - S J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Qld, Australia
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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
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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.
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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
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Zafon C, Puig-Domingo M, Biarnés J, Halperin I, Bella MR, Castells I, González C, Megía A, Santos L, García-Pascual L, Reverter JL, Pizarro E, Mauricio D. A descriptive study of the characteristics of differentiated thyroid cancer in Catalonia during the period 1998-2012. The CECaT registry. ACTA ACUST UNITED AC 2015; 62:264-9. [PMID: 25979187 DOI: 10.1016/j.endonu.2015.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 02/19/2015] [Accepted: 03/09/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The consortium for the study of thyroid cancer (CECaT), including 20 hospitals and one research institute, was recently created in Catalonia (Spain). One of the first initiatives of the group was to perform a descriptive analysis of the characteristics of patients with differentiated thyroid carcinoma (DTC). PATIENTS AND METHODS The cohort included 1,855 patients from 11 hospitals treated over a period of 15 years (1998-2012). RESULTS In this series, 1.470 (79.2%) patients were women. Mean age was 47.7 (15.7) years old. Age was significantly higher in male than in female patients, 49.3 (15) versus 47.3 (15.8); p=0.02. Papillary thyroid carcinoma accounted for 88.9% of cases. Mean tumor size was 21.5 (16) mm, and was significantly lower in females than in males, 20.1 (14.5) mm and 26.6 (20.3) mm respectively (p<0.001). After a follow-up period of 5.5 (3.7) years, information was available for 1,355 patient, of whom 1065 (78.6%) were free of disease, 239 (17.6%) had no tumor persistence, and 51 (3.8) % had died. The risk of persistent or recurrent disease was significantly associated to older age at diagnosis, male gender, larger tumor size, lymph node metastases at surgery, no signs of thyroiditis in the remaining thyroid tissue, and presence of vascular and/or extraglandular invasion. CONCLUSIONS Patient characteristics analyzed are similar to those reported in other parts of the world.
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Affiliation(s)
- Carles Zafon
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España.
| | - Manel Puig-Domingo
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Josefina Biarnés
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Irene Halperin
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Maria Rosa Bella
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Ignasi Castells
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Cintia González
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Ana Megía
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Lola Santos
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Luís García-Pascual
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Jordi Lluís Reverter
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Eduarda Pizarro
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
| | - Dídac Mauricio
- Servicio de Endocrinología y Nutrición, Hospital General Universitari Vall d'Hebron, Barcelona, España
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[Rising incidence of papillary thyroid carcinoma in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:84-92. [PMID: 24357177 DOI: 10.1007/s00103-013-1884-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The incidence of thyroid cancer (TC), a rare malignancy, has strongly risen in recent decades. Possible causes of this rise include increasing diagnostic activity, nuclear tests after World War II, and the Chernobyl disaster. AIM This article presents the time trends of TC incidence between 2003 and 2008 in Germany according to histological tumor type and sex, and provides a description of TC incidence according to districts (Kreise) and sex in Germany. METHODS Data on persons newly diagnosed with thyroid cancer (ICD-10 code, C73) between 2003 and 2008 were obtained from the Center of Cancer Registry Data at the Robert Koch Institute. Official population and mortality data were used. Age-specific and age-standardized incidence rates (ASIR) were calculated according to sex and tumor histology. RESULTS Between 2003 and 2008, the ASIR of TC rose from 2.7 to 3.4 (men) and from 6.5 to 8.9 (women) per 100,000 per year. This rise can be almost completely attributed to the rising incidence of papillary TC. The steepest rise in frequency was observed in TNM-T1 tumors. A positive north-south gradient of TC incidence was found. DISCUSSION The cause of the marked rise of TC incidence in recent decades is unknown. The positive north-south gradient of the TC incidence may possibly be attributed in part to long-standing differences of iodine intake between different German regions. CONCLUSION An epidemiological study of the possible causes of the rising TC incidence and of the regional differences of TC incidence in Germany is recommended.
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Marcello MA, Malandrino P, Almeida JFM, Martins MB, Cunha LL, Bufalo NE, Pellegriti G, Ward LS. The influence of the environment on the development of thyroid tumors: a new appraisal. Endocr Relat Cancer 2014; 21:T235-54. [PMID: 24948559 DOI: 10.1530/erc-14-0131] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Most epidemiological studies concerning differentiated thyroid cancers (DTC) indicate an increasing incidence over the last two decades. This increase might be partially explained by the better access to health services worldwide, but clinicopathological analyses do not fully support this hypothesis, indicating that there are carcinogenetic factors behind this noticeable increasing incidence. Although we have undoubtedly understood the biology and molecular pathways underlying thyroid carcinogenesis in a better way, we have made very little progresses in identifying a risk profile for DTC, and our knowledge of risk factors is very similar to what we knew 30-40 years ago. In addition to ionizing radiation exposure, the most documented and established risk factor for DTC, we also investigated the role of other factors, including eating habits, tobacco smoking, living in a volcanic area, xenobiotics, and viruses, which could be involved in thyroid carcinogenesis, thus, contributing to the increase in DTC incidence rates observed.
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Affiliation(s)
- M A Marcello
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - P Malandrino
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - J F M Almeida
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - M B Martins
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - L L Cunha
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - N E Bufalo
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - G Pellegriti
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
| | - L S Ward
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM-Unicamp), Rua Tessalia Vieira de Camargo, 126, Barao Geraldo, Campinas, Sao Paulo, 13083-887, BrazilEndocrinologyDepartment of Clinical and Molecular Biomedicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy
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Cheng SP, Hsu YC, Liu CL, Liu TP, Chien MN, Wang TY, Lee JJ. Significance of allelic percentage of BRAF c.1799T > A (V600E) mutation in papillary thyroid carcinoma. Ann Surg Oncol 2014; 21 Suppl 4:S619-26. [PMID: 24748129 DOI: 10.1245/s10434-014-3723-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND Somatic BRAF mutation is frequently observed in papillary thyroid carcinoma (PTC). Recent evidence suggests that PTCs are heterogeneous tumors containing a subclonal or oligoclonal occurrence of BRAF mutation. Conflicting results have been reported concerning the prognostic significance of the mutant allele frequency. Our present aim was to investigate the association between the percentage of BRAF c.1799T > A (p.Val600Glu) alleles and clinicopathological parameters in PTC. METHODS Genomic DNA was extracted from fresh-frozen specimens obtained from 50 PTC patients undergoing total thyroidectomy. The BRAF mutation status was determined by Sanger sequencing. The percentage of mutant BRAF alleles was quantified by mass spectrometric genotyping, pyrosequencing, and competitive allele-specific TaqMan PCR (castPCR). RESULTS Positive rate of BRAF mutation was 72 % by Sanger sequencing, 82 % by mass spectrometric genotying, and 84 % by pyrosequencing or castPCR. The average percentage of mutant BRAF alleles was 22.5, 31, and 30.7 %, respectively. There was a good correlation among three quantification methods (Spearman's rho = 0.87-0.97; p < 0.0001). The mutant allele frequency was significantly correlated with tumor size (rho = 0.47-0.52; p < 0.01) and extrathyroidal invasion. The frequency showed no difference in pathological lymph node metastasis. CONCLUSIONS The percentage of mutant BRAF alleles is positively associated with tumor burden and extrathyroidal invasion in PTC. Relatively good correlations exist among mass spectrometric genotyping, pyrosequencing, and castPCR in quantification of mutant BRAF allele frequency.
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Affiliation(s)
- Shih-Ping Cheng
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
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Guay B, Johnson-Obaseki S, McDonald JT, Connell C, Corsten M. Incidence of differentiated thyroid cancer by socioeconomic status and urban residence: Canada 1991-2006. Thyroid 2014; 24:552-5. [PMID: 24003960 DOI: 10.1089/thy.2013.0308] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The incidence of thyroid cancer is increasing in Canada. The purpose of this study was to investigate the following questions. First, what was the magnitude of increased incidence of thyroid cancer in Canada from 1991-2006? Second, is there an association between socioeconomic status (SES) and thyroid cancer incidence in Canada? Third, does the relationship between SES and the incidence of thyroid cancer vary by rural/urban status? METHODS Thyroid cancer cases were drawn from the Canadian Cancer Registry. Demographic and socioeconomic information were extracted from the Canadian Census of Population data. We linked cases to income quintiles (InQs) according to patients' postal codes, and categorized place of residence into city, town, or rural. We then performed a negative binomial regression analysis on the incidence of thyroid cancer to identify relationships between these variables. RESULTS The overall incidence of thyroid cancer in Canada increased by 156% between 1991 and 2006. Incidence was significantly lower among individuals from lower InQs (incidence rate ratio 0.77 for lowest InQ compared to highest). The incidence of thyroid cancer was more than 25% lower in towns or rural areas compared to cities, after controlling for SES and demographic factors. Lastly, when we allowed the relationship between thyroid cancer incidence and geography of residence to vary by SES, we found that the difference in incidence between highest and lowest InQs was significantly larger in cities than in towns and was insignificant in rural areas. CONCLUSIONS Our study confirmed a dramatic increase in thyroid cancer incidence in Canada. Thyroid cancer incidence was significantly higher in higher InQs and in cities. These data support the theory that increased access to imaging is largely responsible for this increased incidence.
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Affiliation(s)
- Benoit Guay
- 1 Division of Otolaryngology, Laval University , Quebec City, Canada
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Kitahara CM, Gamborg M, de González AB, Sørensen TI, Baker JL. Childhood height and body mass index were associated with risk of adult thyroid cancer in a large cohort study. Cancer Res 2014; 74:235-42. [PMID: 24247722 PMCID: PMC3891884 DOI: 10.1158/0008-5472.can-13-2228] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Taller stature and obesity in adulthood have been consistently associated with an increased risk of thyroid cancer, but few studies have investigated the role of childhood body size. Using data from a large prospective cohort, we examined associations for height and body mass index (BMI) at ages 7 to 13 years with risk of thyroid cancer in later life. The study population included 321,085 children from the Copenhagen School Health Records Register, born between 1930 and 1989 in Copenhagen, Denmark, with measurements of height and weight from 7 to 13 years of age. These data were linked with the Danish Cancer Registry to identify incident thyroid cancer cases (1968-2010). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for age- and sex-specific height and BMI SD scores (SDS) using proportional hazards models stratified by birth cohort and sex. During follow-up (median = 38.6 years), 171 women and 64 men were diagnosed with thyroid cancer. Both height and BMI were positively associated with thyroid cancer risk, and these associations were similar by age at measurement. Using age 10 as an example, HRs per 1 unit increase in SDS for height (~6-7 cm) and BMI (~1.5-2 kg/m(2)) were 1.22 (95% CI, 1.07-1.40) and 1.15 (95% CI, 1.00-1.34), respectively. These results, together with the relatively young ages at which thyroid cancers are diagnosed compared with other malignancies, suggest a potential link between early-life factors related to growth and body weight and thyroid carcinogenesis.
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Affiliation(s)
- Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Michael Gamborg
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
| | - Amy Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Thorkild I.A. Sørensen
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jennifer L. Baker
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Aldawish M, Jha N, McEwan AJB, Severin D, Ghosh S, Morrish DW. Low but measurable stimulated serum thyroglobulin levels <2 µg/L frequently predict incomplete response in differentiated thyroid cancer patients. Endocr Res 2014; 39:157-63. [PMID: 24460082 DOI: 10.3109/07435800.2013.865211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The study was aimed to determine the response and predictive risk factors of differentiated thyroid cancer (DTC) with measurable (0.4-2.0 µg/L) stimulated serum thyroglobulin (sTg) during the 10-24 months after radioiodine remnant ablation (RRA) and their long-term outcomes. METHODS Out of 839 retrospectively reviewed patients, 95 eligible DTC patients were included. Patients were classified as having incomplete response or no evidence of disease (NED). The sTg cut-off values with highest predicted accuracy for incomplete response at 10-24 months were calculated with receiver operator characteristics curve analysis. RESULTS AND CONCLUSION At 10-24 months after RRA, incomplete response was identified in 54 patients (57%) and 38/54 (70.4%) patients were found with structural evidence of disease. The remaining 16 patients (29.6%) had biochemical evidence of disease without structural evidence of disease. Forty-one patients (43%) were classified as having NED at 10-24 months after RRA and 27 patients (66%) did not receive further radioactive iodine (RAI) therapy and remained disease free at median follow-up of 6.5 years. Fourteen patients received second RAI treatment after 6 months and before the 10-24 months assessment time point. Of these, 2 had persistent tumor 6 years later. The sTg >0.6 µg/L at 6-10 months after RRA had optimal sensitivity (83.3%), specificity (56%) and negative predictive value (72%) of detecting incomplete response at 10-24 months after RRA. A total of 23/43 patients in the American Thyroid Association low-risk category had incomplete response after first RRA and 5/23 (21.7%) had recurrent/persistent disease at long-term follow-up.
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Ondrusova M, Kajo K, Ondrus D. Changing patterns in thyroid cancer incidence and mortality in the Slovak Republic by histological type and age. Int J Clin Oncol 2013; 19:805-13. [PMID: 24212324 DOI: 10.1007/s10147-013-0633-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 10/17/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thyroid cancer (TC) is the most common malignant disease of the endocrine system; however, in the Slovak Republic (SR), time trends of incidence and mortality according to histological type and age of patients have never been reported. MATERIALS AND METHODS Long-term (1968-2007) trends from the National Cancer Registry data of overall, histology and age-specific incidence and mortality in the SR have been calculated using join-point regression and other descriptive characteristics. RESULTS Age-standardized overall incidence rates increased significantly in females by an estimated annual percentage change (APC) of 3.6 %, and in males by 2.2 %. Overall mortality decreased by APC -2.1 % in females and -0.9 % in males. The mean ages of female and male TC patients at the time of diagnosis significantly decreased; ages at the time of death significantly increased. The incidence of papillary carcinoma rose significantly in females by 8.9 %, compared with 6.1 % in males; follicular carcinoma in males and females was stable. Medullary carcinoma was stable in females; in males, it rose by 5.2 %. Poorly differentiated TC was stable in females; undifferentiated/anaplastic carcinomas decreased in both sexes. CONCLUSIONS The incidence of TC, especially of selected histological types, is dramatically rising in the SR in both genders, while mortality is decreasing. Patients diagnosed in recent years are younger and died at a greater age than those reported in older national data. These trends seem to be affected by more intensive diagnosis in the most recent years.
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Affiliation(s)
- Martina Ondrusova
- St. Elisabeth University of Health and Social Sciences, Palackeho 1, 811 00, Bratislava, Slovak Republic,
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Kweon SS, Shin MH, Chung IJ, Kim YJ, Choi JS. Thyroid cancer is the most common cancer in women, based on the data from population-based cancer registries, South Korea. Jpn J Clin Oncol 2013; 43:1039-46. [PMID: 23894204 DOI: 10.1093/jjco/hyt102] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Similar to worldwide trends, the incidence of thyroid cancer in South Korea has increased steadily in recent decades. We examined the trends in thyroid cancer incidence in Gwangju and Jeonnam provinces between 1996 and 2010, and identified 19 881 cases (men 3282/16.5%; women 16 599/83.5%) from the Gwangju Cancer Registry and Jeonnam Cancer Registry databases, which are population-based cancer registries. Age-standardized incidence rates per 100 000 persons, using hypothetical world standard population (Segi), increased from 1.9 in 1996 to 27.0 in 2010 in men, and from 10.6 to 111.3 in women, respectively. The estimated annual percentage changes (95% confidence interval) of age-standardized incidence rates were 27.1% (24.6-29.6) and 19.7% (16.4-23.2) for men and women, respectively, during the same period. The proportion of papillary-type thyroid cancer increased from 74.2 and 75.4% in 1996 to 97.9 and 98.3% in 2010 for men and women, respectively. We found the most prominent increasing trends and the highest incidence rate of thyroid cancer among those that have ever been reported. Thyroid cancer has been the leading cancer in women since 2003 and is now the fifth most common cancer in men in Gwangju and Jeonnam, South Korea.
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Affiliation(s)
- Sun-Seog Kweon
- *Department of Preventive Medicine, Chonnam National University Medical School, 160, Baekseok-ro, Dong-gu, Gwangju, South Korea.
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