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. 2021 Oct 12;13(20):5104.
doi: 10.3390/cancers13205104.

Opposite Incidence Trends for Differentiated and Medullary Thyroid Cancer in Young Dutch Patients over a 30-Year Time Span

Chantal A Lebbink  1   2 , Medard F M van den Broek  3 , Annemiek B G Kwast  4 , Joep P M Derikx  5 , Miranda P Dierselhuis  2 , Schelto Kruijff  6 , Thera P Links  7 , A S Paul van Trotsenburg  8 , Gerlof D Valk  3 , Menno R Vriens  9 , Annemarie A Verrijn Stuart  1 , Hanneke M van Santen  1   2 , Henrike E Karim-Kos  2   4
Affiliations

Opposite Incidence Trends for Differentiated and Medullary Thyroid Cancer in Young Dutch Patients over a 30-Year Time Span

Chantal A Lebbink et al. Cancers (Basel). .

Erratum in

Abstract

Thyroid cancer is the most common endocrine malignancy in children. A rising incidence has been reported worldwide. Possible explanations include the increased use of enhanced imaging (leading to incidentalomas) and an increased prevalence of risk factors. We aimed to evaluate the incidence and survival trends of thyroid cancer in Dutch children, adolescents, and young adults (0-24 years) between 1990 and 2019. The age-standardized incidence rates of differentiated thyroid cancer (DTC, including papillary and follicular thyroid cancer (PTC and FTC, respectively)) and medullary thyroid cancer (MTC), the average annual percentage changes (AAPC) in incidence rates, and 10-year overall survival (OS) were calculated based on data obtained from the nationwide cancer registry (Netherlands Cancer Registry). A total of 839 patients aged 0-24 years had been diagnosed with thyroid carcinoma (PTC: 594 (71%), FTC: 128 (15%), MTC: 114 (14%)) between 1990 and 2019. The incidence of PTC increased significantly over time (AAPC +3.6%; 95%CI +2.3 to +4.8), the incidence rate of FTC showed a stable trend ((AAPC -1.1%; 95%CI -3.4 to +1.1), while the incidence of MTC decreased significantly (AAPC: -4.4% (95%CI -7.3 to -1.5). The 10-year OS was 99.5% (1990-1999) and 98.6% (2000-2009) in patients with DTC and 92.4% (1990-1999) and 96.0% (2000-2009) in patients with MTC. In this nationwide study, a rising incidence of PTC and decreasing incidence of MTC were observed. For both groups, in spite of the high proportion of patients with lymph node involvement at diagnosis for DTC and the limited treatment options for MTC, 10-year OS was high.

Keywords: adolescents; children; epidemiology; incidence; survival; thyroid cancer; young adults.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Time trends in incidence of patients aged 0–24 years with thyroid carcinoma in The Netherlands, 1990–2019. Abbreviations: AAPC, average annual percent change; CI, confidence interval. Three-year moving averages of the age-standardized incidence rate of thyroid carcinoma (standardized according to the World Standard Population) are shown. AAPC was estimated from a regression line, which was fitted to the natural logarithm of the rates using the year of diagnosis as a regressor variable.
Figure 2
Figure 2
Time trends in incidence of patients aged 0–24 years with thyroid carcinoma by histology and age in the Netherlands, 1990–2019. (A) Papillary thyroid carcinoma. (B) Follicular thyroid carcinoma. (C) Medullary thyroid carcinoma. Abbreviations: AAPC, average annual percent change; CI, confidence interval. Three-year moving averages of the age-specific incidence rate of thyroid carcinoma are shown. The incidence rates of the patients 0–9 and 0–17 years are age-standardized according to the World Standard Population. AAPC was estimated from a regression line, which was fitted to the natural logarithm of the rates using year of diagnosis as a regressor variable. * Estimation of a reliable average annual percentage change was not possible because of n = 0 in >5 incidence years.
Figure 2
Figure 2
Time trends in incidence of patients aged 0–24 years with thyroid carcinoma by histology and age in the Netherlands, 1990–2019. (A) Papillary thyroid carcinoma. (B) Follicular thyroid carcinoma. (C) Medullary thyroid carcinoma. Abbreviations: AAPC, average annual percent change; CI, confidence interval. Three-year moving averages of the age-specific incidence rate of thyroid carcinoma are shown. The incidence rates of the patients 0–9 and 0–17 years are age-standardized according to the World Standard Population. AAPC was estimated from a regression line, which was fitted to the natural logarithm of the rates using year of diagnosis as a regressor variable. * Estimation of a reliable average annual percentage change was not possible because of n = 0 in >5 incidence years.
Figure 3
Figure 3
Sex distribution of differentiated thyroid carcinoma within different age groups in the Netherlands, 1990–2019. Sex distribution of differentiated thyroid carcinoma of the age groups <10, 10–14 years, 15–17 years, and 18–24 years. Both percentage and the absolute number of patients are shown.
Figure 4
Figure 4
Observed survival of patients, aged 0–24 years with thyroid carcinoma in the Netherlands, 1990–2019. Abbreviations: DTC, differentiated thyroid carcinoma; MTC, medullary thyroid carcinoma. Survival time was calculated as the time elapsed between the date of diagnosis and the date of death due to any cause (event) or censoring (i.e., loss to follow-up, emigration, or 1 February 2021), whichever came first. The log rank test showed a significantly different 10-year survival between DTC and MTC: p < 0.001.
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