Trends in pediatric and adolescent thyroid carcinoma incidence and survival in the United States, 2001-2022.

Abstract

e18102 Background: Thyroid carcinoma incidence in children, adolescents, and young adults has changed substantially over recent decades. Understanding trends in incidence and survival is crucial for clinical management and healthcare planning. Methods: Data from the North American Association of Central Cancer Registries (NAACR) and SEER registries (representing up to 76% of U.S. children, adolescents, and young adults) were analyzed for patients aged <40 years diagnosed between 2001-2022. Age-adjusted incidence rates per 1,000,000 were calculated and standardized to the 2000 U.S. population. Five-year relative survival rates were assessed for diagnoses from 2001-2020. Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were calculated using Joinpoint Trend Analysis Software. Results: Thyroid carcinoma incidence in patients aged <40 years increased substantially from approximately 44 per 1,000,000 in 2001 to a peak of approximately 80 per 1,000,000 in 2014-2015, representing an 82% increase over this period. Subsequently, incidence rates declined to approximately 68 per 1,000,000 by 2022, a 15% decrease from peak levels. Despite the rise and subsequent decline in incidence, 5-year relative survival rates remained consistently excellent throughout the study period, maintaining rates of approximately 98-100% for all patients diagnosed between 2001-2020, with no statistically significant trend in survival outcomes. Conclusions: This analysis demonstrates a biphasic trend in pediatric and adolescent thyroid carcinoma incidence, with a sustained increase until mid-2010s followed by a decline in recent years. The initial rise likely reflects increased detection through enhanced imaging and surveillance, while the recent decline may represent stabilization of diagnostic practices. The consistently excellent survival rates exceeding 98% underscore the favorable prognosis of thyroid carcinoma in younger populations and the effectiveness of current therapeutic approaches. These findings have important implications for clinical management strategies and suggest that the recent decline in incidence may reflect more judicious use of diagnostic imaging and biopsy practices without compromising patient outcomes.