A Birth Cohort Analysis of the Incidence of Papillary Thyroid Cancer in the United States, 1973-2004
A Birth Cohort Analysis of the Incidence of Papillary Thyroid Cancer in the United States, 1973-2004
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DOI：
10.1089/thy.2008.0342
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发表时间：
2009-10-01
期刊：
影响因子：
6.6
通讯作者：
Zhang, Yawei
中科院分区：
文献类型：
--
作者：
Zhu, Cairong;Zheng, Tongzhang;Zhang, Yawei
背景：乳头状甲状腺癌的发病率在过去三十年中一直在增加，1975年至2004年间增加了65-126%。目前尚不清楚增加的原因。这项研究调查了美国乳头状甲状腺癌的发病模式，并评估了出生队列的组成部分(基于出生年份定义)、时间段和年龄作为观察到的疾病时间趋势的决定因素。方法：利用美国国家癌症研究所1973-2004年的监测、流行病学和最终结果计划的数据，我们使用单变量分析和年龄-时期-队列模型来评估出生队列模式，并评估年龄、时期和队列对发病率随时间变化趋势的影响。结果：无论男性还是女性，发病率的上升都显示出明显的出生队列模式。年龄-时期-队列模型的结果显示，虽然周期效应似乎对观察到的发病率趋势有影响，但出生队列效应也可能解释了研究期间乳头状甲状腺癌的部分上升趋势，特别是在女性中。结论：虽然可能由于诊断技术的进步和对甲状腺小结节医学检测的增加而产生的周期效应可能解释了观察到的发病率增加的部分原因，但我们推测，出生队列相关的环境暴露变化(如接触诊断X射线和多溴联苯醚的增加)也是过去几十年中观察到的乳头状甲状腺癌增加的原因。
Background: The incidence of papillary thyroid cancer has been reported to be increasing during the past three decades, with a 65-126% increase between 1975 and 2004. The reason for the increase is currently unknown. This study examined the incidence pattern of papillary thyroid cancer in the United States, and evaluated the components of birth cohort (defined based on year of birth), time period, and age as determinants of the observed time trend of the disease.Methods: Using the data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program for 1973-2004, we conducted both univariate analysis and age-period-cohort modeling to evaluate birth cohort patterns and evaluate age, period, and cohort effects on incidence trends over time.Results: The increasing incidence showed a clear birth cohort pattern for both men and women. The results from age-period-cohort modeling showed that, while period effect appeared to have had an impact on the observed incidence trends, birth cohort effect may also explain part of the increasing trend in papillary thyroid carcinoma during the study period, especially among women.Conclusion: While a period effect that is likely due to advancements in diagnostic techniques and increased medical detection of small thyroid nodules may explain some of the observed increase in the incidence, we speculate that birth cohort-related changes in environmental exposures (such as increased exposure to diagnostic X-rays and polybrominated diphenyl ethers) have also contributed to the observed increase in papillary thyroid cancer during the past decades.