Early mortality critically impedes improvements in thyroid cancer survival through a half century

Author:

Tichanek Filip12,Försti Asta34,Liska Vaclv15,Hemminki Otto67,Koskinen Anni8,Hemminki Akseli69ORCID,Hemminki Kari110ORCID

Affiliation:

1. Biomedical Center, Faculty of Medicine in Pilsen, Charles University in Prague , Alej Svobody 76, 30605 Pilsen , Czech Republic

2. Institute of Pathological Physiology, Faculty of Medicine in Pilsen, Charles University , Pilsen , Czech Republic

3. Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany

4. Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK) , Heidelberg , Germany

5. Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Charles University in Prague , 30605 Pilsen , Czech Republic

6. Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki , Finland

7. Department of Urology, Helsinki University Hospital and University of Helsinki , Helsinki , Finland

8. Department of Otorhinolaryngology—Head and Neck Surgery, Helsinki University Hospital and University of Helsinki , Helsinki , Finland

9. Comprehensive Cancer Center, Helsinki University Hospital , Helsinki , Finland

10. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) , Im Neuenheimer Feld 580, D-69120 Heidelberg , Germany

Abstract

Abstract Objectives We analyze survival in thyroid cancer from Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE) over a 50-year period (1971-2020), and additionally consider concomitant changes in incidence and mortality. Design Population-based survival study. Methods Relative 1-, 5/1 (conditional)-, and 5-year survival data were obtained from the NORDCAN database for years 1971-2020. Incidence and mortality rates were also assessed. Results A novel consistent observation was that 1-year survival was worse than 5/1-year survival but the difference between these decreased with time. Relative 1-year survival in thyroid cancer (mean for the 4 countries) reached 92.7% for men and 95.6% for women; 5-year survival reached 88.0% for men and 93.7% for women. Survival increased most for DK which started at a low level and reached the best survival at the end. Male and female incidence rates for thyroid cancer increased 3- and 4-fold, respectively. In the same time, mortality halved for men and for women, it decreased by 2/3. Conclusions We documented worse relative survival in the first year than in the 4 subsequent years, most likely because of rare anaplastic cancer. Overall survival in thyroid cancer patients increased in the Nordic countries in the course of 50 years; 5-year survival was close to 90% for men and close to 95% for women. Even though overdiagnosis may explain some of 5-year survival increase, it is unlikely to influence the substantial increase in 1-year survival. The unmet need is to increase 1-year survival by diagnosing and treating aggressive tumors before metastatic spread.

Funder

European Union’s Horizon 2020 research and innovation program

Jane and Aatos Erkko Foundation

Sigrid Juselius Foundation

Finnish Cancer Organizations

University of Helsinki

Helsinki University Central Hospital

Novo Nordisk Foundation

Päivikki and Sakari Sohlberg Foundation

Finnish Red Cross Blood Service

Cooperatio Program, research area SURG

National Institute for Cancer Research—NICR

European Union—Next Generation EU

Publisher

Oxford University Press (OUP)

Subject

Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism

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