全球63个国家的甲状腺癌流行病学模式的演变和2013年至2017年的过度诊断估计:基于人口的研究研究
Mengmeng Li1, Luigino Dal Maso2, Margherita Pizzato3
1Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
The lancet. Diabetes & endocrinology
|October 10, 2024
概括
全球甲状腺癌发病率正在上升,主要是由于过度诊断. 超过75%的病例被过度诊断,这代表着一个重大的公共卫生挑战,需要紧急应对策略.
科学领域:
- 流行病学 流行病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 在全球范围内,甲状腺癌的发病率一直在增加.
- 过度诊断是这种增长的主要驱动力.
- 需要了解过度诊断的范围,并确定干预领域.
研究的目的:
- 评估甲状腺癌诊断流行病的特征.
- 为了估计五大洲的过度诊断率.
- 确定需要干预策略的地区.
主要方法:
- 利用IARC全球癌症观测中心 (1980-2017) 和世卫组织 (1980-2022) 的数据.
- 分析了按年龄标准化的发生率和按性别的死亡率 (ASR).
- 使用经过验证的方法估计过度诊断的病例.
主要成果:
- 从1980年到2017年,甲状腺癌发病率在大多数国家都增加了,但显著的例外显示最近的下降.
- 死亡率仍然远低于发病率.
- 过度诊断因国家而异,有些人在女性中超过85%;总体而言,75.6%的病例被过度诊断.
结论:
- 尽管一些高收入国家出现平原化或下降,但甲状腺癌的过度诊断仍然是一个重大的全球公共卫生问题.
- 过度诊断在转型国家迅速扩大,需要立即关注.
- 制定和实施应对策略对于应对这一挑战至关重要.
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