Trends and disparities in thyroid cancer mortality in the United States: A 24-year retrospective analysis.

Abstract

e18161 Background: Thyroid cancer remains a significant cause of mortality globally, with varying trends across demographic, geographic, and socioeconomic groups. Understanding these patterns is critical for developing effective prevention and intervention strategies. This study examines thyroid cancer-related mortality trends in the United States from 1999 to 2023, focusing on age-adjusted mortality rates (AAMRs) and disparities across demographic and geographic classifications. Methods: This descriptive study utilized the CDC WONDER database to extract data on thyroid cancer (ICD-10 code C73) deaths among adults aged 25 and older from 1999 to 2023. AAMRs per 1,000,000 individuals were calculated and stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Temporal trends were analyzed using Joinpoint regression to compute annual percent changes (APCs) with 95% confidence intervals (CIs). Statistical significance was set at p<0.05. Results: Between 1999 and 2023, there were 55,971 deaths attributed to thyroid cancer (Men: 24,398; Women: 31,573). Overall, the AAMR increased modestly, with an APC of 1.0 (95% CI: 0.8 to 1.2). Men exhibited a slightly higher AAMR increase (APC: 1.2; 95% CI: 1.1 to 1.4) compared to women (APC: 0.9; 95% CI: 0.7 to 1.2). Racial disparities revealed varied trends. Non- Hispanic White individuals experienced a steady AAMR increase (APC: 1.0; 95% CI: 0.8 to 1.2), while Hispanic populations showed a smaller increase (APC: 0.4; 95% CI: -0.1 to 1.1). Non-Hispanic Asians or Pacific Islanders had a slight decline (APC: -0.4; 95% CI: -1.1 to 0.5), and Non-Hispanic Black populations showed segmented trends, with an APC of 0.3 (95% CI: - 7.8 to 16.7) from 1999 to 2018 and a subsequent increase (APC: 3.7; 95% CI: -5.5 to 10.5) from 2018 to 2020. Geographically, the West exhibited the highest overall AAMR (11.0; 95% CI: 10.8–11.2), followed by the Midwest (9.9; 95% CI: 9.7–10.0) and Northeast (9.8; 95% CI: 9.6–10.0), with the South reporting the lowest AAMR (9.0; 95% CI: 8.8–9.1). Hawaii had the highest state-level AAMR (12.3; 95% CI: 10.8–13.7), while Georgia recorded the lowest (7.6; 95% CI: 7.2–8.1). Urban-rural disparities indicated a slightly higher APC in non-metropolitan areas (1.0; 95% CI: 0.7–1.4) compared to metropolitan areas (0.8; 95% CI: 0.6–1.0). Conclusions: Thyroid cancer-related mortality has shown a gradual increase in the United States over the past two decades, with distinct gender, racial, and geographic disparities. Men, non-metropolitan residents, and individuals in the West and Hawaii faced higher mortality burdens. These findings underscore the importance of targeted public health strategies to address these disparities and reduce thyroid cancer mortality in vulnerable populations.