Recent incidences and differential trends of thyroid cancer in the USA.
Recent incidences and differential trends of thyroid cancer in the USA.
复制标题
DOI：
10.1530/erc-15-0445
复制
发表时间：
2016-04
影响因子：
3.9
通讯作者：
Xing M
中科院分区：
文献类型：
--
作者：
Mao Y;Xing M
近几十年来，甲状腺癌的发病率迅速上升，但其趋势尚不清楚。为了研究这一点，我们分析了1992-2012年美国SEER 13的数据库，特别关注传统乳头状甲状腺癌（CPTC）和滤泡变异型PTC（FVPTC）。在75，992例甲状腺癌中，61.3%为CPTC，25.7%为FVPTC，其发病率（IR）从1992年至2012年均显著增加（P均<0.001），CPTC是FVPTC的2.4倍（P<0.001），总发病率年平均变化百分率（AAPC）前者为6.3%，后者为5.3%。近二十年来，几乎所有种族/人口统计学群体中，所有甲状腺癌的IR均增加，尽管PTC最显著，但不同甲状腺癌的发病率趋势不同，尤其是CPTC和FVPTC之间的差异。如联合点分析显示，1996年前CPTC的APC为1.5%（P>0.05），1996年后跃升至6.8%（P<0.05），而2000年前FVPTC的APC为6.6%（P<0.05），2000年后降至4.8%（P<0.05）。PTC的IR和发病率趋势在不同种族/人口统计学组之间不均匀，如黑人女性中两种PTC变体的IR均低于非西班牙裔白色女性，但前者的AAPC发病率高于后者。有趣的是，这些数据还表明，PTC的发病率在最近两年正趋于稳定。这些新的观察有助于了解甲状腺癌的发病率和发病趋势。
The incidence rate of thyroid cancer has been rising rapidly in recent decades, but its trend remains unclear. To investigate this, we analyzed the database of SEER 13, 1992-2012 in USA, with a particular focus on conventional papillary thyroid cancer (CPTC) and follicular-variant PTC (FVPTC). Of the 75,992 thyroid cancers, 61.3% were CPTC, and 25.7% were FVPTC, and their incidence rates (IRs) were both significantly increased from 1992 to 2012 (P all <0.001), with CPTC being 2.4-time FVPTC (P<0.001) and the overall average annual percent change (AAPC) of incidence being 6.3% in the former and 5.3% in the latter. IRs were increased in all thyroid cancers, albeit most dramatically in PTC, in virtually all ethnic/demographic groups in recent two decades, but the incidence trends varied among different thyroid cancers, particularly differentiable between CPTC and FVPTC. For example, joinpoint analyses revealed that the APC of CPTC before 1996 was 1.5% (P>0.05), which jumped to 6.8% (P<0.05) after 1996, while the APC of FVPTC before 2000 was 6.6% (P<0.05), which dropped to 4.8% (P<0.05) after 2000. IRs and incidence trends of PTC were uneven among different ethnic/demographic groups, as exemplified by the lower IRs of both PTC variants in the black females than non-Hispanic white females but higher AAPCs of incidence in the former than the latter. Interestingly, the data also suggest that the incidence rise of PTC is becoming plateaued in the most recent two years. These novel observations are helpful in understanding the incidence and incidence trends of thyroid cancer.