Trends In The Global Disease Burden Of Thyroid Cancer From 1990 To 2019 And Its Projections In 20 Years

Background:Thyroid cancer is the most common malignancy of the endocrine system.Mortality of thyroid cancer has been on a stable or declining trend in most countries over the last few decades,but its incidence has been steadily increasing.The global prevalence of thyroid cancer showed marked regional differences,with incidence rates being higher in geographical regions such as East Asia,South Asia and North America.However,with continuing changes in the level of diagnostic surveillance and changes in diagnostic criteria worldwide,future trends in thyroid cancer disease burden across income levels and regions remain unclear,and the merits of the current models for long-term prediction of cancer disease burden are still inconclusive.Objectives:This study comprehensively evaluated the global thyroid cancer disease burden in 2019,compared the predictive effectiveness of five thyroid cancer disease burden models,and used the optimal model to forecast thyroid cancer incidence and mortality trends over the next 20 years,to provide a basis for policymakers to assess the disease burden of thyroid cancer and develop relevant policies.Methods:1.Analyze the morbidity,mortality,and disability-adjusted life years(DALY)rates of thyroid cancer by sex,age,region,and income levels in 2019 based on the Global Burden of Disease Study 2019(GBD 2019).2.Analyze the trends in morbidity,mortality and DALY rates of thyroid cancer by gender,region,and income levels from 1990 to 2019.3.Compare the prediction results of five models including the Bayesian age-period-cohort(BAPC)model from 2010 to 2019 based on coverage and bias to find the most suitable prediction model.4.Calculate the standardized morbidity and standardized mortality of thyroid cancer in the world in 2039 based on the best-performing BAPC model by different sex,ages,income levels,and regional strata,as well as their estimated annual percentage changes(EAPC).Results:1.The global thyroid cancer rates of incidence,mortality and DALY in 2019 were 2.8/100,000,0.6/100,000,and 15.0/100,000,respectively.The morbidity and mortality of thyroid cancer in women were significantly higher than those in men.2.In the past 30 years,the morbidity of thyroid cancer has shown an upward trend(EAPC=1.25,95%CI:1.12,1.38),while the mortality(EAPC=-0.15,95%CI:-0.19,-0.11)and DALY rate(EAPC=-0.14,95%CI:-0.18,-0.09)have shown a downward trend.3.According to the comprehensive analysis of coverage and deviation of thyroid cancer outcomes predicted from 2010 to 2019,the BAPC model had the best predictive performance on the morbidity and mortality of thyroid cancer.4.According to the prediction results of the BAPC model,the morbidity of thyroid cancer will rise to 3.85/100,000,and the mortality will decrease to 0.52/100,000 in 2039.The morbidity of thyroid cancer is expected to show a decreasing trend in high-income countries(EAPC=-0.16,95%CI:-0.18,-0.15).While an increasing trend in mortality in low-income(EAPC=0.03,95%CI:0.02,0.03)and lower-middle-income countries(EAPC=0.14,95%CI:0.12,0.15).Conclusion:1.In the past 30 years,the morbidity of thyroid cancer in the world has been increasing,while mortality has shown a downward trend.Among them,the morbidity and mortality of women were higher than those of men.2.BAPC model has the best predictive performance on morbidity and mortality of thyroid cancer.3.According to the BAPC model based on GBD 2019,the trend of increasing morbidity and decreasing mortality of thyroid cancer in the world will remain for the next 20 years.Among them,morbidity and mortality will increase faster in lower-middle-income countries than in other countries.