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Abstract
Background and Objectives
The incidence of thyroid cancer is increasing worldwide. The increase in the frequency of screening tests may have led to an over-detection of small thyroid cancers. The Korean Thyroid Association (KTA) discourages the find needle aspiration of thyroid nodules ≤0.5 cm. The aim of this study was to evaluate time trends of characteristics of thyroid cancer patients in a single medical center.
Materials and Methods
This study included 15,465 patients who underwent operation due to thyroid cancer from 1995 to 2012. Data on age, gender of patients and histology, clinical stage of the thyroid cancer were reviewed retrospectively.
Results
New thyroid cancer cases have dramatically increased and papillary thyroid carcinoma (PTC) accounted for a major part of this increase. PTCs were accounted for 98% of all thyroid cancer surgeries in 2012 and 79% in 1995. The proportion of PTCs ≤0.5 cm has increased from 1% in 1995 to 32% in 2009 and then slightly decreased afterward. The peak age of patients with PTC has increased from 40 years in 1995-2000 to 55 years in 2006-2012. The proportion of small follicular thyroid carcinomas and medullary thyroid carcinomas (≤1.0 cm) also steadily increased during study periods.
References
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Fig. 1.
Time trends of the thyroid cancers. (A) Changes in the number of thyroid cancer patients according to their pathology type. (B) Changes in the number of papillary thyroid carcinoma patients according to their primary tumor size. (C) Changes in the proportion of papillary thyroid carcinoma patients according to their primary tumor size. The number in this table presented the percentage of patients in each year.
Fig. 2.
Time trends in the number of thyroid cancer patients except papillary thyroid carcinoma. (A) Changes in the number of thyroid cancer patients except papillary thyroid carcinoma according to their pathology type. (B) Changes in the number of follicular thyroid carcinoma patients according to their primary tumor size. (C) Changes in the number of medullary thyroid carcinoma patients according to their primary tumor size.
Fig. 3.
Time trends in the age of thyroid cancer patients. The X axis represents the age of patients and the Y axis represents the percentage of patients. Patients were classified into 3 groups according to their year of operation; 1995-2000, 2001-2005 and 2006-2012. (A) Overall patients. (B) Female. (C) Male.
Table 1.
Time trends in surgical extent and stage of papillary thyroid carcinoma
| 1995 | 1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Extent of surgery | ||||||||||||||||||
| Total thyroidectomy | 57.1 | 85.0 | 93.5 | 94.4 | 86.5 | 77.1 | 73.6 | 75.8 | 68.0 | 73.7 | 77.8 | 78.1 | 78.6 | 73.0 | 66.7 | 62.1 | 59.5 | 54.0 |
| Partial thyroidectomy | 42.9 | 15.0 | 6.5 | 5.6 | 13.5 | 22.9 | 26.0 | 24.2 | 32.0 | 26.3 | 22.1 | 21.9 | 21.3 | 27.0 | 33.3 | 37.7 | 40.5 | 46.0 |
| Other⋆ | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.4 | 0.0 | 0.0 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 | 0.2 | 0.0 | 0.0 |
| Extent of invasion | ||||||||||||||||||
| No perlthyroldal extension | 58.6 | 44.1 | 52.2 | 49.5 | 48.3 | 40.7 | 43.8 | 45.2 | 52.6 | 51.0 | 45.9 | 37.4 | 38.5 | 41.8 | 40.7 | 37.7 | 46.2 | 52.7 |
| Microscopic Invasion | 35.7 | 52.8 | 43.5 | 48.0 | 49.8 | 57.9 | 54.3 | 53.7 | 46.0 | 48.4 | 53.9 | 62.2 | 60.5 | 57.5 | 59.1 | 61.8 | 53.7 | 47.3 |
| Macroscopic Invasion | 5.7 | 3.1 | 4.3 | 2.6 | 1.9 | 1.4 | 1.9 | 1.1 | 1.4 | 0.6 | 0.3 | 0.3 | 0.5 | 0.5 | 0.2 | 0.3 | 0.2 | 0.0 |
| T stage | ||||||||||||||||||
| pT1 | 35.7 | 25.2 | 32.6 | 30.6 | 31.4 | 30.8 | 30.6 | 37.4 | 42.2 | 44.4 | 40.1 | 35.1 | 37.0 | 39.0 | 39.5 | 36.5 | 43.7 | 51.0 |
| pT2 | 20.0 | 18.1 | 15.2 | 15.3 | 12.6 | 8.9 | 10.2 | 5.7 | 9.8 | 5.6 | 5.0 | 2.0 | 1.3 | 2.5 | 1.1 | 1.0 | 2.2 | 1.6 |
| pT3 | 38.6 | 53.5 | 47.8 | 51.0 | 54.1 | 58.9 | 57.4 | 55.9 | 46.7 | 49.4 | 54.6 | 62.6 | 61.0 | 57.9 | 59.2 | 62.2 | 54.0 | 47.4 |
| pT4a | 5.7 | 3.1 | 4.3 | 3.1 | 1.9 | 1.4 | 1.9 | 1.1 | 1.4 | 0.6 | 0.4 | 0.3 | 0.5 | 0.5 | 0.2 | 0.3 | 0.1 | 0.0 |
| N stage | ||||||||||||||||||
| pNO/Nx | 67.1 | 33.9 | 33.3 | 33.2 | 38.6 | 42.5 | 50.2 | 46.3 | 57.1 | 55.6 | 55.0 | 52.8 | 54.8 | 61.5 | 62.7 | 59.6 | 56.7 | 59.1 |
| pN1a | 21.4 | 46.5 | 52.2 | 52.0 | 47.3 | 46.7 | 38.1 | 43.4 | 35.4 | 36.1 | 35.5 | 36.7 | 34.6 | 31.0 | 30.1 | 32.8 | 35.9 | 31.9 |
| pN1b | 11.4 | 19.7 | 14.5 | 14.8 | 14.0 | 10.7 | 11.7 | 10.3 | 7.5 | 8.3 | 9.6 | 10.6 | 10.6 | 7.5 | 7.2 | 7.6 | 7.4 | 9.1 |
| M Stage | ||||||||||||||||||
| M0 | 97.1 | 96.1 | 94.9 | 95.4 | 95.7 | 96.3 | 98.1 | 97.5 | 98.6 | 99.4 | 98.7 | 98.3 | 99.3 | 99.6 | 99.7 | 99.6 | 99.8 | 99.6 |
| M1 | 2.9 | 3.9 | 5.1 | 4.6 | 4.3 | 3.7 | 1.9 | 2.5 | 1.4 | 0.6 | 1.4 | 1.7 | 0.7 | 0.4 | 0.3 | 0.4 | 0.3 | 0.4 |
| TNM stages | ||||||||||||||||||
| I | 74.3 | 63.8 | 59.4 | 59.7 | 57.5 | 57.5 | 57.0 | 59.1 | 61.9 | 60.6 | 57.6 | 57.9 | 50.5 | 51.9 | 54.1 | 55.3 | 59.5 | 62.3 |
| II | 7.1 | 4.7 | 2.9 | 4.1 | 5.3 | 2.3 | 3.4 | 1.4 | 2.5 | 1.1 | 1.7 | 1.4 | 0.4 | 1.3 | 0.4 | 0.5 | 0.5 | 0.4 |
| III | 15.7 | 22.0 | 26.8 | 26.5 | 30.9 | 34.6 | 34.0 | 33.5 | 32.0 | 33.5 | 36.6 | 35.4 | 41.7 | 42.3 | 41.2 | 40.1 | 36.0 | 32.7 |
| IVA | 2.9 | 6.3 | 8.0 | 7.1 | 3.9 | 3.7 | 4.5 | 4.6 | 2.9 | 4.5 | 3.6 | 4.5 | 6.7 | 4.3 | 4.2 | 4.0 | 3.9 | 4.3 |
| IVC | 0.0 | 3.1 | 2.9 | 2.6 | 2.4 | 1.9 | 1.1 | 1.4 | 0.7 | 0.3 | 0.7 | 0.8 | 0.5 | 0.2 | 0.1 | 0.2 | 0.2 | 0.3 |
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