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. 2020 Aug 1;105(8):2507-2514.
doi: 10.1210/clinem/dgaa192.

Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis

Chiara Panato  1 , Salvatore Vaccarella  2 , Luigino Dal Maso  1 , Partha Basu  2 , Silvia Franceschi  3 , Diego Serraino  1 , Kevin Wang  4 , Feitong Lei  5 , Quan Chen  6 , Bin Huang  5   6 , Aju Mathew  4   7
Affiliations

Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis

Chiara Panato et al. J Clin Endocrinol Metab. .

Abstract

Context/objective: Increases of thyroid cancer (TC) incidence emerged in the past several decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area.

Design: TC cases aged 0 to 74 years reported to Indian cancer registries during 2006 through 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area.

Results: Between 2006 to 2008 and 2012 to 2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100,000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012-2014), with 93% increase in women and 64% in men compared with 2006 to 2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35 to 54 years, and 30% at ages 55 to 64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, whereas none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, or Sikkim.

Conclusions: Relatively high and increasing TC ASRs emerged in Indian regions where better access to health care was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.

Keywords: India; Thyroid cancer; incidence; overdiagnosis; time trends.

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Figures

Figure 1.
Figure 1.
Observed changes in age-specific incidence rates of thyroid cancer per 100,000 by sex and period in India, 2006-2014.
Figure 2.
Figure 2.
Observed versus expecteda age-specific incidence rates of thyroid cancer per 100,000 women by registry in India, 2006-2014. aEstimated using the slope calculated in the historical period 1958–1967, see Methods
See this image and copyright information in PMC

References

    1. Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon: IARC, 2018. Available from: https://gco.iarc.fr/today. Accessed December 2, 2019.
    1. Vaccarella S, Dal Maso L, Laversanne M, Bray F, Plummer M, Franceschi S. The impact of diagnostic changes on the rise in thyroid cancer incidence: a population-based study in selected high-resource Countries. Thyroid. 2015;25(10):1127-1136. - PubMed
    1. James BC, Mitchell JM, Jeon HD, Vasilottos N, Grogan RH, Aschebrook-Kilfoy B. An update in international trends in incidence rates of thyroid cancer, 1973-2007. Cancer Causes Control. 2018;29(4-5):465-473. - PubMed
    1. Vaccarella S, Franceschi S, Bray F, et al. Worldwide thyroid cancer epidemic? The increasing impact of overdiagnosis. New Engl J Med. 2016;375:614-617. - PubMed
    1. Cordioli MICV, Canalli MHBS, Coral MHC. Increase incidence of thyroid cancer in Florianopolis, Brazil: comparative study of diagnosed cases in 2000 and 2005. Arq Bras Endocrinol Metabol. 2009;53:453-460. - PubMed

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