Rising Incidence Of Thyroid Cancer Research Articles

Possibility of measuring serum taurine level as an early marker in the prognosis of thyroid disorders, especially thyroid cancer

People's awareness of thyroid diseases has gradually grown along with the gradual rise in thyroid cancer incidence. Thyroid dysfunction imposes a significant psychological burden on those who are diagnosed, as it affects most physiological processes. At the moment, ultrasonography and fine needle aspiration cytology are the primary methods used to diagnose thyroid cancer. There are still certain thyroid nodules that cannot be accurately and adequately classified as benign or malignant prior to surgery. Consequentially, we suggested using a more sensitive biomarker to diagnose thyroid cancer. Taurine is measured in the plasma of 60 patients from the National Cancer Institute and 10 healthy volunteers. After a full clinical examination, 20 patients were diagnosed with goitres, 20 with benign tumours, and 20 with malignant tumours. The results showed non-significant (P > 0.05) changes in the levels of TSH in all patients except in the goitre group (P < 0.001). Serum taurine levels exhibited values that significantly differed from normal (P< 0.05) for goitre and benign tumours and (P < 0.001) for malignant tumours. In conclusion, it would appear that taurine can be used as a sensitive biomarker in the early prognosis of thyroid cancer.

Somatostatin receptor imaging of thyroid tissue and differentiated thyroid cancer using gallium-68-labeled radiotracers-a review of clinical studies.

The rise in thyroid cancer incidence, especially papillary thyroid cancer (PTC), has underscored the need for improved diagnostic methods and management strategies. Herein, we aim to comprehensively review the evolving landscape in thyroid cancer diagnosis and the potential utility of Gallium-68 (Ga-68) based somatostatin receptor imaging. We reviewed the clinical studies involving Ga-68 based radiotracers by looking at the following literature databases -PUBMED, EMBASE, WEB OF SCIENCE and COCHRANE. We employed a detailed search strategy with the following search terms; PubMed: ("gallium Ga 68 dotatate" [Supplementary Concept]) AND ("Thyroid Gland"[Mesh] OR "Thyroid Nodule"[Mesh] OR "Thyroid Neoplasms"[Mesh]), Embase ("gallium 68" AND "Thyroid Disease"), Web of Science: ("Gallium 68 and Thyroid"). A comparison between Ga-68 DOTATATE and Ga-68 DOTANOC showed similar sensitivities but a higher uptake for Ga-68 DOTATATE. Studies comparing Ga-68-based SSTR PET with FDG PET highlighted the potential advantages of both approaches, with Ga-68-based SSTR PET being more specific in certain cases. Ga-68-based somatostatin receptor imaging displays clinical utility in RAI-R DTC, offering valuable insight into detecting skeletal lymph node metastases. Notably, it shows potential as a primary imaging tool, potentially augmenting the role of FDG PET. However, SSTR PET imaging's efficacy in distinguishing benign from malignant thyroid nodules varies, with a complex interplay of factors influencing its specificity, indicating its value as an adjunct to existing methods, warranting further research for a refined role in thyroid cancer management. Although study variations exist, Ga-based somatostatin receptor imaging holds potential as a complementary tool alongside diagnostic methods in thyroid cancer diagnosis, with particular relevance to RAI-R DTC. In carefully selected patients demonstrating the presence of Ga-68 DOTATATE avid lesions, further exploration, and investigation into the potential utilization of Lu177 DOTATATE are warranted.

Association of Helicobacter pylori Infection with Papillary Thyroid Carcinoma: A Case-control Study

Background: The thyroid nodules incidence has risen worldwide. Although factors such as increasing the use of imaging techniques and more rapid detection of small thyroid nodules have been implicated in the recent rise in thyroid cancer incidence, some environmental parameters such as infectious agents may be involved. Helicobacter pylori infection is an environmental risk factor, which may mimic the antigenic properties of membranes of thyrocytes. Objectives: This study aimed at evaluating the association of H. pylori infection with benign and malignant thyroid nodules in comparison with the control group. Methods: Patients with benign thyroid nodules, papillary thyroid cancer (PTC), and euthyroid healthy controls without thyroid nodules that had just been diagnosed were included in the study. All participants underwent clinical examination. Various biochemical parameters such as serum H. pylori Ab (IgG) and thyroid function tests were measured. Comparisons were made between groups. Results: Finally, 370 patients with benign thyroid nodules, 364 patients with PTC, and 360 healthy subjects without nodules participated as a control group. In the patients with PTC, the prevalence of H. pylori infection was 89.6%, while in the group of patients with benign thyroid nodules and the control group was 81.1% and 75%, respectively (P < 0.001). Helicobacter pylori antibody (Ab) titer was not significantly associated with any of the anthropometric and biochemical variables. Conclusions: Helicobacter pylori infection was significantly higher in patients with benign thyroid nodules and PTC than in the control group. Also, the rate of infection was significantly higher in the malignant nodule group than in the benign thyroid nodules group.

Incidence of Clinically Relevant Thyroid Cancers Remains Stable for Almost a Century: A Population-Based Study

ObjectiveTo examine the trends in incidence of clinically relevant thyroid cancers within the overall rising incidence of thyroid cancers. Patients and MethodsThis is a population-based cohort study conducted using the Rochester Epidemiology Project database to identify all new cases of thyroid cancer in Olmsted County, Minnesota, between January 1, 1935, and December 31, 2018. We extracted information about demographics and tumor pathologic type, size, and invasiveness. Clinically relevant cancers included aggressive histology or presence of metastatic disease, size larger than 4 cm, and gross extrathyroidal tumor invasion. ResultsBetween 1935 and 2018, 596 thyroid cancer cases were diagnosed (mean age, 46.4 years; 72% female; 87% papillary cancers; and median tumor size, 1.5 cm). The sex- and age-adjusted incidence of thyroid cancer increased from 1.3 per 100,000 person-years (p-y) from 1935–1949 to 12.0 per 100,000 p-y in 2010–2018, corresponding to an absolute change per decade of 1.4 (95% CI, 0.7 to 2.2). There was a nonsignificant period absolute change for patients with tumor greater than 4 cm (0.03; 95% CI, -0.2 to 0.3), with evidence of tumor invasion (0.1; 95% CI, -0.1 to 0.4), and with aggressive histology or presence of metastatic disease (0.2; 95% CI, -0.1 to 0.6). Thyroid cancer mortality was unchanged over the observation period. ConclusionIncidence rates of clinically relevant thyroid cancers, as defined by histology, size, and invasiveness, have not changed significantly in 80 years. The rising thyroid cancer incidence is driven by indolent thyroid cancers.

Thyroid cancer overdiagnosis revisited

BackgroundEvidence has accumulated showing that an increase in thyroid cancer incidence reflects overdiagnosis of clinically unimportant lesions due to the rise in the use of neck ultrasonography. In the manuscript we examine the hypothesis that the rise in thyroid cancer incidence in Russia is largely caused by overdiagnosis. Materials and methodsIncidence and mortality rates of thyroid cancer for Russia overall and its administrative regions were abstracted from the statistical database of the Ministry of Health of Russia. For incidence trends, we calculated the percentage change, linear regression coefficient and p-value. The calculation of excess cases was based on expected age-specific distributions assuming that the incidence of thyroid cancer increases exponentially with age, as predicted by the multistage model of carcinogenesis. FindingsOver the study period (1989–2015) the age standardized incidence of thyroid cancer has tripled in Russian women and doubled in men. Strong support for the hypothesis that the increase in thyroid cancer incidence may be artificial is evident from age-specific incidence trends: increases in incidence in middle age but not in older ages, thereby altering the age curves from the expected exponential shape to an “inverted U” shape. The number of observed cases of thyroid cancer exceeded the expected number by 138, 325 or 70 % of all cases diagnosed with thyroid cancer. We attribute the excess cases to detection by ultrasonography clinically unimportant lesions. This is supported by a very high incidence –to-mortality ratio, low case fatality, high and growing prevalence of thyroid cancer. ConclusionAlthough there is an evidence that exposure to iodine 131 (131I) is an important cause of the increase in incidence of thyroid cancer in high-risk populations, we have shown that this increase could largely be attributed to overdiagnosis associated with ultrasonography screening. Overdiagnosis is the only explanation of the increase in thyroid cancer incidence in low-risk regions.

Metabolic Factors Can Influence the Risk of Differentiated Thyroid Cancer

Abstract Introduction: Worldwide, the increasing incidence of thyroid cancer, along with a parallel increase in obesity and metabolic disorders, suggests that modifications of lifestyle and environmental factors might explain the rise in thyroid cancer incidence (1). Objective: To investigate the association between metabolic syndrome and their elements and their possible association with the risk of thyroid cancer. Materials and Methods: We enrolled 200 patients, who underwent total thyroidectomy for multinodular goiter (Bethesda II-V categories on the basis of fine needle aspiration biopsy cytological examination). We included subjects with differentiated thyroid carcinoma, the ones with poorly differentiated, anaplastic, medullary thyroid carcinomas and secondary tumors were excluded from the analysis. Patients were divided into two groups, according to the post-surgical histological diagnosis: 60 patients diagnosed with papillary or follicular thyroid cancer and 60 diagnosed with benign thyroid disease. The patients had a mean age of 56.9 years old and the majority were females (90%). Relative risk of incident thyroid cancer was assessed by preoperative levels of body mass index (BMI), blood pressure, blood levels of glucose, cholesterol, triglycerides, and the presence of metabolic syndrome (according to the NCEP ATP III definition). The two groups had similar age, gender distribution, smoking habit. Mean BMI was slightly higher in the group with patients with differentiated thyroid cancer and the majority were obese (27.41 ± 5.38 kg/m2versus 26.42 ± 5.18 kg/m2). The patients from the differentiated thyroid cancer group showed a higher percentage of diabetes mellitus and impaired fasting glucose compared to the second group (20% versus 13%), with mean fasting blood sugar levels of 97 ± 2.69 mg/dl in the first group versus 73 ± 3.06 mg/dl in the second group. 30% of the patients from the differentiated thyroid cancer group presented criteria for metabolic syndrome. There was a positive correlation between the presence of hypertension and the diagnosis of differentiated thyroid cancer (p<0.05). Conclusion: Our study showed a potential association between metabolic risk factors and the diagnosis of differentiated thyroid cancer. Besides the improvement of diagnosis, thyroid cancer increasing incidence is probably due to environmental factors and lifestyle modifications. As a future perspective of this study and based on the hypothesis of glucose dependency of many tumor types, another therapeutic strategy can involve diet (low-carbohydrate, high-fat) in order to target metabolism in tumors and alter the Walburg phenothype. Reference: (1). Mele, C., Samà, M. et al. (2019). Circulating adipokines and metabolic setting in differentiated thyroid cancer, Endocrine Connections, 8(7), 997-1006.

Transcriptome network of the papillary thyroid carcinoma radiation marker CLIP2

BackgroundWe present a functional gene association network of the CLIP2 gene, generated by de-novo reconstruction from transcriptomic microarray data. CLIP2 was previously identified as a potential marker for radiation induced papillary thyroid carcinoma (PTC) of young patients in the aftermath of the Chernobyl reactor accident. Considering the rising thyroid cancer incidence rates in western societies, potentially related to medical radiation exposure, the functional characterization of CLIP2 is of relevance and contributes to the knowledge about radiation-induced thyroid malignancies.MethodsWe generated a transcriptomic mRNA expression data set from a CLIP2-perturbed thyroid cancer cell line (TPC-1) with induced CLIP2 mRNA overexpression and siRNA knockdown, respectively, followed by gene-association network reconstruction using the partial correlation-based approach GeneNet. Furthermore, we investigated different approaches for prioritizing differentially expressed genes for network reconstruction and compared the resulting networks with existing functional interaction networks from the Reactome, Biogrid and STRING databases. The derived CLIP2 interaction partners were validated on transcript and protein level.ResultsThe best reconstructed network with regard to selection parameters contained a set of 20 genes in the 1st neighborhood of CLIP2 and suggests involvement of CLIP2 in the biological processes DNA repair/maintenance, chromosomal instability, promotion of proliferation and metastasis. Peptidylprolyl Isomerase Like 3 (PPIL3), previously identified as a potential direct interaction partner of CLIP2, was confirmed in this study by co-expression at the transcript and protein level.ConclusionIn our study we present an optimized preselection approach for genes subjected to gene-association network reconstruction, which was applied to CLIP2 perturbation transcriptome data of a thyroid cancer cell culture model. Our data support the potential carcinogenic role of CLIP2 overexpression in radiation-induced PTC and further suggest potential interaction partners of the gene.

Adiposity Is Associated with Rising Thyroid Cancer Incidence and Development of Larger Thyroid Cancers

Adiposity Is Associated with Rising Thyroid Cancer Incidence and Development of Larger Thyroid Cancers

Rising thyroid cancer incidence in Kerala: Is it real or over diagnosis?

e17589 Background: There has been an increase in the incidence of thyroid cancer in India and in high income countries. One of the reasons for this has been attributed to the large number of screening programs. Kerala state ranks second highest in the incidence of thyroid cancer in India. Screening provides the advantage of early detection of cancer and successful treatment but also tends to over diagnose. Methods: To study the trend of incidence of primary thyroid cancer among newly diagnosed cancer patients and its association with the mode of detection, we retrospectively reviewed hospital based cancer registry data of patients with thyroid cancer who were treated at AIMS (Amrita Institute of Medical Sciences), Kochi between 2004-2014. All patients who were newly diagnosed with primary thyroid cancer at our center or referred to us after initial surgery were included in this analysis. Patients with recurrent cancer/metastases were excluded. Results: We analyzed the records of 2,315 newly diagnosed thyroid cancer patients. Median age was 44.1yrs (range 13-90yrs). There were 619 males and 1696 females. Papillary type was the most common 85.8% followed by follicular type 7.4%. 1235 cases were operated at AIMS. 74 cases (3.2%) were diagnosed incidentally by Ultrasonography/PET scan/CT scan. All others (97% n = 2,245) presented with neck swelling. It was seen that the proportion of new cases of thyroid cancer among all new cancer cases was increasing serially from 4.6 % (n = 106, 95% 2004) to 7.4% (n = 195) to13.7% (n = 317, 2014). There was a significant increase in the number of cases of T1a and T1b at the time of diagnosis during the study period (n = 1235, p value < 0.001 and p value for trend < 0.001 respectively) which indicates that there was early diagnosis. 97% of the cases presented with thyroid related symptoms indicating that clinical presentation has still been the main mode of detection in our series. Conclusions: Our data shows that there may be a true increase in the number of cases of thyroid cancer as majority presented with clinical symptoms, except few detected incidentally. As it is a single institution based data we need further studies to see if over use of USG based imaging for any thyroid swelling is responsible for an apparent increase in the number of thyroid cancer cases.

Rising Thyroid Cancer Incidence in Southern India: An Epidemic of Overdiagnosis?

Background:Thyroid cancer incidence is rising in high-income countries. This increase in disease burden is attributed to the phenomenon of overdiagnosis.Objective:We aimed to investigate trends in thyroid cancer rates in India, focusing on the state of Kerala in southern India, which has reported a high incidence of the disease.Design:Population-based study using data from the National Cancer Registry Program.Participants:We used data from the Population Based Cancer Registries for Thiruvananthapuram (capital of Kerala state), Delhi, Mumbai, Bangalore, and Chennai. We used data for three reporting periods from 2005 to 2014 (represented as 2006, 2009, and 2012).Main Outcome Measures:We reported the age-adjusted incidence rate (AARi) and mortality rate (AARm) per 100,000 women and the proportion of thyroid cancers diagnosed in females per 100 cancer cases.Results:During 2006, the AARi for thyroid cancer in women in Thiruvananthapuram was 6.9 per 100,000, rising to 10 in 2009 and 13.3 in 2012. There was a 93% increase in incidence rates over less than a decade. The AARis in the other four cities were stable. In 2012, Thiruvananthapuram had at least a fourfold higher incidence compared with other regions. Thyroid was the primary site in one of every 10 cancers diagnosed in Thiruvananthapuram, and large numbers of patients were <40 years of age. The AARm remained stable in all regions.Conclusion:We reported a high burden of thyroid cancer in Kerala, India, which is most likely due to overdiagnosis.

Lower Rates of Residual/Recurrent Disease in Patients With Incidentally Discovered Thyroid Carcinoma

Incidentally discovered thyroid cancers (IDTCs) have contributed to the rapid rise in thyroid cancer incidence over the past 20 years. Since death rates from thyroid cancer are not increasing, we hypothesized that IDTCs are less aggressive compared to clinically apparent thyroid cancer (CATC). A retrospective study of patients and tumor characteristics of IDTCs and their rates of residual/recurrent (R/R) disease were determined at a median follow-up of 27 months in the setting of a large academic medical center. Patient analysis groups (IDTC [n = 46] and CATC [n = 126]) were based upon how the cancer was initially discovered. Patients were followed clinically and by biochemical testing and ultrasonography. We also compared time to progression between these groups. Patients in the two groups had similar demographic and tumor characteristics. At the close of the study, R/R status in the IDTC group was 6.7%, compared to 20.8% in the CATC group (P = .04). Of the 28 individuals in our overall cohort who had R/R disease, 3 were from the IDTC group and 25 were from the CATC group (P = .04). All three of the IDTC recurrences occurred within the first 6 months of follow-up. Using Kaplan-Meier analysis, there was a nonsignificant trend for longer progression-free survival in the IDTC group (P = .08). Compared to CATC patients, IDTC patients have a significantly less aggressive course and a trend toward longer progression-free survival. If confirmed by further studies, it may be reasonable to subject them to less intense surveillance and more conservative therapeutic approaches. CATC = clinically apparent thyroid cancers CT = computed tomography HMH = Houston Methodist Hospital IDTC = incidentally discovered thyroid cancer MRI = magnetic resonance imaging PET = positron emission tomography PTMC = papillary thyroid microcarcinoma R/R = residual/recurrent RRA = radioiodine remnant ablation Tg = thyroglobulin TgAb = anti-thyroglobulin antibody TSH = thyroid-stimulating hormone US = ultrasonography.

Rising Thyroid Cancer Incidence Proximate to a New York City-Area Nuclear Power Plant

Thyroid cancer incidence has risen steadily in the US for several decades. While any cause of this trend has yet to be clearly identified, most analyses have concluded that there are factors other than improved detection accounting for the increase. Since exposure to radioactive iodine is the only acknowledged root cause of thyroid cancer, a review of temporal trends in incidence since the late 1970s near the Indian Point nuclear power plant, just 23 miles from the New York City border, was conducted. Rates in the four counties closest to Indian Point, where virtually the entire population resides within 20 miles of the plant, were compared with national trends in the US. The relative ratio in the local area was 0.778 in the period 1976-1981, or 22.2 percent lower than the national rate. This ratio increased steadily, to 1.579 (57.9 percent greater than the US) by the period 2000-2004, which slightly declined to 1.515 (51.5 percent greater) in the latest period available (2010-2014). Significant increases occurred for both males and females, and in each of the four counties. Annual new cases diagnosed among residents of the four counties increased from 51 to 412 between 1976-1981 and 2010-2014. Because the two large reactors at Indian Point began operations in 1973 and 1976, and exposures to radioiodine isotopes can manifest as cancer from five years to several decades after exposure, iodine emissions from Indian Point emissions should be considered as a potential factor in these trends. More studies near Indian Point and other nuclear installations should be conducted to further explore this potential association.

Practical Barriers to Implementation of Thyroid Cancer Guidelines in the Asia-Pacific Region

Numerous published guidelines have described the optimal management of thyroid cancer. However, these rely on the clinical availability of diagnostic and therapeutic modalities. We hypothesized that the availability of medical resources and economic circumstances vary in Asia-Pacific countries, making it difficult to implement guideline recommendations into clinical practice. We surveyed participants at the 2009 and 2013 Congresses of the Association of Southeast Asian Nations Federation of Endocrine Societies by distributing questionnaires to attendees at registration. Responses were obtained from 268 respondents in 2009 and 163 respondents in 2013. Similar to the high prevalence of low-risk thyroid cancer observed in the Surveillance, Epidemiology, and End Results database, across the Asia-Pacific countries surveyed in 2009 and 2013, 50 to 100% of the respondents from the Philippines, Malaysia, Singapore, China, Taiwan, Thailand, Hong Kong, Korea, and Sri Lanka reported that more than 50% of the patients had low-risk thyroid cancer on follow-up. Importantly, there was much variation with regards to the perceived availability of investigation and treatment modalities. We found a wide variation in clinicians' perception of availability of diagnostic and therapeutic modalities in the face of a rise in thyroid cancer incidence and thyroid cancer management guidelines that emphasized their importance. The lack of availability of management tools and treatments will prove to be a major barrier to the implementation of thyroid cancer management guidelines in Southeast Asia, and likely in other parts of the world as well.

Thyroid Cancer Epidemic: A Peril or an Alarm?

Thyroid Cancer Epidemic: A Peril or an Alarm?

The Impact of Diagnostic Changes on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Selected High-Resource Countries.

Thyroid cancer (TC) incidence is rising in many countries, but the corresponding mortality is constant or declining. Incidence increases appear largely restricted to small papillary TC in young/middle-age individuals. We compared age-specific incidence rates across countries and time periods in order to estimate the fraction of TC possibly attributable to increased surveillance of the thyroid gland (diagnostic changes) following the introduction of neck ultrasonography in the 1980s. We focused on high-resource countries, including four Nordic countries, England and Scotland, France, Italy, the United States, Australia, Japan, and the Republic of Korea. Before the 1970s, TC incidence in Nordic countries increased proportionally to the second power of age, consistent with the multistage model of carcinogenesis. Using this historical observation for reference, we attributed the progressive departure from linearity of the age curves in each country to an increased detection of asymptomatic disease in young/middle-age individuals. The proportion of cases attributable to diagnostic changes was estimated from the difference between observed rates and those expected using the Nordic countries as reference. Diagnostic changes may account for ≥60% of TC cases diagnosed in 2003-2007 in women aged under 80 years in France, Italy, the United States, Australia, and the Republic of Korea, and approximately 50% in other assessed countries, except Japan (30%). The proportions attributable to diagnostic changes were higher in countries with largest incidence increases and were consistent across sexes, although increases were smaller and delayed in men. A large proportion of TC cases diagnosed in high-resource countries in the last two decades are likely to be due to diagnostic changes. This proportion has progressively increased over time, and it is likely to grow further in the future. Since there is evidence of harm but no proof of benefit from the intense scrutiny of the thyroid, the dangers of overdiagnosis and overtreatment of TC should be urgently addressed.

The Impact of Subclinical Disease and Mechanism of Detection on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Olmsted County, Minnesota During 1935 Through 2012.

An ongoing epidemic of thyroid carcinoma (TC) has affected Americans since 1975. Understanding the contribution of subclinical disease and the mechanism of such disease detection may help to alter the course of this epidemic. We used Rochester Epidemiology Project resources to examine the incidence of TC cases, disease specific mortality, and method of diagnosis during 1935 through 2012. During 2000-2012, we also extracted the mechanism of detection of clinically occult tumors. The age-adjusted incidence (AAI) for TC increased from 7.1 [95% confidence interval (CI) 5.5-8.8] per 100,000 person-years (p-y) during 1990-1999 to 13.7 [CI 11.8-15.6] per 100,000 p-y during 2000-2012, with no change in disease-specific mortality since 1935. The incidence trend analysis stratified by the mechanism of detection revealed the AAI of clinically recognized TC was 5.5 per 100,000 p-y [CI 3.4-7.5] in 1960-1969, a rate similar to the incidence seen during 2000-2012. However, AAI of clinically occult TC increased from 0.2 per 100,000 p-y [CI 0.0-0.6] in 1935-1949 to 1.9 per 100,000 p-y [CI 1.2-2.9] in 1990-1999 and to 7.4 per 100,000 p-y [CI 6.0-8.8] in 2000-2012. During 2000-2012, the most frequent reasons for recognition of "occult" tumors were (1) incidental discovery during diagnostic neck imaging in 40 (19%), (2) pathology review of specimens from thyroid surgery for benign conditions in 29 (14%), and (3) investigations of patients with symptoms or palpable nodules that were clearly not associated with coexistent but occult TC but triggered the use of diagnostic neck imaging in 37 (27%). In this population-based study conducted in Olmsted County, Minnesota, the rapid increased incidence of TC during 2000-2012 can be completely attributed to the increased diagnosis of occult TCs, which are mainly found through the use of diagnostic neck imaging. The incidence of clinical TC and disease-specific TC mortality remains stable since 1970, implying that the observed increased incidence is due to the increased detection of subclinical lesions.

Increasing thyroid cancer incidence in Queensland, Australia 1982-2008 - true increase or overdiagnosis?

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. 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. Thyroid cancer ASR in Queensland increased from 2·2 to 10·6/100000 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. 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.

Thyroid cancer incidence in New Jersey: time trend, birth cohort and socioeconomic status analysis (1979-2006).

The study's purpose was to investigate thyroid cancer incidence time trends, birth cohort effects, and association with socioeconomic status (SES) in New Jersey (NJ), a high incidence state, using NJ State Cancer Registry data. Thyroid cancer incidence rates in each sex, nearly all age groups, two major histologies and all stages significantly increased between 1979 and 2006. For each sex, age-specific incidence rates began greatly increasing in the 1924 birth cohort and, generally, the highest thyroid cancer incidence rate for each five-year age group occurred in the latest birth cohort and diagnosis period. Thyroid cancer incidence rates were significantly higher in NJ Census tracts with higher SES and in counties with a higher percentage of insured residents. These results support further investigation into the relationship between rising thyroid cancer incidence and increasing population exposure to medical (including diagnostic) radiation, as well as widespread use of more sensitive diagnostic techniques.

Abstract LB-390: Thyroid cancer incidence trends by gender and histology in Sao Paulo, Brazil, 1997-2005

Abstract Thyroid cancer incidence has been increasing steadily in much of the developed world, but there is limited information on trends in the developing world. The overall rise in thyroid cancer incidence varies by gender, race/ethnicity, and geographic location, with the largest increases found among women and white non-Hispanics. Where histology is available, this increase has been accompanied by a change in the distribution of histological types, with a particular increase in papillary thyroid cancer. Sao Paulo, Brazil is the largest registry in Brazil and covers has one of the ten highest rates of thyroid cancer incidence worldwide, and has the highest rate among Brazilian registries. The Sao Paulo Registry covers about 15 million people in the region. Approximately 1000 new thyroid cancer cases are documented each year in Sao Paulo. This large number of cases presents the opportunity to evaluate trends in thyroid cancer incidence in a Latin American population. Using 12,495 cases reported between 1997 and 2005 to the Sao Paulo Cancer Registry, we analyzed thyroid cancer incidence patterns by gender and histology using Joinpoint analysis to calculate the annual percentage change (APC) in incidence, adjusting for age (standard world population). We found that females made up the vast majority of cases (87%) compared with males (13%). Papillary was the most common histology (74.7%), followed by follicular (17.3%), medullary (4%), and other (4%) among 77% of cases with histological confirmation. Overall incidence rates increased for both males and females, with a larger APC for females (+7.7%) compared with males (+6.6%). The greatest increases were seen for papillary and follicular histologies for both sexes. Rates increased most for females and males greater than 50 years of age compared with those 50 years or younger. Mortality rates remained relatively constant. These findings suggest that incidence rates of thyroid cancer are increasing in Sao Paulo, following a similar trend as seen in many developed countries. Further research looking at tumor stage and size could help to understand the potential causes of this increase. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-390.

Geographic Variation in U.S. Thyroid Cancer Incidence and a Cluster Near Nuclear Reactors in New Jersey, New York, and Pennsylvania

In the United States, thyroid cancer incidence (along with liver cancer) is increasing more rapidly than any other malignancy, rising nearly threefold from 1980 to 2006. Improved diagnosis has been proposed by some as the major reason for this change, while others contend that additional factors also account for the increase. Among U.S. states, 2001-2005 age-adjusted thyroid cancer incidence rates vary from 5.4 to 12.8 per 100,000. County-specific incidence data, available for the first time, document that most U.S. counties with the highest thyroid cancer incidence are in a contiguous area of eastern Pennsylvania, New Jersey, and southern New York State. Exposures to radioactive iodine emissions from 16 nuclear power reactors within a 90-mile radius in this area indicate that these emissions are a likely etiological factor in rising thyroid cancer incidence rates.