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Thyroid cancer on the rise among young adults in Denmark
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The thyroid cancer rate has remained steady since 1980 among Danish children and adolescents, but diagnoses among patients aged 18 to 24 years have grown, with specific increases among women and those with papillary carcinoma, according to findings published in Thyroid.
Jakob Schmidt Jensen, of the department of otorhinolaryngology, head and neck surgery, and audiology at Rigshospitalet, University of Copenhagen, and colleagues used data from the Danish Cancer Registry, the Danish Pathology Data Bank and the central population register to study the incidence of thyroid cancer among Denmark residents aged 0 to 24 years from 1980 to 2014.
Among the study population, 297 people were diagnosed with thyroid cancer. Of those, 213 were girls and women. Papillary carcinoma accounted for 72% of the diagnoses. Median age at diagnosis was 21 years with higher incidence among those aged 18 to 24 years (1.31 per 100,000) compared with those aged 0 to 17 years (0.21 per 100,000; P < .001).
Young adults also experienced an accelerated growth in average annual incidence rate during the study period, with the rate rising from 1.15 per 100,000 in 1980 to 2.91 in 2014. Girls and women were more adversely affected than boys and men, with an incidence rate of 0.75 per 100,000 in 2014, up from a mark of 0.21 in 1980. The incidence rate for boys and men increased only marginally from 0.15 in 1980 to 0.21 in 2014.
“A higher incidence was observed among females compared to males,” the researchers wrote. “This has been demonstrated previously, and it has been suggested that this difference may be caused or modulated by estrogens.”
Thyroid cancer occurred more frequently as patients aged. Among those aged 24 years, there was a 1.7 per 100,000 incidence rate, which was a substantial increase from the reading of 0.05 for those younger than 1 year.
“The curve seems to demonstrate a change around the age of 10 years, especially among female patients,” the researchers wrote. “An increase in incidence at the onset of puberty has also been demonstrated by others. The explanation for this is plausibly the increase in female sex hormones at puberty.”
The researchers also examined overall survival rates and noted there were nine deaths among the 297 people diagnosed with thyroid cancer in the sample. Papillary carcinoma accounted for six of the deaths, and a patient’s sex did not appear to affect survival. Three of the deaths occurred before age 30 years. The 15-year overall survival rate was 99% among all thyroid cancer patients, which remained steady during the 35-year study period; the 96% survival rate for medullary carcinoma was the lowest of each specific type.
“A significant difference was observed in the distribution of tumor types between children and adolescents and young adults,” the researchers wrote. “This finding is most likely explained by the fact that medullary carcinomas in patients with a hereditary genetic predisposition for this cancer most commonly present in childhood, explaining why this tumor is more common among children and adolescents.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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Schmidt Jensen J, et al. Thyroid. 2018;doi:10.1089/thy.2018.0067.
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