Evaluation and projection of the global burden of thyroid cancer from 1990 to 2035: an analysis based on the Global Burden of Disease Study

1990年至2035年全球甲状腺癌负担的评估和预测:基于全球疾病负担研究的分析

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Abstract

BACKGROUND: Thyroid cancer (TC) is one of the most rapidly increasing endocrine malignancies worldwide, yet its long-term epidemiologic trends remain incompletely understood. We aimed to evaluate the global, regional, and national burden of TC from 1990 to 2021 and project its incidence and mortality to 2035 based on data from the Global Burden of Disease (GBD) Study. METHODS: The Global Burden of Disease database was used to collect age-standardized incidence rates (ASIR), age-standardized death rates (ASDR) and disability-adjusted life years (DALYs) for TC. Age-standardized rates (ASRs) were employed as indicators for these measurements. We calculated the estimated annual percent change (EAPC) and measured the mean change in ASRs. Additionally, we assessed TC-attributable risk factors and trends across different regions and age groups worldwide. The Bayesian age-period-cohort model was applied to predict future trends until 2035. RESULTS: In 2021, the worldwide TC age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), and age-standardized DALY rates (ASDALYR) per 100,000 population were 2.91 (95% uncertainty interval (UI), 2.61-3.21), 0.53 (95% UI, 0.47-0.57), and 14.57 (95% UI, 12.78-16.11), respectively. Compared with 1990, the EAPC was 1.25 (95% UI, 1.13-1.37) for ASIR, -0.24 (95% UI, -0.27 to 0.21) for ASDR, and -0.14 (95% UI, -0.17 to 0.11) for ASDALY, respectively. As individuals age, the disease burden of TC increases, and there are significant variations across different regions worldwide. Elevated body mass index is a major risk factor for TC-related deaths and DALYs. From 2022 to 2035, the global ASIR is expected to rise slightly from 3.00 (95% UI, 2.92-3.08) in 2022 to 3.62 (95% UI, 3.26-3.97) in 2035, while ASDR and ASDALYR are anticipated to remain relatively stable with just marginal variations.The global ASIR of TC experienced an upward trend from 1990 to 2021; however, ASDR and ASDALY slightly decreased. Projections from 2022 to 2035 indicate a slight increase in ASIR, with ASDR and ASDALY remaining stable. CONCLUSION: The global burden of thyroid cancer remains substantial and is projected to continue increasing through 2035. Public health strategies should be strengthened to address modifiable risk factors, particularly reducing obesity rates and optimize comprehensive cancer control for TC, with targeted approaches to early diagnosis in high-risk populations rather than population-wide screening.

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