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The Rising Incidence of Thyroid Cancer: Contributions from Healthcare Practice and Biologic Risk Factors

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Management of Differentiated Thyroid Cancer

Abstract

The incidence of thyroid cancer has dramatically increased over the past several decades, while mortality from thyroid cancer remains exceedingly low. Mortality has increased slightly in more recent years, by less than 1% per year. The simplest explanation for this pattern is an increase in the radiologic detection and pathologic reporting of identified thyroid nodules with very little change in underlying biology. A number of biologic mechanisms have been proposed but are unlikely to account for the dramatic upward trend in incidence over such a short time. Radiation exposure at a young age is an established cause of thyroid cancer, but this typically requires doses equivalent to nuclear catastrophe or radiation cancer treatment and thus is unlikely to have a significant global impact on thyroid cancer incidence. Similarly a number of behavioral and environmental factors influence TSH levels and other proposed hormonal drivers of thyroid cancer cell proliferation. Of these, an increase in obesity and a decrease in smoking may contribute to a small increase in thyroid cancer, but this will require significantly larger and more rigorous studies to formally establish.

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Abbreviations

Gy:

Gray unit of ionizing radiation

HR:

Hazard ratio

Sv:

Sievert unit of ionizing radiation

TSH:

Thyroid-stimulating hormone

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Authors and Affiliations

  1. Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina Lineberger Comprehensive Cancer Center, Campus Box 7213, 170 Manning Drive, 1150 POB, Chapel Hill, NC, 27599-7213, USA

    Benjamin Schmidt

  2. White River Junction Department of Veterans Affairs Hospital, White River Junction, VT, USA

    Louise Davies

  3. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Louise Davies

  4. The Dartmouth Institute for Health Policy and Clinical Practice, VA Outcomes Group—111B, 215 North Main Street, White River Junction, VT, 05009, USA

    Louise Davies

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  1. Benjamin Schmidt
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  2. Louise Davies
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Correspondence to Benjamin Schmidt .

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Editors and Affiliations

  1. General Surgery, Central Arkansas Veterans Healthcare System, University of Arkansas, Little Rock, Arkansas, USA

    Anne T. Mancino

  2. Division of Surgical Oncology, University of North Carolina, Chapel Hill, North Carolina, USA

    Lawrence T. Kim

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Schmidt, B., Davies, L. (2017). The Rising Incidence of Thyroid Cancer: Contributions from Healthcare Practice and Biologic Risk Factors. In: Mancino, A., Kim, L. (eds) Management of Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-54493-9_1

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  • DOI: https://doi.org/10.1007/978-3-319-54493-9_1

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