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Nuklearmedizin 2019; 58(02): 86-92
DOI: 10.1055/a-0859-7454
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Changing trends of incidence and prognosis of thyroid carcinoma

Veränderung der Inzidenz und Prognose des Schilddrüsenkarzinoms
Jamshid Farahati
1   Clinic for Nuclear Medicine, Bethesda, Duisburg, Germany
,
Uwe Mäder
2   Clinic for Nuclear Medicine, University hospital Würzburg, Germany
,
Elena Gilman
1   Clinic for Nuclear Medicine, Bethesda, Duisburg, Germany
,
Rainer Görges
3   Clinic for Nuclear Medicine, University hospital Essen, Germany
,
Ines Maric
1   Clinic for Nuclear Medicine, Bethesda, Duisburg, Germany
,
Ina Binse
3   Clinic for Nuclear Medicine, University hospital Essen, Germany
,
Heribert Hänscheid
2   Clinic for Nuclear Medicine, University hospital Würzburg, Germany
,
Ken Herrmann
3   Clinic for Nuclear Medicine, University hospital Essen, Germany
,
Andreas Buck
2   Clinic for Nuclear Medicine, University hospital Würzburg, Germany
,
Andreas Bockisch
3   Clinic for Nuclear Medicine, University hospital Essen, Germany
› Author Affiliations
Further Information

Publication History

01/22/2019

02/18/2019

Publication Date:
27 March 2019 (online)

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Abstract

Aim to evaluate the time trend of epidemiology of follicular cell derived thyroid cancer (TC) based on data from a well documented cancer registry.

Methods Population based data on TC from Lower Franconia (LF), Germany, within 1981 and 2015 were analysed to estimate the regional epidemiology of TC. The incidence was assessed in 5-year-intervals for gender, histology, and tumor stage.

Results Incidence of TC solely attributable to papillary TC (PTC) doubled mainly in T1- and T2-stages within the evaluation period from 4.5 to 8.7/100.000/y in females and 1.7 to 4.1/100.000/y in males. There was no significant change of follicular TC (FTC), whereas anaplastic TC (ATC) decreased in the same interval. The number of lymph-node metastases and T3-cases increased, while the frequency of T4-stage and distant metastases decreased. Increased incidences of T1- and T2-stages suggest an over-diagnosis. In contrast, increasing number of tumors at T3-stage and with lymph node involvement contradict the over-diagnosis as the only reason for rising incidence. Declining of T4-stages in spite of increasing of T3-stages and N1-cases indicates the value of timely detection and treatment of TC. In accordance, reduced incidence of advanced cancers with M1-stage and ATC cases promote our current management of TC.

Conclusion Timely diagnosis and adequate risk-adopted treatment of thyroid cancer reduce the frequency of high-risk cases with distant metastases and the possible protracted dedifferentiation of TC to anaplastic features. Our analyses support the management algorithm in thyroid cancer according to the recent guidelines of German Nuclear Medicine Society.

Zusammenfassung

Ziel Evaluierung des Trends der Epidemiologie von Schilddrüsenkrebs (TC) in Unterfranken (UF).

Methodik Populationsbasierte Daten aus Unterfranken aus den Jahren 1981 bis 2015 wurden analysiert und die Änderung der Inzidenz des TC ermittelt. Die Inzidenz wurde in 5-Jahres-Intervallen in Bezug auf Geschlecht, Histologie, und Tumorstadium berechnet.

Ergebnisse Die TC-Inzidenz verdoppelte sich im Auswertungszeitraum, bei Frauen von 4,5 auf 8,7/100.000/J und von 1,7 auf 4,1/100.000/J bei Männern, was überwiegend den papillären Schilddrüsenkarzinomen (PTC) in T1- und T2-Stadien zuzuschreiben ist. Es gab keine signifikante Änderung beim follikulären TC (FTC), während die Häufigkeit des anaplastische TC (ATC) abnahm. Die Anzahl der Lymphknotenmetastasen und T3-Fälle stieg, während die Frequenz der T4-Fälle und der Fernmetastasen in diesem Intervall abnahm. Eine erhöhte Inzidenz von Karzinomen in T1- und T2-Stadien ließe sich durch Überdiagnostik erklären. Im Gegensatz dazu sprechen die Zunahme der Inzidenz von Tumoren in T3- und N1-Stadien gegen eine Überdiagnose als einzigen Grund für den Anstieg. Die abnehmende Zahl von Patienten mit T4-Stadium bei gleichzeitigem Anstieg der Fälle im T3- und N1-Stadium sprechen vielmehr für eine rechtzeitige Diagnose von Schilddrüsenkarzinomen. Die abnehmende Inzidenz der weit fortgeschnittenen Fälle mit Fernmetastasen und mit ATC im gleichen Zeitraum bestätigen das bei uns verfolgte Konzept.

Schlussfolgerung Die rechtzeitige Diagnose und adäquate risikoadaptierte Behandlung des Schilddrüsenkarzinoms im Frühstadium reduziert die Häufigkeit von Hochrisiko-Fällen mit Fernmetastasen und verhindert die mögliche Entdifferenzierung vom DTC zu anaplastischen Tumoren. Unsere Analysen bestätigen das therapeutische Management von Schilddrüsenkrebs gemäß Leitlinien der Deutschen Gesellschaft für Nuklearmedizin.

Key words

Epidemiology - screening - over-screening - over-diagnosis - thyroid cancer - Incidence - I-131-therapy

Schlüsselwörter

Epidemiologie - Screening - Over-Screening - Überdiagnose - Schilddrüsenkrebs - Inzidenz - I-131-Therapie
 

  • References

  • 1 Ain K. Anaplastic Thyroid Carcinoma: Behavior, Biology, and Therapeutic Approaches. Thyroid 1998; 8: 715-726
    CrossrefPubMedGoogle Scholar
  • 2 Bibbins-Domingo K, Grossman D, Curry S. et al. US Preventive Services Task Force Screening for Thyroid Cancer. Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2017; 317 (18) 1882-1887
    CrossrefPubMedGoogle Scholar
  • 3 Cooper D, Doherty G, Haugen B. et al. Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009; 19 (11) 1167-1214 [Erratum in: Thyroid 2010; 20 (6) :674–675. Thyroid 2010; 20 (8): 942]
    CrossrefPubMedGoogle Scholar
  • 4 Davies L, Welch H. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006; 295 (18) 2164-2167
    CrossrefPubMedGoogle Scholar
  • 5 Davies L, Welch H. Current Thyroid Cancer Trends in the United States. JAMA Otolaryngology–Head & Neck Surgery 2014; 140 (04) 317-322
    CrossrefPubMedGoogle Scholar
  • 6 Davies L, Morris L, Hankey B. Increases in Thyroid Cancer Incidence and Mortality. JAMA 2017; 318 (04) 389-390
    CrossrefPubMedGoogle Scholar
  • 7 Dietlein M, Eschner W, Grünwald F. et al. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer. Version 4. Nuklearmedizin 2016; 55 (03) 77-89
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Enewold L, Zhu K, Ron E. et al. Rising Thyroid Cancer Incidence in the United States by Demographic and Tumor Characteristics, 1980–2005. Cancer Epidemiology Biomarkers & Prevention 2009; 18 (03) 784-791
    CrossrefPubMedGoogle Scholar
  • 9 Farahati J, Geling M, Mäder U. et al. Changing Trends of Incidence and Prognosis of Thyroid Carcinoma in Lower Franconia, Germany, from 1981–1995. Thyroid 2004; 14 (02) 141-147
    CrossrefPubMedGoogle Scholar
  • 10 Forman D, Bray F, Brewster D. et al. Cancer Incidence in Five Continents, Vol X. Lyon, France: International Agency for Research on Cancer; 2014. Im Internet: http://ci5.iarc.fr Stand: 02.04.2018
    Google Scholar
  • 11 Haugen B, Alexander E, Bible K. et al. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26 (01) 1-133
    CrossrefPubMedGoogle Scholar
  • 12 Haugen B, Sawka A, Alexander E. et al. American Thyroid Association Guidelines on the Management of Thyroid Nodules and Differentiated Thyroid Cancer Task Force Review and Recommendation on the Proposed Renaming of Encapsulated Follicular Variant Papillary Thyroid Carcinoma Without Invasion to Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features. Thyroid 2017; 27 (04) 481-483
    CrossrefPubMedGoogle Scholar
  • 13 Hughes D, Doherty G. Central neck dissection for papillary thyroid cancer. Cancer Control 2011; 18 (02) 83-88
    CrossrefPubMedGoogle Scholar
  • 14 Jung K, Won Y, Kong H. et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015; 47: 127-141
    CrossrefPubMedGoogle Scholar
  • 15 Kent W, Hall S, Isotalo P. et al. Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease. CMAJ 2007; 177 (11) 1357-1361
    CrossrefPubMedGoogle Scholar
  • 16 Kitahara C, Devesa S, Sosa J. Increases in Thyroid Cancer Incidence and Mortality-Reply. JAMA 2017; 318 (04) 390-391
    CrossrefPubMedGoogle Scholar
  • 17 Kitahara C, Sosa J. The changing incidence of thyroid cancer. Nat Rev Endocrinol 2016; 12 (11) 646-653
    CrossrefPubMedGoogle Scholar
  • 18 Lower Franconia inhabitants. Im Internet: http://wiki-de.genealogy.net/Regierungsbezirk_Unterfranken Stand: 02.04.2018
    Google Scholar
  • 19 Mao Y, Xing M. Recent incidences and differential trends of thyroid cancer in the USA. Endocr Relat Cancer 2016; 23 (04) 313-322
    CrossrefPubMedGoogle Scholar
  • 20 Morris L, Tuttle R, Davies L. Changing trends in the incidence of thyroid cancer in the United States. JAMA Otolaryngol Head Neck Surg 2016; 142 (07) 709-711
    CrossrefPubMedGoogle Scholar
  • 21 National Cancer Institute. Surveillance, Epidemiology and End Results Program. Regs Research Data 2016; based on the November 2015 submission. Im Internet: https://seer.cancer.gov/data/access.html Stand: 02.04.2018
    Google Scholar
  • 22 Nishiyama R, Dunn E, Thompson N. Anaplastic spindle-cell and giant-cell tumors of the thyroid gland. Cancer 1972; 30 (01) 113-127
    CrossrefPubMedGoogle Scholar
  • 23 Pellegriti G, Frasca F, Regalbuto C. et al. Worldwide increasing incidence of thyroid cancer [published online May 7, 2013]. J Cancer Epidemiol 2013; 2013: 965212
    CrossrefPubMedGoogle Scholar
  • 24 Rendl J, Bier D, Düchtel C. et al. 1998 Veränderungen in der Iodversorgung Westdeutschlands in den letzten 10. Jahren, gezeigt am Beispiel der Iodausscheidung im Würzburger Raum von 1986–1997. In: Reiners C, Weinheimer B. (eds) Iod und Schilddrüse. Walter de Gruyter; Berlin, New York: 39-46
    CrossrefGoogle Scholar
  • 25 Robert Koch Institute. Cancer in Germany. Im Internet: http://www.krebsdaten.de/Krebs/EN/Content/Publications/Cancer_in_Germany/cancer_chapters_2011_2012/cancer_c73.pdf;jsessionid=-25CAE300BF35759F1E8814D10ECE8948.1_cid390?__blob=publicationFile Stand: 02.04.2018
    Google Scholar
  • 26 Scriba P, Beckers C, Bürgi H. et al. Goiter and iodine deficiency in Europe. Subcommittee for the study of endemic goiter and iodine deficiency of the European thyroid association. The Lancet 1985; 1289-1293
    PubMedGoogle Scholar
  • 27 Tuttle R, Haugen B, Perrier N. Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why?. Thyroid 2017; 27: 751-756
    CrossrefPubMedGoogle Scholar
  • 28 Welch H, Black W. Overdiagnosis in cancer. J Natl Cancer Inst 2010; 102: 605-613
    CrossrefPubMedGoogle Scholar
  • 29 Wiltshire J, Drake T, Uttley L. et al. Systematic Review of Trends in the Incidence Rates of Thyroid Cancer. Im Internet: https://www.ncbi.nlm.nih.gov/pubmed/?term=Balasubramanian%20SP%5BAuthor%5D&cauthor=true&cauthor_uid=27571228 Thyroid 2016; 26: 1541-1552
    CrossrefPubMedGoogle Scholar