Thyroid cancer trends in China and its comparative analysis with G20 countries: Projections for 2020-2040

Abstract

Background: Thyroid cancer, a leading type of endocrine cancer, accounts for 3-4% of all cancer diagnoses. This study aims to analyse and compare thyroid cancer patterns in China and the Group twenty (G20) countries, and predict these trend for the upcoming two decades.

Methods: This observational longitudinal study utilised data from the Global Burden of Disease (GBD) study 2019. We used metrics including incidence, mortality, mortality-incidence ratio (MIR), age-standardised rate (ASR) and average annual percent change (AAPC) to examine thyroid cancer trends. Joinpoint regression analysis was used to identify periods manifesting notable changes. The association between sociodemographic index (SDI) and AAPC were investigated. The autoregressive integrated moving average (ARIMA) model was used to predict thyroid cancer trends from 2020 to 2040.

Results: From 1990 to 2019, thyroid cancer incidence cases in China increased by 289.6%, with a higher AAPC of age-standardised incidence rate (ASIR) in men. Contrastingly, the G20 demonstrated a smaller increase, particularly among women over 50. Despite the overall age-standardised mortality rate (ASMR) was higher in the G20, the increase in mortality was less pronounced than in China. Age-standardised incidence rate increased across all age groups and genders, with a notable rise among men aged 15-49. ASMR decreased in specific age groups and genders, especially among women. Conversely, the ASMR significantly increased in group aged over 70. The MIR exhibited a declining trend, but this decrease was less noticeable in men and the group aged over 70. Joinpoint analysis pinpointed significant shifts in overall ASIR and ASMR, with the most pronounced increase in ASIR during 2003-2011 in China and 2003-2010 in the G20. Predictions suggested a continual ASIR uptrend, especially in the 50-69 age group, coupled with a predicted ASMR downturn among the elderly by 2040. Moreover, the proportion of thyroid cancer deaths attributable to high body mass index (BMI) escalated, with significant increase in Saudi Arabia and a rise to 7.4% in China in 2019.

Conclusions: Thyroid cancer cases in incidence and mortality are escalating in both China and the G20. The increasing trend may be attributed to factors beyond overdiagnosis, including environmental and genetic factors. These findings emphasise the necessity for augmenting prevention, control, and treatment strategies. They also highlight the significance of international collaboration in addressing the global challenge posed by thyroid cancer.

Figure 1

The age distribution for incidence and mortality of thyroid cancer. Panel A. Age distribution of incidence in China for genders. Panel B. Age distribution of mortality in China for genders. Panel C. Age distribution of incidence in the G20 countries for genders. Panel D. Age distribution of mortality in the G20 countries for genders. G20 – Group of Twenty

Figure 2

The trend of ASIR, ASMR and ASR of MIR of thyroid cancer. Panels A–C. The trend of ASIR (A), ASMR (B) and ASR of MIR (C) in different age group, genders in China from 1990 to 2019. Panels D–F. The trend of ASIR (D), ASMR (E) and ASR of MIR (F) in different age group, genders in the G20 countries. ASIR – age-standardised incidence rate, ASMR – age-standardised mortality rate, G20 – Group of Twenty, MIR – mortality-incidence ratio

Figure 3

The joinpoint regression analysis of ASIR, ASMR and ASR of MIR in thyroid cancer. Panels A–C. Joinpoint regression analysis of ASIR (A), ASMR (B) and ASR of MIR (C) in thyroid cancer in China for genders from 1990 to 2019. Panels D–F. Joinpoint regression analysis of ASIR (D), ASMR (E) and ASR of MIR (F) in thyroid cancer in the G20 countries for genders from 1990 to 2019. ASIR – age-standardised incidence rate, ASMR – age-standardised mortality rate, G20 – Group of Twenty, MIR – mortality-incidence ratio

Figure 4

Prediction of ASIR and ASMR of thyroid cancer. Panels A–B. Prediction of ASIR (A) and ASMR (B) of thyroid cancer in different age groups and genders in China until 2040. Panels C–D. Prediction of ASIR (C) and ASMR (D) of thyroid cancer in different age groups and genders in the G20 countries. ASIR – age-standardised incidence rate, ASMR – age-standardised mortality rate, G20 – Group of Twenty

Figure 5

The attributable risk factors of thyroid cancer in the G20 countries in 1990 and 2019. BMI – body mass index, G20 – Group of Twenty

Figure 6

The correlation between SDI and AAPC of ASIR and ASMR in the G20 countries. Panel A. The correlation between SDI and AAPC of ASIR. Panel B. The correlation between SDI and AAPC of ASMR. AAPC – average annual percent change, ASIR – age-standardised incidence rate, ASMR – age-standardised mortality rate, G20 – Group of Twenty, SDI – sociodemographic index