Eur J Endocrinol
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DOI: 10.1530/EJE-08-0624
European Journal of Endocrinology, Vol 160, Issue 1, 71-79
Copyright © 2009 by European Society of Endocrinology
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CLINICAL STUDY

Thyroid cancer: is the incidence rise abating?

Geneviève Sassolas1,*, Zakia Hafdi-Nejjari1,*, Laurent Remontet2, Nadine Bossard2, Aurélien Belot2,4, Nicole Berger-Dutrieux3, Myriam Decaussin-Petrucci3, Claire Bournaud1,5, Jean Louis Peix3, Jacques Orgiazzi3,5, Françoise Borson-Chazot1,5 and the Group of Pathologists of the Rhône Alpes Region

1 Hospices Civils de Lyon, Registre Rhône Alpin des Cancers Thyroïdiens, Fédération d'Endocrinologie et Centre de Médecine Nucléaire Groupement Hospitalier Est, 59 Boulevard Pinel, 69677 Bron Cedex, France2 Hospices Civils de Lyon, Service de Biostatistique, Laboratoire Biostatistique Santé, Université Lyon I, 69495 Pierre Bénite, France3 Hospices Civils de Lyon, Laboratoire d'Anatomie Pathologique, Service d'Endocrinologie et Service de Chirurgie Endocrinienne, Centre Hospitalier Lyon Sud, 69424 Lyon, France4 Département des Maladies Chroniques et des Traumatismes, Institut de Veille Sanitaire, 94 415 Saint-Maurice, France5 Université de Lyon, Université Lyon 1, Inserm U664, F-69008 Lyon, France

(Correspondence should be addressed to F Borson-Chazot; Email: francoise.borson-chazot{at}chu-lyon.fr)

* (G Sassolas and Z Hafdi-Nejjari contributed equally to this work)

Objective: The aim of the present study was to determine recent trends in thyroid cancer incidence rates and to analyze histopathological characteristics and geographical distribution.

Methods: Histologically proven 5367 cases were collected over the period 1998–2006 in France from the Rhône-Alpes thyroid cancer registry. Geographical variations of incidence were analyzed using a mixed Poisson model.

Results: The average incidence rates, age standardized to the world population, were 3.9/100 000 in men and 12.3/100 000 in women, higher than those previously reported in France. After an initial increase during the first 3 years, a steady level of incidence was observed for the period 2001–2006. The annual incidence rate of microcarcinomas was correlated with that of all cancers in men and women (r=0.78 and 0.89; P<0.01) respectively. Papillary microcarcinomas represented 38% of tumors and two-thirds of them measured less than 5 mm in diameter. They were fortuitously discovered after thyroidectomy for benign diseases in 64% of cases. Histological marks of aggressiveness differed according to the size of the tumor. Despite recent advances in diagnosis, 13% of tumors were diagnosed at advanced stage especially in men. Geographical distribution of incidence based on subregional administrative entities showed lower incidence rates in rural than in urban zones in men (relative rate: 0.72; 95% CI: 0.62–0.84) and women (relative rate: 0.85; 95% CI: 0.73–0.93).

Conclusion: The present study suggests that the rise in thyroid cancer incidence is now abating. It could reflect standardization in diagnostic procedures. Further studies, performed on a more prolonged period, are necessary to confirm these data.






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