Abstract

BACKGROUND: Thyroid cancer incidence has significantly increased in the United States over the past few decades. Recent studies have suggested a change in thyroid cancer incidence trends following 2013. The objective of this study was to update the data on thyroid cancer incidence and mortality trends in the US.METHODS: Thyroid cancer incidence and incidence-based mortality trends were evaluated using the Surveillance, Epidemiology, and End Results-18 cancer registry. Cases of thyroid cancer diagnosed in 2000-2018, and thyroid cancer deaths during 2000-2018 were included. Annual percent change (APC) was calculated using joinpoint regression analysis.RESULTS: Among 197,070 patients, female (75.6%) and white (81.0%) patients comprised the majority of cases. Papillary thyroid carcinoma (PTC) was the most common histology (89.1%). Incidence rates increased during 2000 - 2009 (APC 6.80, 95% CI 6.46 to 7.13) and 2009-2014 (APC 2.58, 95% CI 1.71 to 3.47), then decreased during 2014-2018 (APC -2.33, 95% CI -3.15 to -1.51). The incidence trends for PTC overall, localized disease, and tumors = 1.0 cm mirrored the overall thyroid cancer trends, while incidence rates for regional disease stabilized during 2015-2018 (APC -1.65, 95% CI -4.09 to 0.84). The incidence of distant disease decreased during 2015-2018 (APC (APC -17.86, 95% CI -26.47 to -8.25). The incidence of tumors = 1.0 cm decreased (APC -5.83, 95% CI -7.24 to -4.40), while the incidence of tumors 1.1 - 2.0 cm (APC -0.10, 95% CI -1.16 to 0.96), 2.1 - 4.0 cm (APC 1.12, 95% CI -0.17 to 2.43), and > 4.0 cm (APC -1.13, 95% CI -4.58 to 2.45) stabilized during the most recent 4 - 6 years. Incidence-based mortality increased throughout 2000-2018 (average APC 1.35, 95% CI 0.88 to 1.82).CONCLUSION: Thyroid cancer incidence rates have declined since 2014. Similar declines are noted for PTC, localized disease, and tumors = 1.0 cm, but not for tumors > 2.0 cm. Incidence-based mortality rates continue to increase. These findings suggest that changing patterns in the management of thyroid nodules may have led to a decrease in diagnosis of small indolent tumors, but not more advanced tumors.

View details for DOI 10.1089/thy.2021.0662

View details for PubMedID 35132899