Literature DB >> 29502036

The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012.

Luigino Dal Maso1, Chiara Panato2, Silvia Franceschi3, Diego Serraino2, Carlotta Buzzoni4, Susanna Busco5, Stefano Ferretti6, Antonietta Torrisi7, Fabio Falcini8, Manuel Zorzi9, Claudia Cirilli10, Walter Mazzucco11, Michele Magoni12, Paolo Collarile2, Fabio Pannozzo5, Anna Luisa Caiazzo13, Antonio Giampiero Russo14, Alessio Gili15, Adele Caldarella16, Roberto Zanetti17, Maria Michiara18, Lucia Mangone19, Rosa Angela Filiberti20, Mario Fusco21, Francesca Gasparini6, Giovanna Tagliabue22, Rosaria Cesaraccio23, Rosario Tumino24, Luciana Gatti25, Francesco Tisano26, Silvano Piffer27, Giovanna Maria Sini28, Guido Mazzoleni29, Stefano Rosso30, Anna Clara Fanetti31, Salvatore Vaccarella3.   

Abstract

AIMS: In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis.
METHODS: Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology. TC overdiagnosis was estimated by sex, period, age, and Italian region.
RESULTS: In Italy between 1998-2002 and 2008-2012, TC ASR increased of 74% in women (from 16.2 to 28.2/100,000) and of 90% in men (from 5.3 to 10.1/100,000). ASR increases were nearly exclusively due to papillary TC (+91% in women, +120% in men). In both sexes, more than three-fold differences emerged between regions with highest and lowest ASR. Among TC cases diagnosed in 1998-2012 in Italy, we estimated that overdiagnosis accounted for 75% of cases in women and 63% in men and increased over the study period leading to overdiagnosis of 79% in women and 67% in men in 2008-2012. Notably, overdiagnosis was over 80% among women aged <55 years, and substantial variations were documented across Italian regions, in both genders. CONCLUSION(S): Incidence rates of TC are steadily increasing in Italy and largely due to overdiagnosis. These findings call for an update of thyroid gland examination practices in the asymptomatic general population, at national and regional levels.
Copyright © 2018 Elsevier Ltd. All rights reserved.

Entities:  

Keywords:  Incidence; Italy; Mortality; Overdiagnosis; Thyroid cancer; Time trends

Mesh:

Year:  2018        PMID: 29502036     DOI: 10.1016/j.ejca.2018.01.083

Source DB:  PubMed          Journal:  Eur J Cancer        ISSN: 0959-8049            Impact factor:   9.162


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