揭开甲状腺癌发病率的上升和解决过度诊断问题
Debbie W Chen1, Megan R Haymart2
1Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA.
Nature reviews. Endocrinology
|September 3, 2025
概括
全球甲状腺癌发病率急剧上升, 死亡率保持稳定,强调需要解决甲状腺癌的过度诊断和过度治疗问题.
科学领域:
- 癌症学
- 公共卫生
- 医学成像
背景情况:
- 全球甲状腺癌发病率自20世纪80年代以来显著增加.
- 在同一时期,甲状腺癌死亡率保持相对稳定.
- 过度诊断小小的乳头甲状腺癌是导致发病率上升的主要原因.
研究的目的:
- 审查过去40年的甲状腺癌发病率趋势.
- 概述甲状腺癌的已知和潜在风险因素,包括肥胖和环境暴露.
- 探索管理过度诊断和过度治疗的公共卫生挑战的策略.
主要方法:
- 对甲状腺癌发病率和死亡率的流行病学数据的审查.
- 分析诊断成像,特别是超声波对发病率的影响.
- 检查风险因素及其对甲状腺癌趋势的贡献.
主要成果:
- 全球甲状腺癌发病率急剧上升,主要是由于过度诊断乳腺癌.
- 尽管发生率增加,但甲状腺癌死亡率稳定.
- 甲状腺癌发病率增加对整体趋势的贡献
结论:
- 广泛使用成像技术,尤其是超声波, 导致甲状腺癌的诊断过度.
- 需要采取战略来应对过度诊断和随后的过度治疗,以减轻公共卫生负担.
- 了解肥胖和环境暴露等危险因素对于未来的预防和管理至关重要.
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