Trends and disparities in thyroid cancer related mortality from 1999 to 2023: about CDC WONDER database analysis
摘要
Thyroid cancer mortality has varied across demographic groups in the US, but comprehensive recent analyses are limited. This population-based retrospective cohort study examines trends in thyroid cancer-related mortality from 1999 to 2023 using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER).
MethodsMortality due to malignant thyroid neoplasms (ICD-10 C73) was included. Eligibility included US resident deaths recorded between 1999 and 2023 with thyroid cancer as the underlying cause. Trends in age-adjusted mortality rates (AAMR, per 100,000) across sex, age, race/ethnicity, urbanization, and geographic regions were analyzed using Joinpoint regression with Monte Carlo permutation to estimate annual percent change (APC) and average annual percentage changes (AAPC).
ResultsDuring the study period, 53,145 deaths were attributed to malignant neoplasms of the thyroid. The overall AAMR declined from 0.86 to 0.77 per 100,000. Both sexes showed increased mortality until about 2019 and 2020, following which there were significant declines in mortality. Male patients experienced a higher mortality increase pre-2020 and steeper decline post-2020. Rural populations observed greater mortality increases compared to urban populations. Black or African American patients and White patients had consistently lower thyroid cancer-related mortality than Asian or Pacific Islander and Hispanic patients. Asian or Pacific Islander patients demonstrated relatively stable AAMRs over the study period without a statistically significant change. Older age groups, especially ≥ 85 years, had the highest crude mortality and significant increase in mortality post-2017. The South, Midwest, and West regions had significant mortality increases with a sharp rise in the South post-2019.
ConclusionsDespite an overall decline in malignant thyroid neoplasm related mortality since 1999, there are persistent disparities due to sex, age, urbanization, race and region. Future research should investigate the drivers of the disparities closely, and healthcare policy should also aim to improve availability and accessibility to thyroid cancer related education, screening, detection, and treatment especially to those populations with disproportionately high risk.
Clinical trial numberNot applicable.