Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005

Abstract

Thyroid cancer incidence has been rising in the United States, and this trend has often been attributed to heightened medical surveillance and the 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 program of the National Cancer Institute. The rates varied by histologic type, sex, and race/ethnicity. Papillary carcinoma was the only histologic type for which incidence rates increased 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 increased nearly 100% among White non-Hispanics and Black females but only 20% to 50% among White Hispanics, Asian/Pacific Islanders, and Black males. The increases were most rapid for localized stage and small tumors; however, rates also increased for large tumors and tumors of regional and distant stage. Since 1992-1995, half the overall increase in papillary carcinoma rates was due to increasing rates of very small (<or=1.0 cm) cancers, 30% to cancers 1.1 to 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 increases in papillary thyroid cancer rates. Thus, other possible explanations should be explored.

Figure 1

Histology-specific trends in thyroid cancer incidence in SEER* diagnosed from 1980–1983 to 2003–2005 by sex and race/ethnicity. Rates are age-adjusted (2000 US Standard Population) and each point represents 3 or 4-years. *Nine regions were included for the Whites and Blacks and eleven were included for the White non-Hispanics, White Hispanics and Asian/Pacific Islanders.

Figure 2

Stage-specific trends in papillary thyroid cancer incidence in SEER* diagnosed from 1980–1983 to 2003–2005 by sex and race/ethnicity. Rates are age-adjusted (2000 US Standard Population) and each point represents 3 or 4-years. *Nine regions were included for the Whites and Blacks and eleven were included for the White non-Hispanics, White Hispanics and Asian/Pacific Islanders.

Figure 3

Size-specific trends in papillary thyroid cancer incidence in SEER* diagnosed from 1988–1991 to 2003–2005 by sex and race/ethnicity. Rates are age-adjusted (2000 US Standard Population) and each point represents 3 or 4-years. *Nine regions were included for the Whites and Blacks and eleven were included for the White non-Hispanics, White Hispanics and Asian/Pacific Islanders.

Figure 4

Age-specific trends in papillary thyroid cancer incidence in the SEER* diagnosed from 1980–1983 to 2003–2005 by sex and race/ethnicity. Rates are age-adjusted (2000 US Standard Population) and each point represents 3 or 4-years. *Nine regions were included for the Whites and Blacks and eleven were included for the White non-Hispanics, White Hispanics and Asian/Pacific Islanders.