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. 2018 Mar 15;18(1):291.
doi: 10.1186/s12885-018-4081-7.

Thyroid cancer: trends in incidence, mortality and clinical-pathological patterns in Zhejiang Province, Southeast China

Lingbin Du  1 , Youqing Wang  1 , Xiaohui Sun  2 , Huizhang Li  1 , Xinwei Geng  3 , Minghua Ge  4   5 , Yimin Zhu  6
Affiliations

Thyroid cancer: trends in incidence, mortality and clinical-pathological patterns in Zhejiang Province, Southeast China

Lingbin Du et al. BMC Cancer. .

Abstract

Background: Thyroid cancer is the most common malignant disease of the endocrine system. Previous studies indicate a rapid increase in the incidence of thyroid cancer in recent decades, and this increase has aroused the great public concern. The aim of this study was to analyze the trends in incidence, mortality and clinical-pathological patterns of thyroid cancer in Zhejiang province.

Methods: Population-based incidence and mortality rates of thyroid cancer were collected from eight cancer registries in Zhejiang from 2000 to 2012. The incidence and mortality rates were age-standardized to Segi's world population. A Joinpoint model was used to examine secular trends in age-adjusted thyroid cancer rates with the Joinpoint Regression Program Version 4.0.0. Thyroid cancer patients were recruited from Zhejiang Cancer Hospital from 1972 to 2014. Patient demographics, tumor histology and tumor size were compared among the different periods of 1972-1985, 1986-1999 and 2000-2014.

Results: The age-standardized incidence rate of thyroid cancer in Zhejiang cancer registries was 2.75/105 in 2000, and increased to 19.42/105 in 2012. Additionally, we observed significantly increasing incidence rates with the Annual Percent Change (APC) of 22.86% (95%CI, 19.2%-26.7%). The age-standardized mortality of thyroid cancer in Zhejiang cancer registries was 0.23/105 in 2000 and 0.25/105 in 2012. No significant change in mortality rate was found. We observed a rapid increase in the proportions of papillary thyroid carcinoma (PTC) in 12,508 patients with thyroid carcinoma identified in the Zhejiang Cancer Hospital from 1972 to 2014 while the proportions of poorly differentiated thyroid cancer (PDTC), medullary thyroid carcinoma (MTC) and follicular thyroid carcinoma (FTC) decreased over the decades. In the PTC cases, the proportion of patients with maximum tumor diameter (MTD) < 1 cm dramatically and significantly increased from 0 in 1972-1985 to 32.1% in 2000-2014.

Conclusions: A rapid increase in incidence and a stable trend in mortality of thyroid cancer were found in the distribution of thyroid cancer. Most of the increased incidence was PTC, especially the papillary thyroid microcarcinoma (PTMC) with MTD < 1 cm. This increase in incidence might be due to increased diagnosis with advanced technology.

Keywords: Incidence; Mortality; Over diagnosis; PTMC; Pathological classifications; Thyroid cancer.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable. Anonymised cancer registry data and hospital records were analyzed in this study, therefore not requiring ethics approval. No patient identifying information is reported.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The Joinpoint analysis of age-standardized incidence rates for thyroid cancer in Zhejiang, 2000–2012
Fig. 2
Fig. 2
The Joinpoint analysis of age-standardized incidence rates in males for thyroid cancer in Zhejiang, 2000–2012
Fig. 3
Fig. 3
The Joinpoint analysis of age-standardized incidence rates in females for thyroid cancer in Zhejiang, 2000–2012
Fig. 4
Fig. 4
Age-standardized (per 100,000 world standard) incidence rates of thyroid cancer in Zhejiang, 2000–2012
Fig. 5
Fig. 5
The Joinpoint analysis of age-standardized mortality rates for thyroid cancer in Zhejiang, 2000–2012
Fig. 6
Fig. 6
The Joinpoint analysis of age-standardized mortality rates in males for thyroid cancer in Zhejiang, 2000–2012
Fig. 7
Fig. 7
The Joinpoint analysis of age-standardized mortality rates in females for thyroid cancer in Zhejiang, 2000–2012
Fig. 8
Fig. 8
Age-standardized (per 100,000 world standard) mortality rates of thyroid cancer in Zhejiang, 2000–2012
Fig. 9
Fig. 9
The temporal changes of the number of different histological subtypes of thyroid cancer in Zhejiang Cancer Hospital, 1972–2014
Fig. 10
Fig. 10
The temporal changes of the number of different sizes of PTC cases in Zhejiang Cancer Hospital, 1972–2014
See this image and copyright information in PMC

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