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Cited by 2,159Thyroid Cancer Diagnosis and TreatmentGlobal Cancer Incidence and ScreeningThyroid and Parathyroid Surgery

Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013

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Lim, Hyeyeun, Devesa, Susan S., Sosa, Julie A., Check, David, Kitahara, Cari M.·2017·JAMA
DOI 10.1001/jama.2017.2719PMC PMC8216772
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Abstract

Importance: Thyroid cancer incidence has increased substantially in the United States over the last 4 decades, driven largely by increases in papillary thyroid cancer. It is unclear whether the increasing incidence of papillary thyroid cancer has been related to thyroid cancer mortality trends. Objective: To compare trends in thyroid cancer incidence and mortality by tumor characteristics at diagnosis. Design, Setting, and Participants: Trends in thyroid cancer incidence and incidence-based mortality rates were evaluated using data from the Surveillance, Epidemiology, and End Results-9 (SEER-9) cancer registry program, and annual percent change in rates was calculated using log-linear regression. Exposure: Tumor characteristics. Main Outcomes and Measures: Annual percent changes in age-adjusted thyroid cancer incidence and incidence-based mortality rates by histologic type and SEER stage for cases diagnosed during 1974-2013. Results: Among 77 276 patients (mean [SD] age at diagnosis, 48 [16] years; 58 213 [75%] women) diagnosed with thyroid cancer from 1974-2013, papillary thyroid cancer was the most common histologic type (64 625 cases), and 2371 deaths from thyroid cancer occurred during 1994-2013. Thyroid cancer incidence increased, on average, 3.6% per year (95% CI, 3.2%-3.9%) during 1974-2013 (from 4.56 per 100 000 person-years in 1974-1977 to 14.42 per 100 000 person-years in 2010-2013), primarily related to increases in papillary thyroid cancer (annual percent change, 4.4% [95% CI, 4.0%-4.7%]). Papillary thyroid cancer incidence increased for all SEER stages at diagnosis (4.6% per year for localized, 4.3% per year for regional, 2.4% per year for distant, 1.8% per year for unknown). During 1994-2013, incidence-based mortality increased 1.1% per year (95% CI, 0.6%-1.6%) (from 0.40 per 100 000 person-years in 1994-1997 to 0.46 per 100 000 person-years in 2010-2013) overall and 2.9% per year (95% CI, 1.1%-4.7%) for SEER distant stage papillary thyroid cancer. Conclusions and Relevance: Among patients in the United States diagnosed with thyroid cancer from 1974-2013, the overall incidence of thyroid cancer increased 3% annually, with increases in the incidence rate and thyroid cancer mortality rate for advanced-stage papillary thyroid cancer. These findings are consistent with a true increase in the occurrence of thyroid cancer in the United States.

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  • The incidence of non-MTC has tripled in the last three decades (from 5 to 15 per 100,000 persons), driven mainly by overdiagnosis and increased detection of low-risk thyroid cancer.

    “The incidence of non-MTC has tripled in the last three decades (from 5 to 15 per 100,000 persons), driven mainly by overdiagnosis and increased detection of low-risk thyroid cancer that will otherwise lead to no patient harm if it remained undiagnosed.39,40”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [40]

    The Results report that overall thyroid cancer incidence rose from 4.56 to 14.42 per 100,000 between 1974–77 and 2010–13, and the Discussion identifies overdiagnosis as the dominant explanation for rising papillary thyroid cancer incidence. The cited figures cover all thyroid cancers, including MTC, over roughly four decades—not specifically non-MTC over three decades. The Discussion also notes a smaller possible real increase in incidence. (LLM, conf=0.87)

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  • Thyroid cancer diagnosis is an outcome prone to over-detection owing to medical surveillance.

    “In other words, thyroid cancer diagnosis is an outcome that is prone to over-detection owing to medical surveillance, an important covariate to be assessed in clinical studies.40,41”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [40]

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Authors
Lim, H., Devesa, S. S., Sosa, J. A., Check, D., & Kitahara, C. M.
Affiliations
  • National Cancer Institute (US)
  • Duke University (US)
Corresponding author
Kitahara, Cari M.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2017-04-04
Volume
317
Issue
13
Pages
1338
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2017.2719
PMC
PMC8216772
OpenAlex
W2603577764
Cited by
2,159
References
29
Citations by year
2026: 149 · 2025: 189 · 2024: 273 · 2023: 267 · 2022: 314 · 2021: 281 · 2020: 303 · 2019: 183 · 2018: 140 · 2017: 50 · 2015: 3 · 2014: 1 · 2013: 2
FWCI
146.24
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institutes of Health (Z99 CA999999)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
thyroid cancer, papillary thyroid carcinoma, incidence trends, mortality trends, incidence-based mortality, histological subtypes, SEER stage, tumor characteristics, cancer surveillance, United States, age-standardized rates, annual percent change, men, racial differences, socioeconomic status, regional variation, cancer registry data
MeSH terms
Thyroid Cancer, Papillary, Adolescent, Adult, Aged, Aged, 80 and over, Carcinoma, Carcinoma, Papillary, Female, Humans, Male, Middle Aged, Thyroid Neoplasms, United States, Incidence, SEER Program, Young Adult

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