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. 2018 May:94:6-15.
doi: 10.1016/j.ejca.2018.01.083. Epub 2018 Mar 20.

The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012

Luigino Dal Maso  1 , Chiara Panato  2 , Silvia Franceschi  3 , Diego Serraino  2 , Carlotta Buzzoni  4 , Susanna Busco  5 , Stefano Ferretti  6 , Antonietta Torrisi  7 , Fabio Falcini  8 , Manuel Zorzi  9 , Claudia Cirilli  10 , Walter Mazzucco  11 , Michele Magoni  12 , Paolo Collarile  2 , Fabio Pannozzo  5 , Anna Luisa Caiazzo  13 , Antonio Giampiero Russo  14 , Alessio Gili  15 , Adele Caldarella  16 , Roberto Zanetti  17 , Maria Michiara  18 , Lucia Mangone  19 , Rosa Angela Filiberti  20 , Mario Fusco  21 , Francesca Gasparini  6 , Giovanna Tagliabue  22 , Rosaria Cesaraccio  23 , Rosario Tumino  24 , Luciana Gatti  25 , Francesco Tisano  26 , Silvano Piffer  27 , Giovanna Maria Sini  28 , Guido Mazzoleni  29 , Stefano Rosso  30 , Anna Clara Fanetti  31 , Salvatore Vaccarella  3 ; for AIRTUM working group
Collaborators, Affiliations

The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012

Luigino Dal Maso et al. Eur J Cancer. 2018 May.

Abstract

Aims: In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis.

Methods: Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology. TC overdiagnosis was estimated by sex, period, age, and Italian region.

Results: In Italy between 1998-2002 and 2008-2012, TC ASR increased of 74% in women (from 16.2 to 28.2/100,000) and of 90% in men (from 5.3 to 10.1/100,000). ASR increases were nearly exclusively due to papillary TC (+91% in women, +120% in men). In both sexes, more than three-fold differences emerged between regions with highest and lowest ASR. Among TC cases diagnosed in 1998-2012 in Italy, we estimated that overdiagnosis accounted for 75% of cases in women and 63% in men and increased over the study period leading to overdiagnosis of 79% in women and 67% in men in 2008-2012. Notably, overdiagnosis was over 80% among women aged <55 years, and substantial variations were documented across Italian regions, in both genders.

Conclusion(s): Incidence rates of TC are steadily increasing in Italy and largely due to overdiagnosis. These findings call for an update of thyroid gland examination practices in the asymptomatic general population, at national and regional levels.

Keywords: Incidence; Italy; Mortality; Overdiagnosis; Thyroid cancer; Time trends.

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