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Assessing the Rise in Papillary Thyroid Cancer Incidence: A 38-Year Australian Study Investigating WHO Classification Influence.

J Epidemiol Glob Health

January 2025

Centre of Environment and Population Health, School of Medicine and Dentistry, Griffith University, Nathan, QLD, 4111, Australia.

The incidence of thyroid cancer has shown marked increases globally over recent decades. This study investigated how the incidence of papillary thyroid carcinoma (PTC) subtypes and World Health Organisation (WHO) endocrine tumour classification changes have affected overall thyroid cancer incidence recorded in Australia. Using incidence data from the Australian Institute of Health and Welfare cancer registry (spanning 1982 to 2019), this descriptive epidemiological study employed joinpoint regression analysis to assess temporal trends in thyroid carcinoma incidence, focusing on PTC.

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The study aimed to analyze the long-term outcomes of [Lu]Lu-DOTAGA.FAPi dimer therapy in individuals diagnosed with radioiodine-resistant (RAI-R) follicular cell-derived thyroid cancer. In this retrospective study, 73 patients with RAI-R follicular thyroid carcinoma who had undergone multiple lines of previous treatments were included.

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Background: Occult papillary thyroid carcinoma (PTC) refers to the PTC accidentally found due to its occult lesions. Classic, as the most common subtype of PTC, is usually considered to have a low degree of malignancy and a favorable prognosis. Currently, the American Thyroid Association Management Guidelines adopted active surveillance (AS) as an alternative to immediate surgery in some low-risk PTC patients with less than 1 cm in diameter.

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Background: The differential diagnosis between benign and malignant thyroid nodules continues to be a major challenge in clinical practice. The rising incidence of thyroid neoplasm and the low incidence of aggressive thyroid carcinoma, urges the exploration of strategies to improve the diagnostic accuracy in a pre-surgical phase, particularly for indeterminate nodules, and to prevent unnecessary surgeries. Only in 2022, the 5th WHO Classification of Endocrine and Neuroendocrine Tumors, and in 2023, the 3rd Bethesda System for Reporting Thyroid Cytopathology and the European Thyroid Association included biomarkers in their guidelines.

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Thyroid cancers are the most common endocrine organ cancers. Encapsulated follicular variant papillary thyroid carcinomas (EFVPTC) are quite slow (indolent). Non-invasive follicular thyroid neoplasm with papillary nuclear feature (NIFTP) is a new entity identified as a result of studies in recent years.

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