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. 2019 Jul 15;125(14):2497-2505.
doi: 10.1002/cncr.32125. Epub 2019 Apr 23.

Trends in pediatric thyroid cancer incidence in the United States, 1998-2013

Marie-Odile Bernier  1   2 , Diana R Withrow  2 , Amy Berrington de Gonzalez  2 , Clara J K Lam  3 , Martha S Linet  2 , Cari M Kitahara  2 , Meredith S Shiels  4
Affiliations

Trends in pediatric thyroid cancer incidence in the United States, 1998-2013

Marie-Odile Bernier et al. Cancer. .

Abstract

Background: Pediatric differentiated thyroid cancer (DTC) rates have increased over time in the United States and worldwide. Improvements in imaging for the diagnosis of DTC have been hypothesized as a potential driver of these increases. This study stratifies temporal trends in pediatric DTC by stage and tumor size to assess whether rates of large, late-stage cancers, which are likely to be clinically meaningful, are increasing over time.

Methods: Age-standardized incidence rates (ASRs) of DTC and annual percent changes (APCs) in primary DTC rates were estimated for 0- to 19-year-olds with data from 39 US cancer registries during 1998-2013.

Results: During 1998-2013, 7296 cases of DTC were diagnosed (6652 papillary cases and 644 follicular cases). APCs of pediatric DTCs significantly increased by 4.43%/y [95% CI, 3.74%/y-5.13%/y], primarily because of increases in papillary histologies. Increasing trends were observed for children aged 10 to 19 years for both sexes and for non-Hispanic whites, non-Hispanic blacks, and Hispanics. Rates increased significantly over the time period for all tumor stages (APClocalized , +4.06%/y [95% CI, 2.84%/y-5.29%/y]; APCregional , +5.68%/y [95% CI, 4.64%/y-6.73%/y]; APCdistant , +8.55%/y [95% CI, 5.03%/y-12.19%/y]) and across tumor sizes (APC<1 cm , +9.46%/y [95% CI, 6.13%/y-12.90%/y]; APC1-2 cm , +6.92%/y [95% CI, 4.31%/y-9.60%/y]; APC>2 cm , +4.69%/y [95% CI, 2.75%/y-6.67%/y]).

Conclusions: Significantly increasing rates of DTC over time among 10- to 19-year-olds in the United States are unlikely to be entirely explained by increases in medical surveillance during childhood because rates of large and late-stage DTC are increasing over time. Future studies should examine environmental and other factors that may be contributing to rising DTC rates.

Keywords: epidemiology; incidence; pediatrics; registries; thyroid cancer.

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Conflict of interest statement

No conflict of interest disclosures

Figures

Figure 1.
Figure 1.
Trends in differentiated thyroid cancer incidence by histology, 3-year moving average.
Figure 2.
Figure 2.. Trends in differentiated thyroid cancer incidence by age and sex, 3-year moving average.
The error bars that would have crossed the x-axis has been truncated at 2013.
Figure 3.
Figure 3.. Trends in differentiated thyroid cancer incidence by tumor size, 3-year moving average.
Study period limited to 2004–2013, when tumor size was routinely collected
Figure 4.
Figure 4.. Trends in differentiated thyroid cancer incidence by stage at diagnosis, 3-year moving average.
Analysis limited to the 25 registries that had at least 50% completeness for this variable - 97% known stages. Error bars that would cross the x-axis have been omitted.
Figure 5.
Figure 5.
Trends in differentiated thyroid cancer incidence by race and ethnicity
See this image and copyright information in PMC

Comment in

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