Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality

Hyeong Sik Ahn, Hyun Jung Kim, Kyoung Hoon Kim, Young Sung Lee, Seung Jin Han, Yuri Kim, Min Ji Ko, Juan P. Brito

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: The incidence of thyroid cancer has increased worldwide. The country where the incidence has increased most is South Korea. The goal of this study is to understand the magnitude of association between opportunistic thyroid cancer screening and thyroid cancer incidence, thyroid cancer subtype, and disease-specific mortality. Methods: We used the 2010 Korea Community Health Survey, which queried 226,873 individuals if they had been screened for thyroid cancer in the last two years. Thyroid cancer incidence data from 2008 to 2010 were obtained from the Korea Cancer registry data, and mortality data from 2007-2010 were obtained from the Statistics Korea database. The ecological association between thyroid screening and thyroid cancer incidence and mortality by age and sex were examined across Korea's 16 administrative regions by general linear regression models. Results: Between 2008 and 2010, the incidence of thyroid cancer was 64.1 per 100,000 individuals: The incidence in females was 107.3 and in males was 21.1. There was a strong positive correlation between regional thyroid cancer screening and regional thyroid cancer incidence (r = 0.77, [95% confidence interval 0.70-0.82]). The magnitude of correlation was higher for females (r = 0.88 [CI 0.83-0.92]) than in males (r = 0.76 [CI 0.67-0.84]) in any age group. Thyroid screeningwas only associatedwith increased detection of papillary thyroid cancer (r = 0.74 [CI 0.59- 0.88]); and not associated with mortality (r=-0.08 [CI -0.59-0.63]) due to thyroid cancer. Conclusions: The magnitude of association between thyroid cancer screening in South Korea and the incidence of thyroid cancer strongly suggests that screening is the most important driver of the epidemic of thyroid cancer, particularly among females. Thyroid cancer screening, however, was only associated with the increase of one tumor histology, papillary thyroid cancer, and it did not have any association with thyroid cancer mortality. The extent to which opportunistic thyroid cancer screening is converting thousands of asymptomatic persons to cancer patients without any known benefit to them needs to be examined carefully.

Original languageEnglish
Pages (from-to)1535-1540
Number of pages6
JournalThyroid
Volume26
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1

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Republic of Korea
Early Detection of Cancer
Thyroid Neoplasms
Mortality
Neoplasms
Incidence
Korea
Linear Models
Thyroid Gland

Keywords

  • Korea
  • Overdiagnosis
  • Screening
  • Thyroid cancer

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality. / Ahn, Hyeong Sik; Kim, Hyun Jung; Kim, Kyoung Hoon; Lee, Young Sung; Han, Seung Jin; Kim, Yuri; Ko, Min Ji; Brito, Juan P.

In: Thyroid, Vol. 26, No. 11, 01.11.2016, p. 1535-1540.

Research output: Contribution to journalArticle

Ahn, Hyeong Sik ; Kim, Hyun Jung ; Kim, Kyoung Hoon ; Lee, Young Sung ; Han, Seung Jin ; Kim, Yuri ; Ko, Min Ji ; Brito, Juan P. / Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality. In: Thyroid. 2016 ; Vol. 26, No. 11. pp. 1535-1540.
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abstract = "Background: The incidence of thyroid cancer has increased worldwide. The country where the incidence has increased most is South Korea. The goal of this study is to understand the magnitude of association between opportunistic thyroid cancer screening and thyroid cancer incidence, thyroid cancer subtype, and disease-specific mortality. Methods: We used the 2010 Korea Community Health Survey, which queried 226,873 individuals if they had been screened for thyroid cancer in the last two years. Thyroid cancer incidence data from 2008 to 2010 were obtained from the Korea Cancer registry data, and mortality data from 2007-2010 were obtained from the Statistics Korea database. The ecological association between thyroid screening and thyroid cancer incidence and mortality by age and sex were examined across Korea's 16 administrative regions by general linear regression models. Results: Between 2008 and 2010, the incidence of thyroid cancer was 64.1 per 100,000 individuals: The incidence in females was 107.3 and in males was 21.1. There was a strong positive correlation between regional thyroid cancer screening and regional thyroid cancer incidence (r = 0.77, [95{\%} confidence interval 0.70-0.82]). The magnitude of correlation was higher for females (r = 0.88 [CI 0.83-0.92]) than in males (r = 0.76 [CI 0.67-0.84]) in any age group. Thyroid screeningwas only associatedwith increased detection of papillary thyroid cancer (r = 0.74 [CI 0.59- 0.88]); and not associated with mortality (r=-0.08 [CI -0.59-0.63]) due to thyroid cancer. Conclusions: The magnitude of association between thyroid cancer screening in South Korea and the incidence of thyroid cancer strongly suggests that screening is the most important driver of the epidemic of thyroid cancer, particularly among females. Thyroid cancer screening, however, was only associated with the increase of one tumor histology, papillary thyroid cancer, and it did not have any association with thyroid cancer mortality. The extent to which opportunistic thyroid cancer screening is converting thousands of asymptomatic persons to cancer patients without any known benefit to them needs to be examined carefully.",
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T1 - Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality

AU - Ahn, Hyeong Sik

AU - Kim, Hyun Jung

AU - Kim, Kyoung Hoon

AU - Lee, Young Sung

AU - Han, Seung Jin

AU - Kim, Yuri

AU - Ko, Min Ji

AU - Brito, Juan P.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background: The incidence of thyroid cancer has increased worldwide. The country where the incidence has increased most is South Korea. The goal of this study is to understand the magnitude of association between opportunistic thyroid cancer screening and thyroid cancer incidence, thyroid cancer subtype, and disease-specific mortality. Methods: We used the 2010 Korea Community Health Survey, which queried 226,873 individuals if they had been screened for thyroid cancer in the last two years. Thyroid cancer incidence data from 2008 to 2010 were obtained from the Korea Cancer registry data, and mortality data from 2007-2010 were obtained from the Statistics Korea database. The ecological association between thyroid screening and thyroid cancer incidence and mortality by age and sex were examined across Korea's 16 administrative regions by general linear regression models. Results: Between 2008 and 2010, the incidence of thyroid cancer was 64.1 per 100,000 individuals: The incidence in females was 107.3 and in males was 21.1. There was a strong positive correlation between regional thyroid cancer screening and regional thyroid cancer incidence (r = 0.77, [95% confidence interval 0.70-0.82]). The magnitude of correlation was higher for females (r = 0.88 [CI 0.83-0.92]) than in males (r = 0.76 [CI 0.67-0.84]) in any age group. Thyroid screeningwas only associatedwith increased detection of papillary thyroid cancer (r = 0.74 [CI 0.59- 0.88]); and not associated with mortality (r=-0.08 [CI -0.59-0.63]) due to thyroid cancer. Conclusions: The magnitude of association between thyroid cancer screening in South Korea and the incidence of thyroid cancer strongly suggests that screening is the most important driver of the epidemic of thyroid cancer, particularly among females. Thyroid cancer screening, however, was only associated with the increase of one tumor histology, papillary thyroid cancer, and it did not have any association with thyroid cancer mortality. The extent to which opportunistic thyroid cancer screening is converting thousands of asymptomatic persons to cancer patients without any known benefit to them needs to be examined carefully.

AB - Background: The incidence of thyroid cancer has increased worldwide. The country where the incidence has increased most is South Korea. The goal of this study is to understand the magnitude of association between opportunistic thyroid cancer screening and thyroid cancer incidence, thyroid cancer subtype, and disease-specific mortality. Methods: We used the 2010 Korea Community Health Survey, which queried 226,873 individuals if they had been screened for thyroid cancer in the last two years. Thyroid cancer incidence data from 2008 to 2010 were obtained from the Korea Cancer registry data, and mortality data from 2007-2010 were obtained from the Statistics Korea database. The ecological association between thyroid screening and thyroid cancer incidence and mortality by age and sex were examined across Korea's 16 administrative regions by general linear regression models. Results: Between 2008 and 2010, the incidence of thyroid cancer was 64.1 per 100,000 individuals: The incidence in females was 107.3 and in males was 21.1. There was a strong positive correlation between regional thyroid cancer screening and regional thyroid cancer incidence (r = 0.77, [95% confidence interval 0.70-0.82]). The magnitude of correlation was higher for females (r = 0.88 [CI 0.83-0.92]) than in males (r = 0.76 [CI 0.67-0.84]) in any age group. Thyroid screeningwas only associatedwith increased detection of papillary thyroid cancer (r = 0.74 [CI 0.59- 0.88]); and not associated with mortality (r=-0.08 [CI -0.59-0.63]) due to thyroid cancer. Conclusions: The magnitude of association between thyroid cancer screening in South Korea and the incidence of thyroid cancer strongly suggests that screening is the most important driver of the epidemic of thyroid cancer, particularly among females. Thyroid cancer screening, however, was only associated with the increase of one tumor histology, papillary thyroid cancer, and it did not have any association with thyroid cancer mortality. The extent to which opportunistic thyroid cancer screening is converting thousands of asymptomatic persons to cancer patients without any known benefit to them needs to be examined carefully.

KW - Korea

KW - Overdiagnosis

KW - Screening

KW - Thyroid cancer

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