Send to

Choose Destination
J Pediatr. 2014 Jun;164(6):1481-5. doi: 10.1016/j.jpeds.2014.01.059. Epub 2014 Mar 12.

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

Author information

Faculty of Medical Sciences of Santa Casa of São Paulo, São Paulo, Brazil.
Dana-Farber/Boston Children's Center for Cancer and Blood Disorders and Harvard Medical School, Boston, MA.
Dana-Farber/Boston Children's Center for Cancer and Blood Disorders and Harvard Medical School, Boston, MA. Electronic address:



To investigate trends in incidence of differentiated thyroid carcinomas among children and adolescents and young adults.


In this ecological time-trends study, we selected cases of differentiated thyroid carcinomas (1984-2010) in patients <30 years from Surveillance, Epidemiology, and End Results 9 cancer registries by using International Classification of Diseases for Oncology, 3rd edition, codes for papillary and follicular cancers. Patients with multiple other primary diseases before differentiated thyroid carcinomas were excluded. SEER*Stat software, version 8.0.4 (National Cancer Institute, Bethesda, Maryland) was used to calculate age-standardized rates (estimated per 1,000,000/persons) and annual percentage changes (APCs) were calculated by the Joinpoint model (Joinpoint software, version 4.0.4; National Cancer Institute).


Rates ranged from 2.77 (1990) to 9.63 (2009) and from 18.35 (1987) to 50.99 (2009), for male and female subjects, respectively. A significant increasing trend in incidence was observed for both male (APC 3.44; 95% CI 2.60-4.28) and female (APC 3.81; 95% CI 3.38-4.24) patients. When a stratified analysis on the basis of tumor size was performed, significant increasing trends were noted for the following categories: <0.5 cm (females: APC 5.09, 95% CI 3.54-6.65), 0.5-0.9 cm (females: APC 8.45, 95% CI 7.09-9.82), 1.0-1.9 cm (males: APC 5.09, 95% CI 3.20-7.01; females: APC 3.42, 95% CI 2.78-4.07), and ≥2 cm (males: APC 2.62, 95% CI 1.64-3.60; females: APC 2.96, 95% CI 2.34-3.59).


Incidence rates for differentiated thyroid carcinomas are increasing among children and adolescents and young adults in the US. The increasing trends for larger tumors rules out diagnostic scrutiny as the only explanation for the observed results. Environmental, dietary, and genetic influences should be investigated.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center