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. 2024 Dec 30;24(1):1587.
doi: 10.1186/s12885-024-13211-8.

Thyroid cancer survival and prognostic factors in Yantai, China (2012-2022): a population-based study

Haiyun Liu  1 , Shuxia Zhang  2 , Xiaohui Liu  3 , Qianqian Wang  4 , Hongjie Zhang  5 , Weihong Cui  6
Affiliations

Thyroid cancer survival and prognostic factors in Yantai, China (2012-2022): a population-based study

Haiyun Liu et al. BMC Cancer. .

Abstract

Background: Although thyroid cancer is associated with low mortality rates, significant racial disparities in thyroid cancer outcomes have not been adequately studied in Asia. Moreover, the Asian population consists of different ethnic groups that are not homogeneous. This study aimed to perform a population-based analysis of survival outcomes and prognostic factors in thyroid cancer patients.

Methods: The demographic data and tumor characteristics of all the thyroid cancer patients identified were obtained from the Yantai Cancer Registry. The thyroid cancer-specific death risk in patients was evaluated using the proportion of deaths, standardized mortality ratio (SMR) and absolute excess risk (AER). The Kaplan‒Meier method and the Cox proportional hazards regression model were used to evaluate overall survival (OS) and prognosis.

Results: A total of 10,852 new cases of thyroid cancer occurred with a 5-year OS of 96.20% in Yantai from 2012 to 2022. The SMR decreased from 1.06 (95%CI: 0.93 - 1.33) in 2012 to 0.50 (95%CI: 0.42 - 0.63) in 2022 and the AER decreased from 11.07 (95%CI: -13.42 - 47.39) per 10,000 population in 2012 to -105.02 (95%CI: -149.53 - -63.02) per 10,000 population in 2022. Disparities in the OS of thyroid cancer patients were found across different diagnosis periods, genders, age groups, places of residence, occupational classes, tumor sites and sizes, cervical lymph node metastasis statuses, TgAb levels, pathological types, clinical stages and treatment timings (all p < 0.05). Multivariate analysis showed that age group (≥ 65 years: HR = 1.727), tumor site (location in the isthmus: HR = 3.117), tumor size (> 3 cm: HR = 3.170), cervival lymph node metastasis (HR = 1.876), TgAb levels (115 - 500 IU/ml: HR = 7.103; > 500 IU/ml: HR = 13.554), pathological types (MTC: HR = 2.060; ATC: HR = 10.747), clinical stages (stage II: HR = 2.224; stage III: HR = 3.361; stage IV: HR = 3.494), treatment timing (> 3 months: HR = 2.594), diagnosis period (2017 - 2022: HR = 0.633) and gender (female: HR = 0.711) were found to be associated with the risk of death; after stratified adjustment, significant differences in prognostic factors were identified among thyroid cancer patients with varying pathological types.

Conclusion: The risk of death from thyroid cancer in Yantai has significantly decreased and the OS of patients has improved significantly in the past decade. The prognosis of thyroid cancer in this area was notably impacted by various factors and the resolution of survival study outcomes for thyroid cancer patients should be enhanced.

Keywords: Overall survival; Population-based; Prognostic factors; Thyroid cancer.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. This study collected data on patients with malignant tumors strictly following the Measures for the Administration of Tumor Registration issued by China's National Health Commission. The study did not involve the collection of biological specimens or direct patient contact, thus ethical approval was not required. As a retrospective study, the need for written informed consent was waived by the ethics committee of Yantai CDC. All methods were conducted with the utmost care to protect patient privacy and ensure information security, in compliance with the guidelines and regulations for population-based cancer registries set by the China CDC. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig.1
Fig.1
Flowchart of population-based cancer registration and follow-up in Yantai
Fig.2
Fig.2
The risk of death among patients with thyroid cancer in Yantai during 2012 − 2022. Note: SMR: Standardized mortality ratio; AER: Absolute excess risk
Fig. 3
Fig. 3
Overall survival of patients with thyroid cancer diagnosed in Yantai during 2012 − 2022
Fig.4
Fig.4
Kaplan–Meier curves comparing the overall survival according to subgroups of prognostic factors. Notes: TgAb: Anti-thyroglobulin antibodies; FTC: Follicular thyroid cancer; MTC: Medullary thyroid cancer; ATC: Anaplastic thyroid cancer; RI: Radioiodine
Fig. 5
Fig. 5
Multivariate analysis on prognosis factors for thyroid cancer survival in Yantai during 2012 − 2022. Notes: FTC: Follicular thyroid cancer; MTC: Medullary thyroid cancer; ATC: Anaplastic thyroid cancer
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