Nationwide cohort study on the epidemiology and survival outcomes of thyroid cancer
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Fu-Chao Liu1,2,*, Huan-Tang Lin1,2,*, Shu-Fu Lin3, Chang-Fu Kuo4,5, Ting-Ting Chung6 and Huang-Ping Yu1,2
1Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
2College of Medicine, Chang Gung University, Taoyuan, Taiwan
3Department of Endocrinology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
4Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
5Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK
6Office for Big Data Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
*These authors have contributed equally in this study
Huang-Ping Yu, email: [email protected]
Keywords: thyroid cancer, epidemiology, survival outcome, National Health Insurance, Taiwan Cancer Registry
Received: April 28, 2017 Accepted: May 31, 2017 Published: July 22, 2017
In the past three decades, the thyroid cancer incidence has surged globally. Herein, the Taiwan National Health Insurance database was used to identify thyroid cancer patients and to estimate the prevalence and incidence of thyroid cancer during 1997-2012. The Taiwan Cancer Registry and the National Death Registry databases were crosslinked to obtain information on the histological subtypes and survival rates. Joinpoint regression analysis was used for estimating the average annual percentage changes (APCs) in prevalence, incidence, and survival. The age-standardized incidence of thyroid cancer increased from 5.66 per 100,000 person-years in 1997 to 12.30 per 100,000 person-years in 2012, with an average APC of 5.1 (6.9 in males, 4.6 in females). Thyroid cancer was more prevalent in patients with high socioeconomic status and in urban areas. Papillary carcinoma was the most abundant subtype, with a 2.9-fold increase of incident cases noted during 1998-2012 (from 80.6% to 89.8% of all cases). Among the different treatments, partial thyroidectomy increased the most (average APC, 17.3). The overall survival rates by sex and subtype remained stable over time, with 5-year survival rates of 90.2% in 1997 and 92.4% in 2010. In conclusion, 2.2- and 4.2-fold increases in the incidence and prevalence of thyroid cancer, respectively, were observed during 1997-2012 in Taiwan. The surging incidence of thyroid cancer but stable survival rates, and mainly increased in the papillary subtype, altogether imply enhanced detection of subclinical lesions. A true increase due to environmental carcinogens might also be responsible, but warrant further investigations.
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