AACE/ACE Disease State Clinical ReviewAmerican Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: The Increasing Incidence of Thyroid Cancer
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INTRODUCTION
Thyroid cancer has been much in the news lately because of reports of large increases in incidence. However, it is now recognized that not all pathologic entities labeled as cancer act similarly, nor do they all act aggressively. Also, it is increasingly recognized that measures of incidence, mortality, and survival may be fnected by many epidemiologic factors and may not always be reflective of either true increases in disease, treatment successes, or screening efforts (1). A current example
Epidemiologic Data
Data on the incidence of thyroid cancer are from SEER 9 (Surveillance, Epidemiology and End Results) Program, supported by the National Cancer Institute, from 1975 to 2011. SEER 9 covers approximately 10% of the U.S. population and includes the longest contributing sites to the program: Atlanta, Connecticut, Detroit, Hawaii, Iowa, New Mexico, San Francisco-Oakland, Seattle-Puget Sound, and Utah. SEER is the best source of population-based data available in the U.S. for cancer incidence,
Part I: Current Epidemiology of Thyroid Cancer in the U.S.
In 2014, it was estimated that there would be 62,980 new cases of thyroid cancer in the U.S. Thyroid cancer accounts for about 3.8% of new cancers diagnosed each year in the U.S. and is the ninth most common in incidence after prostate, breast, lung, colon, melanoma of the skin, bladder, non-Hodgkin's lymphoma, and renal cancer. Deaths due to thyroid cancer are uncommon. It was estimated that there would be an estimated 1,890 deaths due to thyroid cancer in the U.S. in 2014. The more common
DISCUSSION
The incidence of thyroid cancer has tripled over the past 30 years, with the majority of the rise occurring in the past 15 years. The overwhelming majority of the increase has been due to the increased detection of papillary cancer, a histologic type known to be commonly present at death without ever having caused symptoms. Tumors of all sizes have increased in incidence, but in absolute and relative terms the greatest increase has been observed in cancers less than 2 cm in size. Throughout,
CONCLUSION
Research should focus on illuminating which thyroid cancers need treatment. Patients should be advised of the benefits as well as harms that can occur with treatment of incidentally identified, small, asymptomatic thyroid cancers.
ACKNOWLEDGMENT
Dr. Davies received support from the Department of Veterans fnairs; Dr. Haymart received support from the National Institutes of Health (1K07CA154595-02).
REFERENCES (64)
- et al.
Incidence and histopathological behavior of papillary microcarcinomas: study of 429 cases
Otolaryngol Head Neck Surg
(2008) - et al.
American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations
Endocr Pract
(2010) - et al.
Medical exposure to radiation and thyroid cancer
Clin Oncol (R Coll Radiol)
(2011) - et al.
Patient risk related to common dental radiographic examinations: the impact of 2007 International Commission on Radiological Protection recommendations regarding dose calculation
J Am Dent Assoc
(2008) - et al.
Thyroid malignancy in endemic nodular goitres: prevalence, pattern and treatment
Eur J Surg Oncol
(2001) - et al.
Overdiagnosis in cancer
J Natl Cancer Inst
(2010) International Classification of Diseases for Oncology
(2000)- Cancer Fast Stats, National Cancer Institute. Available at: http://seer.cancer.gov/faststats/. Accessed April 9,...
- et al.
Increasing incidence of thyroid cancer in the United States, 1973–2002
JAMA
(2006) - et al.
Increasing incidence of differentiated thyroid cancer in the United States, 1988–2005
Cancer
(2009)
Current thyroid cancer trends in the United States
JAMA Otolaryngol Head Neck Surg
The increase in thyroid cancer incidence during the last four decades is accompanied by a high frequency of BRAF mutations and a sharp increase in RAS mutations
J Clin Endocrinol Metab
Higher rate of BRAF mutation in papillary thyroid cancer over time: a single-institution study
Cancer
Occult papillary carcinoma of the thyroid. A “normal” finding in Finland. A systematic autopsy study
Cancer
Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods
Cancer
Gross and microscopic findings in clinically normal thyroid glands
J Clin Endocrinol Metab
Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules
J Ultrasound Med
The increasing incidence of thyroid cancer: the influence of access to care
Thyroid
Thyroid cancer is the most common cancer in women, based on the data from population-based cancer registries, South Korea
Jpn J Clin Oncol
Current status of thyroid cancer screening in Korea: results from a nationwide interview survey
Asian Pac J Cancer Prev
The incidence of thyroid cancer is affected by the characteristics of a healthcare system
J Korean Med Sci
Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996–2010
JAMA
Thyroid nodules and thyroid cancer
West J Med
Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer
Thyroid
Epidemiological and economic trends in inpatient and outpatient thyroidectomy in the United States, 1996–2006
Thyroid
Principles and Techniques of Surgical Pathology
Protocol for the examination of specimens from patients with carcinomas of the thyroid gland
College of American Pathologists Protocols
Diagnostic changes as a reason for the increase in papillary thyroid cancer incidence in Geneva, Switzerland
Cancer Causes Control
Observer variation in the diagnosis of follicular variant of papillary thyroid carcinoma
Am J Surg Pathol
Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005
Cancer Epidemiol Biomarkers Prev
Thyroid cancers detected by imaging are not necessarily small or early stage
Thyroid
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DISCLOSURE
The authors have no multiplicity of interest to disclose.
The opinions represented in the AACE/ACE Disease State Clinical Review: The Increasing Incidence of Thyroid Cancer are the expressed opinions of the Endocrine Surgery Scientific Committee of the American Association of Clinical Endocrinologists. AACE/ACE Disease State Clinical Reviews are systematically developed documents written to assist health care professionals in medical decision making for specific clinical conditions, but are in no way a substitute for a medical professional's independent judgment and should not be considered medical advice. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment of the authors was applied.
This review article is a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with, and not a replacement for, their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances.