scholarly journals Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis

2020 ◽  
Vol 105 (8) ◽  
pp. 2507-2514
Author(s):  
Chiara Panato ◽  
Salvatore Vaccarella ◽  
Luigino Dal Maso ◽  
Partha Basu ◽  
Silvia Franceschi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Access To Health Care ◽  
Cancer Registries ◽  
Incidence Rates ◽  
Indian Women ◽  
Screening Practice ◽  
Access To Health ◽  
Indian Men ◽  
Transitioning Countries ◽  
New Strategies

Abstract Context/Objective Increases of thyroid cancer (TC) incidence emerged in the past several decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area. Design TC cases aged 0 to 74 years reported to Indian cancer registries during 2006 through 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area. Results Between 2006-2008 and 2012-2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100,000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012-2014), with 93% increase in women and 64% in men compared with 2006-2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35 to 54 years, and 30% at ages 55 to 64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, whereas none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, or Sikkim. Conclusions Relatively high and increasing TC ASRs emerged in Indian regions where better access to health care was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.

Thyroid cancer incidence in India between 2006 and 2014 and impact of overdiagnosis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18574-e18574
Author(s):  
Aju Mathew ◽  
Luigino Dal Maso ◽  
Chiara Panato ◽  
Diego Serraino ◽  
Silvia Franceschi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Registries ◽  
Incidence Rates ◽  
Limited Evidence ◽  
Indian Women ◽  
Screening Practice ◽  
Indian Men ◽  
Transitioning Countries ◽  
Thyroid Cancer Incidence ◽  
New Strategies

e18574 Background: Increases of thyroid cancer (TC) incidence emerged in the last decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area. Methods: TC cases aged 0-74 years reported to Indian cancer registries during 2006- 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area. Results: Between 2006-2008 and 2012-2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100.000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012- 2014), with 93% increase in women and 64% in men compared to 2006-2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35-54 years, and 30% at ages 55-64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, while none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, and Sikkim. Conclusions: Relatively high and increasing TC ASRs emerged in Indian regions where better access to healthcare was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.

Increase in the incidence of differentiated thyroid carcinoma in children, adolescents, and young adults (AYA): A population-based study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9523-9523
Author(s):  
Lucas B. Vergamini ◽  
A. Lindsay Frazier ◽  
Fernanda L. Abrantes ◽  
Karina Braga Ribeiro ◽  
Carlos Rodriguez-Galindo
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Cancer Registries ◽  
International Classification Of Diseases ◽  
The United States ◽  
Differentiated Thyroid Carcinoma ◽  
Population Based ◽  
Incidence Rates ◽  
Primary Tumors ◽  
Increasing Trends

9523 Background: Studies have shown an increase in thyroid cancer incidence among adults since the 1990s. However, few studies have evaluated this occurrence among children and AYA. Increases resulting from enhanced detection are most likely to involve small tumors. The objective of this study is to investigate trends in incidence of differentiated thyroid carcinomas in children and AYA by size and sex. Methods: This is an ecological time-trend study. Cases of differentiated thyroid cancer (1984-2008) in patients younger than 30 years old were selected from SEER 9 cancer registries using International Classification of Diseases for Oncology 3rd edition (ICD-O-3) codes for papillary and follicular cancers (codes 8050/3, 8052/3, 8130/3, 8260/3, 8290/3, 8330-8332/3, 8335/3, 8340-8344/3, 8450/3 and 8452/3). Patients who had multiple primary tumors were excluded from the study. SEER*Stat software was used to calculate age-standardized rates (estimated per 1,000,000 persons; World Standard Population) and annual percentage changes (APC) were calculated using Joinpoint model. Results: Rates ranged from 2.77 (1990) to 7.45 (2002) for males and from 17.19 (1987) to 41.3 (2008) for females. Overall, a significant increasing trend in incidence was observed for females (APC=3.20, 95%CI 2.80, 3.60). When a stratified analysis based on tumor size was performed, significant increasing trends were noted for the following categories: 0.5-0.9 cm (Males: APC=3.50, 95%CI 1.50, 5.40; Females: APC=7.30, 95%CI 5.90, 8.80), 1.0-1.9 cm (Males: APC=3.20, 95%CI 1.00, 5.40; Females: APC=2.90, 95%CI 2.20, 3.70), and ≥ 2cm (Males: APC=1.30, 95%CI 0.30, 2.40; Females: APC=2.50, 95%CI 1.70, 3.20). However, no statistically significant trends were noted for tumors <0.5 cm (Males: APC=2.50, 95%CI -0.30, 5.40; Females: APC=2.0, 95%CI -6.90, 11.80). Conclusions: Incidence rates for differentiated thyroid carcinoma are also increasing among children and AYA in the United States. The absence of increasing trends for small tumors (< 0.5cm) rules out diagnostic scrutiny as the only explanation for the observed results. Environmental, dietary and genetic factors should be investigated.

scholarly journals Thyroid Cancer Incidences From Selected South America Population-Based Cancer Registries: An Age-Period-Cohort Study

2018 ◽  
pp. 1-11 ◽  
Author(s):  
Anne Karin da Mota Borges ◽  
Adalberto Miranda-Filho ◽  
Sérgio Koifman ◽  
Rosalina Jorge Koifman
Keyword(s):  
Thyroid Cancer ◽  
Costa Rica ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Period Effect ◽  
Incidence Trends ◽  
Drift Model ◽  
Age Cohort ◽  
Rate Ratios

Purpose The incidence of thyroid cancer (TC) has increased substantially worldwide. However, there is a lack of knowledge about age-period-cohort (APC) effects on incidence rates in South American countries. This study describes the TC incidence trends and analyzes APC effects in Cali, Colombia; Costa Rica; Goiânia, Brazil; and Quito, Ecuador. Materials and Methods Data were obtained from the Cancer Incidence in Five Continents series, and the crude and age-standardized incidence rates were calculated. Trends were assessed using the estimated annual percentage change, and APC models were estimated using Poisson regression for individuals between age 20 and 79 years. Results An increasing trend in age-standardized incidence rates was observed among women from Goiânia (9.2%), Costa Rica (5.7%), Quito (4.0%), and Cali (3.4%), and in men from Goiânia (10.0%) and Costa Rica (3.4%). The APC modeling showed that there was a period effect in all regions and for both sexes. Increasing rate ratios were observed among women over the periods. The best fit model was the APC model in women from all regions and in men from Quito, whereas the age-cohort model showed a better fit in men from Cali and Costa Rica, and the age-drift model showed a better fit among men from Goiânia. Conclusion These findings suggest that overdiagnosis is a possible explanation for the observed increasing pattern of TC incidence. However, some environmental exposures may also have contributed to the observed increase.

scholarly journals Difference in access to health care for newly arrived refugees in Germany: a natural quasi-experiment

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Wenner ◽  
K Rolke ◽  
O Razum
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Access To Health Care ◽  
Emergency Service ◽  
Local Level ◽  
Incidence Rates ◽  
Health Care Use ◽  
Federal State ◽  
Access Barriers ◽  
Access To Health

Abstract Background Providing quantitative evidence on structural access barriers to health care for newly arrived refugees constitutes a challenge due to a lack of suitable data. The coexistence of two different local access models in Germany allows for a comparative analysis of the association between access policies and realized access. Our study compares these two models to establish whether they lead to differences in access to care among refugees. Methods Municipalities in Germany’s largest federal state of North Rhine-Westphalia (NRW) have implemented different access models to which refugees are quasi-randomly assigned. We recruited 6 municipalities of which 3 decided to implement the health care voucher (HcV) model and 3 the electronic health card model (eHC) in a natural quasi-experimental study design. Analyses were based on claims data collected from the welfare offices or the statutory health insurance. We compared standardized incidence rates (SIR) based on 3 indicators: emergency service, ambulatory sensitive hospitalization and use of specialized care. Results We included data on health care use of all recently assigned refugees in the 6 municipalities over a period of 7 quarters (2016/17). The average quarterly sample size is n = 9,077 which corresponds to 6.5% of the population of recently assigned refugees in NRW at that time. We find differences in realized access between the models. For emergency care, the SIR differ significantly between municipalities using the HcV model (SIR:1.88; 95%-CI: 1.62-2.18) and eHC model (SIR:1.33; 95%-CI: 1.14-1.55). Conclusions Local decisions regarding the organization of access to health care are associated with differences in realized access to health care of refugees in NRW. The implementation of the eHC model may contribute to a decrease of emergency service. Further analyses should attempt to reduce a possible (self-)selection bias of municipalities which might have led to an underestimation of the difference between models. Key messages The organization of health care for newly arrived refugees on the local level is decisive for their access to care. Local policy makers may use their scope for action to remove access barriers for newly arrived refugees.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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