A two-decade review of thyroid cancer mortality among older adults in the U.S.

Abstract

e18153 Background: Thyroid cancer is the fourth leading cause of cancer-related deaths worldwide and the fifth in the United States. Although its incidence has declined over the past decade, incidence-based mortality has increased, as noted in previous literature, however this trend has not been thoroughly investigated. Methods: Data were collected from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) database, from 1999 to 2020. Participants were identified using the ICD-10 code C73 in adults above 65 years of age for various thyroid cancer types. Age-adjusted mortality rates (AAMR) per 100,000 population were calculated annually. Joinpoint regression was used to estimate the annual percent change (APC) with 95% confidence intervals (CI) and p-values. Disparities were examined across age, gender, race/ethnicity, Hispanic vs. non-Hispanic status, metropolitan vs. non-metropolitan areas, and census regions. Statistical significance was defined at p < 0.05. Results: Between 1999 and 2020, 34,227 thyroid cancer deaths occurred in the USA, with an increasing trend (AAPC: 0.97, CI: 0.71–1.28). The AAMR rose from 3.19 in 1999 to 4.06 in 2021, peaking in individuals aged 85+ (7.524, AAPC: 1.47, CI: 1.07–1.98) and lowest in those aged 65–74 (2.278, AAPC: 0.44, CI: 0.06–0.93). Males and females had similar AAMRs (3.72 vs. 3.74), though the increase was steeper in males (AAPC: 1.36, CI: 1.06–1.73) than females (AAPC: 0.76, CI: 0.40–1.18). Metropolitan and non-metropolitan areas had comparable AAMRs (3.75 vs. 3.71), but trends rose faster in non-metropolitan areas (AAPC: 1.30, CI: 0.94–1.72). The West had the highest AAMR (4.20) and largest increase (AAPC: 1.75, CI: 1.10–2.64), while the South had the lowest (3.42) and a declining trend was seen in Northeast (AAPC: -0.78, CI: -1.37 to -0.27). Hispanics had a higher AAMR (4.41) than non-Hispanics (3.67). Among non-Hispanics, Asians/Pacific Islanders had the highest AAMR (4.73) and Blacks/African Americans the lowest (3.46). Non-Hispanic Whites showed an increasing trend (AAPC:1.03, CI: 0.77–1.32), while Asians/Pacific Islanders showed a decline (AAPC: -0.26, CI: -1.06 to 0.85). Conclusions: Thyroid cancer mortality has risen in the USA over the past two decades, with higher increases in males, Hispanics, non-metropolitan areas, the West region, and individuals aged 85 plus. Targeted interventions are needed to address these disparities in mortality and the rising trend.