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Trends in pediatric thyroid cancer incidence in the United States, 1998‐2013
Author(s) -
Bernier MarieOdile,
Withrow Diana R.,
Berrington de Gonzalez Amy,
Lam Clara J. K.,
Linet Martha S.,
Kitahara Cari M.,
Shiels Meredith S.
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32125
Subject(s) - medicine , thyroid cancer , incidence (geometry) , cancer , thyroid , stage (stratigraphy) , papillary thyroid cancer , follicular phase , oncology , paleontology , physics , optics , biology
Background Pediatric differentiated thyroid cancer (DTC) rates have increased over time in the United States and worldwide. Improvements in imaging for the diagnosis of DTC have been hypothesized as a potential driver of these increases. This study stratifies temporal trends in pediatric DTC by stage and tumor size to assess whether rates of large, late‐stage cancers, which are likely to be clinically meaningful, are increasing over time. Methods Age‐standardized incidence rates (ASRs) of DTC and annual percent changes (APCs) in primary DTC rates were estimated for 0‐ to 19‐year‐olds with data from 39 US cancer registries during 1998‐2013. Results During 1998‐2013, 7296 cases of DTC were diagnosed (6652 papillary cases and 644 follicular cases). APCs of pediatric DTCs significantly increased by 4.43%/y [95% CI, 3.74%/y‐5.13%/y], primarily because of increases in papillary histologies. Increasing trends were observed for children aged 10 to 19 years for both sexes and for non‐Hispanic whites, non‐Hispanic blacks, and Hispanics. Rates increased significantly over the time period for all tumor stages (APC localized , +4.06%/y [95% CI, 2.84%/y‐5.29%/y]; APC regional , +5.68%/y [95% CI, 4.64%/y‐6.73%/y]; APC distant , +8.55%/y [95% CI, 5.03%/y‐12.19%/y]) and across tumor sizes (APC <1 cm , +9.46%/y [95% CI, 6.13%/y‐12.90%/y]; APC 1‐2 cm , +6.92%/y [95% CI, 4.31%/y‐9.60%/y]; APC >2 cm , +4.69%/y [95% CI, 2.75%/y‐6.67%/y]). Conclusions Significantly increasing rates of DTC over time among 10‐ to 19‐year‐olds in the United States are unlikely to be entirely explained by increases in medical surveillance during childhood because rates of large and late‐stage DTC are increasing over time. Future studies should examine environmental and other factors that may be contributing to rising DTC rates.