Épidémie de (sur-diagnostic du) cancer de la thyroïde
(encore un !)
Depuis 1975, triplement de l’incidence, stabilité de la mortalité.
JAMA Network | JAMA Otolaryngology–Head & Neck Surgery | Current Thyroid Cancer Trends in the United States
Since 1975, the incidence of thyroid cancer has now nearly tripled, from 4.9 to 14.3 per 100 000 individuals. Virtually the entire increase was attributable to papillary thyroid cancer: from 3.4 to 12.5 per 100 000.
The absolute increase in thyroid cancer in women was almost 4 times greater than that of men (from 3.1 to 6.9 = 3.8 per 100 000 men). The mortality rate from thyroid cancer was stable between 1975 and 2009 (approximately 0.5 deaths per 100 000).
Conclusions and Relevance
There is an ongoing epidemic of thyroid cancer in the United States. The epidemiology of the increased incidence, however, suggests that it is not an epidemic of disease but rather an epidemic of diagnosis. The problem is particularly acute for women, who have lower autopsy prevalence of thyroid cancer than men but higher cancer detection rates by a 3:1 ratio.
L’étude de cohortes de long-terme est encore à mettre en place…
Burkey is among researchers planning a major study seeking to provide answers. Patients diagnosed with thyroid cancers will be randomly assigned treatment or just observation.
Remarque : la dépêche AP pose la question Thyroid cancer cases soar ; is it over diagnosed ? à laquelle l’étude du JAMA donne une réponse dépourvue d’ambigüité…