Abstract

We evaluated the spatial variation in thyroid cancer incidence and its determinants in Korea considering its importance in cancer prevention and control. This study was based on the ecological design with cancer incidence data by administrative district from the National Cancer Center and regional characteristics generated from the Korea Community Health Survey Data. We identified spatial clusters of thyroid cancer incidences based on spatial scan statistics. Determinants of regional variation in thyroid cancer incidence were assessed using the Besag-York-Mollie model with integrated nested Laplace approximations. Spatial clusters for low and high thyroid cancer incidences were detected in the northeastern and southwestern regions, respectively. Regional variations in thyroid cancer incidence can be attributed to the prevalence of recipients of basic livelihood security (coefficient, − 1.59; 95% credible interval [CI], − 2.51 to − 0.67), high household income (coefficient, 0.53; 95% CI, 0.31 to 0.76), heavy smoking (coefficient, − 0.91; 95% CI, − 1.59 to − 0.23), thyroid dysfunction (coefficient, 3.24; 95% CI, 1.47 to 5.00), and thyroid cancer screening (coefficient, 0.38; 95% CI, 0.09 to 0.67). This study presented the spatial variations in thyroid cancer incidence, which can be explained by the prevalence of socioeconomic factors, thyroid cancer screening, thyroid dysfunction, and smoking.

Highlights

  • We evaluated the spatial variation in thyroid cancer incidence and its determinants in Korea considering its importance in cancer prevention and control

  • Hot spots and cold spots for thyroid cancer incidence were confirmed in the northwest and northeast regions, respectively. These regional variations in thyroid cancer incidence can be partially explained by regional distribution of the prevalence of recipients of basic livelihood security, household income, smoking, thyroid dysfunction, and thyroid cancer screening

  • We found that regions with a high prevalence of thyroid cancer screening were linked to high thyroid cancer incidence in this study

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Summary

Introduction

We evaluated the spatial variation in thyroid cancer incidence and its determinants in Korea considering its importance in cancer prevention and control. Spatial clusters for low and high thyroid cancer incidences were detected in the northeastern and southwestern regions, respectively. Several studies have been conducted using this tool to assess regional variations in thyroid cancer incidence and to identify its determinants for health i­mprovement[6,7,8,9]. These studies were limited in that analyses considering spatial autocorrelation were not performed, nor were major potential determinants that are wellknown risk factors for thyroid cancer, such as radiation e­ xposure10, ­obesity[11], and thyroid conditions (such as autoimmune ­thyroiditis[12] and ­goiter13), comprehensively considered. The limitations of the study were as follows: (1) district units considered to draw conclusions regarding regional variation in thyroid cancer incidence and its determinants were extremely large and (2) potential determinants except for thyroid cancer screening were not considered

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