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Cited by 49Thyroid Cancer Diagnosis and TreatmentGlobal Cancer Incidence and ScreeningThyroid and Parathyroid Surgery

Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis

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Panato, Chiara, Vaccarella, Salvatore, Dal Maso, Luigino, Basu, Partha, Franceschi, Silvia, Serraino, Diego, Wang, Kevin, Lei, Feitong +3 more·2020·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/clinem/dgaa192PMC PMC7947989
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Abstract

Context/Objective: Increases of thyroid cancer (TC) incidence emerged in the past several decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area. Design: TC cases aged 0 to 74 years reported to Indian cancer registries during 2006 through 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area. Results: Between 2006-2008 and 2012-2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100,000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012-2014), with 93% increase in women and 64% in men compared with 2006-2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35 to 54 years, and 30% at ages 55 to 64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, whereas none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, or Sikkim. Conclusions: Relatively high and increasing TC ASRs emerged in Indian regions where better access to health care was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.

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  • Recent modifications of national and international clinical practice guidelines recommend against screening for thyroid cancer and advocate active surveillance for microcarcinoma.

    “In recent years, there have been modifications of national and international clinical practice guidelines, 11,150,151 which recommend against screening for thyroid cancer and advocate active surveillance for microcarcinoma.152,153”

    From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [150]

    The Conclusions and Discussion recommend discouraging opportunistic thyroid-cancer screening, particularly among younger Indian women. The paper does not describe changes to national or international clinical guidelines or say that they advocate active surveillance for microcarcinoma. (LLM, conf=0.83)

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  1. [1]1. Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon: IARC, 2018. Available from: https://gco.iarc.fr/today. Accessed December 2, 2019. [Google Scholar]
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Authors
Panato, C., Vaccarella, S., Dal Maso, L., Basu, P., Franceschi, S., Serraino, D., Wang, K., Lei, F., Chen, Q., Huang, B., & Mathew, A.
Affiliations
  • Centro di Riferimento Oncologico (IT)
  • Centre international de recherche sur le cancer (FR)
  • Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
  • University of Kentucky (US)
Corresponding author
Vaccarella, Salvatore
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2020-04-16
Volume
105
Issue
8
Pages
2507-2514
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/clinem/dgaa192
PMC
PMC7947989
OpenAlex
W3017004020
Cited by
49
References
33
Citations by year
2026: 5 · 2025: 12 · 2024: 12 · 2023: 8 · 2022: 7 · 2021: 4 · 2020: 1
FWCI
3.77
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • Italian Association for Cancer Research (16921)
  • Italian Ministry of Health (5X1000)
  • Markey Cancer Center Support (NCI P30 CA177558)
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, cancer incidence, overdiagnosis, incidence trends, sex differences, regional variation, age-standardized incidence rate, India, Thiruvananthapuram, young women
MeSH terms
Medical Overuse, Adolescent, Adult, Age Factors, Aged, Child, Child, Preschool, Female, Geography, Humans, India, Infant, Infant, Newborn, Male, Mass Screening, Middle Aged, Registries, Sex Factors, Thyroid Neoplasms, Incidence, Young Adult

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