Changing natural history of differentiated thyroid cancer

Excerpt

The incidence of thyroid cancer has been increasing in many countries over the last 30 years. In the USA, the incidence of thyroid cancer increased from 3.6/100.000 people in 1973 to 8.7/100.000 people in 2002 [1]. This phenomenon is mainly due to an increase in the papillary histotype, which raised from 2.7 to 7.7/100.000, a 2.9-fold increase. The same trend has been reported in Europe [2]. The bulk of the increase is probably the results of better detection of small cancer, measuring 1.5 cm or less. Despite increasing incidence, the mortality from papillary thyroid cancer remained stable (0.5 deaths/100.000 in both 1973 and 2002) [1]. A recent study by Pagano et al. [3] confirm this trend in thyroid cancer patients diagnosed in a tertiary hospital in north Italy, in an area characterized by moderate iodine deficiency. The authors compared the epidemiological and clinico-pathological features of patients according to the time of diagnosis (1997–2005 and 2006–2010). The cut off of 2005 was chosen because it is coincident with the introduction of iodine prophylaxis and with the adoption of international guidelines for the diagnosis and management of thyroid cancer [4, 5]. …