Temporal and geographical variations of thyroid cancer incidence and mortality in France during 1986–2015: The impact of overdiagnosis |
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| Institution: | 1. Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China;2. International Agency for Research on Cancer, Lyon, France;3. Registre du cancer de l’Isère, Grenoble, France;4. Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France;5. Fédération d’Endocrinologie, Groupement Hospitalier Est and Registre des Cancers Thyroïdiens du Rhône, Hospices Civils de Lyon, Lyon, France;6. Service de Chirurgie Endocrinienne, Groupement Hospitalier Sud and Registre des Cancers Thyroïdiens du Rhône, Hospices Civils de Lyon, Lyon, France;7. Claudius Regaud Institute, IUCT-Oncopole, Tarn Cancer Registry, Toulouse, France;8. Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy;9. Health data department, Lyon University Hospital, Lyon, France;1. Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda;2. Harvard Medical School, Boston, MA, United States;3. Moi University, Eldoret, Kenya;4. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;5. University of California, San Francisco, CA, United States;6. Masaka Regional Referral Hospital, Masaka, Uganda;7. Mbarara Regional Referral Hospital, Mbarara, Uganda;8. Indiana University, Indianapolis, IN, United States;1. Harvard School of Public Health, Boston, USA;2. Department of Surgery & Cancer, Imperial College London, UK;3. Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, USA;4. Oxford University Clinical Academic Graduate School, John Radcliffe Hospital, Oxford, UK;1. Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany;2. Danish Cancer Society, Strandboulevarden 49, 2100, København, Denmark;1. Regional Cancer Center, Trivandrum, Kerala, India;2. Natural Background Radiation Cancer Registry, Karunagappally, Kerala, India;3. Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;1. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA;2. Data Analytics Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA;3. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA;4. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA;1. Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA;2. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA;3. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;4. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA;5. Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA |
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| Abstract: | BackgroundFrance is among the countries showing fastest growth of thyroid cancer (TC) incidence and highest incidence rates in Europe. This study aimed to clarify the temporal and geographical variations of TC in France and to quantify the impact of overdiagnosis.MethodsWe obtained TC incidence data in 1986–2015, and mortality data in 1976–2015, for eight French departments covering 8% of the national population, and calculated the age-standardised rates (ASR). We estimated the average annual percent changes (AAPC) of TC incidence, overall and by department and histological subtype. Numbers and proportions of TC cases attributable to overdiagnosis were estimated by department and period, based on the comparison between the shape of the age-specific curves with that observed prior to changes in diagnostic practice.ResultsDuring 1986–2015, there were 13,557 TC cases aged 15–84 years. Large variations of TC incidence were observed across departments, with the highest ASR and the fastest increase in Isère. Papillary subtype accounted for 82.8% of the cases, and presented an AAPC of 7.0% and 7.6% in women and men, respectively. Anaplastic TC incidence decreased annually 3.0% in women and 0.8% in men. Mortality rates declined consistently for all departments. The absolute number (and proportion) of TC cases attributable to overdiagnosis grew from 1074 (66%) in 1986–1995 to 3830 (72%) in 2006–2015 in women, and varied substantially across departments.ConclusionsOverdiagnosis plays an important role in the temporal and regional variations of TC incidence in France. Monitoring the time trends and regulating the regional healthcare practice are needed to reduce its impact. |
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| Keywords: | Thyroid cancer Time trends Geographical variations Overdiagnosis |
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