Background

Thyroid cancer incidence rates have increased in many countries and settings; however, mortality rates have remained stable at lower rates. This epidemiological pattern has been largely attributed to an overdiagnosis effect. Timely evidence for the global epidemiological status is necessary to identify the magnitude of this problem and the areas mostly affected by it. We therefore aimed to provide an up-to-date assessment on the global distribution of thyroid cancer incidence and mortality rates in 2020.

Methods

We extracted age-standardised incidence and mortality rates per 100 000 person-years of thyroid cancer as defined by the International Classification of Diseases for Oncology 10th Revision (code C73), for 185 countries or territories by sex and 18 age groups (ie, 0–4, 5–9, …, 80–84, and ≥85 years) from the GLOBOCAN database. Both incidence and mortality estimates were presented by country and aggregated across the 20 UN-defined world regions and according to the UN's four-tier Human Development Index (ie, low, medium, high, and very high) in 2020.

Findings

Globally, in 2020, the age-standardised incidence rates of thyroid cancer were 10·1 per 100 000 women and 3·1 per 100 000 men, and age-standardised mortality rates were 0·5 per 100 000 women and 0·3 per 100 000 men. In both sexes, incidence rates were five times higher in high and very high Human Development Index countries than in low and medium Human Development Index countries, whereas mortality rates were relatively similar across different settings. Incidence rates in women differed by more than 15 times across world regions, with the highest incidence rates being in the Federated States of Micronesia and French Polynesia (18·5 per 100 000 women), North America (18·4 per 100 000), and east Asia (17·8 per 100 000, with South Korea reaching 45 per 100 000). Mortality rates were less than one per 100 000 in most countries and in both sexes. South Korea had the highest incidence-to-mortality rate ratio in both sexes, followed by Cyprus and Canada.

Interpretation

The current thyroid cancer epidemiological landscape is strongly suggestive of a large effect of overdiagnosis in many countries and settings worldwide, confirming the relevance of thyroid cancer overdiagnosis as a global public health problem.

Funding

None.

中文翻译：

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全球甲状腺癌流行病学概况：GLOBOCAN 对 2020 年发病率和死亡率的估计

背景

许多国家和地区的甲状腺癌发病率有所增加；然而，死亡率一直保持在较低的水平。这种流行病学模式主要归因于过度诊断效应。全球流行病学状况的及时证据对于确定这一问题的严重程度以及受其影响最大的地区是必要的。因此，我们的目标是对 2020 年甲状腺癌发病率和死亡率的全球分布进行最新评估。

方法

我们提取了国际肿瘤疾病分类第 10 版（代码 C73）定义的每 10 万人年甲状腺癌的年龄标准化发病率和死亡率，按性别划分的 185 个国家或地区和 18 个年龄组（即 0 –4、5–9、…、80–84 和 ≥85 岁）来自 GLOBOCAN 数据库。发病率和死亡率估计值均按国家和联合国定义的 20 个世界区域汇总，并根据联合国 2020 年的四级人类发展指数（即低、中、高和非常高）。

发现

在全球范围内，2020 年甲状腺癌的年龄标准化发病率为每 10 万女性 10·1 和每 10 万男性 3·1，年龄标准化死亡率为每 10 万女性 0·5 和每 10 万女性 0·3 100 000 人。在两性中，人类发展指数高和极高国家的发病率是人类发展指数低和中等国家的五倍，而不同环境下的死亡率相对相似。世界各地女性的发病率差异超过 15 倍，其中密克罗尼西亚联邦和法属波利尼西亚的发病率最高（每 10 万女性 18·5）、北美（每 10 万女性 18·4）、和东亚（每 10 万人中有 17·8 人，韩国达到每 10 万人中 45 人）。大多数国家和男女的死亡率低于十万分之一。

解释

目前的甲状腺癌流行病学情况强烈暗示过度诊断在全球许多国家和环境中的巨大影响，证实了甲状腺癌过度诊断作为全球公共卫生问题的相关性。

资金

没有任何。