Incidence and prognosis of thyroid cancer in children: based on the SEER database

Bing Zhang,Wenming Wu,Xiaofei Shang,Mingbo Liu,Deliang Huang,Liang Zong

doi:10.1007/s00383-022-05069-3

Abstract

ObjectiveTo update the recognition of the trends in the incidence of childhood thyroid cancer (TC) and its prognosis.MethodsA large-scale sample based on long time-line public database was recruited. Join-point regression model was used to analyze the incidence trend of childhood TC. Univariable and multivariable Cox regression model analyses were applied to explore the survival situation and prognostic factors.ResultsThe incidence rate of childhood TC increased between 1975 and 2016 from 3.8/million (95% CI 2.6–5.5) to 11.5/million (95% CI 9.2–14.1), AAPC = 2.38% (95% CI 1.98–9.65) and could be divided into two stages of increasing trends. The incidence rate of Trend1 (1975–2005) increased slowly (APC = 1.08%, 95% CI 0.38–1.82) while Trend2 (2005–2016) increased dramatically (APC = 6.77%, 95% CI 4.30–9.28). Annual incidence rate of small size tumor (< 4 cm) and local stage childhood TC increased significantly. The overall cumulative survival rate for childhood TC was high up to 97–99%. Males, black race, MTC type, distant metastasis, tumor size ≥ 4 cm, non-primary cancer were the independent risk factors of childhood TC prognosis.ConclusionA contribution of overdetection to rising pediatric TC rates might not be able to rule out. For clinical implications, screening TC in children with potential specific risk factors is feasible. Over-treatment to small size and local stage TC in children should be avoided.

Highlights

Thyroid cancer (TC) is a common endocrine malignant tumor in both adults and children whose incidence has been increasing steadily for decades in the world [1, 2]
Classic Papillary Thyroid Cancer (C-PTC), Variant Papillary Thyroid Cancer (V-PTC), and FTC were classified as differentiated TC (DTC) while MTC and ATC were recognized as undifferentiated TC (UTC)
Age 0–9 group consisted of 213 cases, accounting for 4.90% of the overall subjects; age 10–14 group consisted of 904 cases (20.82%); age 15–19 group consisted of 3,226 cases (74.28%)

Summary

Introduction

Thyroid cancer (TC) is a common endocrine malignant tumor in both adults and children whose incidence has been increasing steadily for decades in the world [1, 2]. TC is likely to be over-diagnosed among adults [5, 6], children are less frequent to receive thyroid screening or imaging examinations of the neck [7, 8]. Studying the incidence trend of childhood TC might better reflect the prevalence of this disease in the population. Some types of childhood TC are more prone to have lymph node metastasis than in adults, with a wider range of lesions and leading a worse prognosis [9, 10]. Many studies have reported the incidence and prevalence of TC in children and adolescents worldwide, with the age ranges from 0 to 20 years [11–13]. Most of the researches focus on exploring risk factors and the survival rate for childhood TC but pay less attentions to the prognosis factors on account of the very low mortality [14–18]

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Discussion

Conclusion