Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005.
Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005.
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DOI：
10.1158/1055-9965.epi-08-0960
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发表时间：
2009-03
期刊：
影响因子：
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通讯作者：
Devesa SS
中科院分区：
文献类型：
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作者：
Enewold L;Zhu K;Ron E;Marrogi AJ;Stojadinovic A;Peoples GE;Devesa SS
甲状腺癌的发病率在美国一直在上升，这一趋势通常归因于加强医疗监督和使用改进的诊断方法。甲状腺癌的发病率因性别和种族/民族而异，这些因素也影响医疗保健的获得和利用。因此，我们根据1980年至2005年期间从国家癌症研究所的监测、流行病学和最终结果（SEER）项目中诊断的48，403例甲状腺癌患者，通过人口统计学和肿瘤特征检查了甲状腺癌的发病率。发生率因组织学类型、性别和人种/种族而异。乳头状癌是所有种族/民族组中发病率持续上升的唯一组织学类型。随后的分析集中在这一时期诊断的39，706例乳头状甲状腺癌。女性乳头状癌发病率上升最快。在1992-1995年和2003-2005年期间，非西班牙裔白色人和黑人女性的失业率几乎上升了100%，但在西班牙裔白色人、亚洲/太平洋岛民和黑人男性中，失业率仅上升了20-50%。局部期和小肿瘤的增长速度最快;然而，大肿瘤以及局部和远处期肿瘤的发病率也有所上升。自1992-1995年以来，乳头状癌发病率总体增加的一半是由于非常小（≤1.0 cm）的癌症发病率增加，30%是1.1-2 cm的癌症，20%是>2 cm的癌症。在白色女性中，大于5厘米的癌症的增长率几乎与最小癌症的增长率相等。医学监测和更敏感的诊断程序不能完全解释所观察到的甲状腺乳头状癌发病率的上升。因此，应探讨其他可能的解释。
Thyroid cancer incidence has been rising in the United States, and this trend has often been attributed to heightened medical surveillance and use of improved diagnostics. Thyroid cancer incidence varies by sex and race/ethnicity, and these factors also influence access to and utilization of healthcare. We therefore examined thyroid cancer incidence rates by demographic and tumor characteristics, based on 48,403 thyroid cancer patients diagnosed during 1980–2005 from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute. Rates varied by histologic type, sex, and race/ethnicity. Papillary carcinoma was the only histologic type for which incidence rates rose consistently among all racial/ethnic groups. Subsequent analyses focused on the 39,706 papillary thyroid cancers diagnosed during this period. Papillary carcinoma rates increased most rapidly among females. Between 1992–1995 and 2003–2005, they rose nearly 100% among White Non-Hispanics and Black females, but only 20–50% among White Hispanics, Asian/Pacific Islanders and Black males. Increases were most rapid for localized stage and small tumors; however, rates also rose for large tumors and tumors of regional and distant stage. Since 1992–1995, half the overall increase in papillary carcinoma rates was due to rising rates of very small (≤1.0 cm) cancers, 30% to cancers 1.1–2 cm, and 20% to cancers >2 cm. Among White females, the rate of increase for cancers >5 cm almost equaled that for the smallest cancers. Medical surveillance and more sensitive diagnostic procedures cannot completely explain the observed rises in papillary thyroid cancer rates. Thus, other possible explanations should be explored.