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dc.contributor.author Pathak, K. Alok
dc.contributor.author Leslie, William D.
dc.contributor.author Klonisch, Thomas C.
dc.contributor.author Nason, Richard W.
dc.date.accessioned 2014-06-25T15:27:06Z
dc.date.available 2014-06-25T15:27:06Z
dc.date.issued 2013-06-26
dc.identifier.citation Pathak, K.A., Leslie, W.D., Klonisch, T.C., Nason, R.W. (2013) The changing face of thyroid cancer in a population-based cohort. Cancer Medicine, 2(4), 537-544. en_US
dc.identifier.uri http://hdl.handle.net/1993/23648
dc.description.abstract In North America, the incidence of thyroid cancer is increasing by over 6% per year. We studied the trends and factors influencing thyroid cancer incidence, its clinical presentation, and treatment outcome during 1970–2010 in a population-based cohort of 2306 consecutive thyroid cancers in Canada, that was followed up for a median period of 10.5 years. Disease-specific survival (DSS) and disease-free survival were estimated by the Kaplan–Meier method and the independent influence of various prognostic factors was evaluated by Cox proportional hazard models. Cumulative incidence of deaths resulting from thyroid cancer was calculated by competing risk analysis. A P-value <0.05 was considered to indicate statistical significance. The age standardized incidence of thyroid cancer by direct method increased from 2.52/100,000 (1970) to 9.37/100,000 (2010). Age at diagnosis, gender distribution, tumor size, and initial tumor stage did not change significantly during this period. The proportion of papillary thyroid cancers increased significantly (P < 0.001) from 58% (1970–1980) to 85.9% (2000–2010) while that of anaplastic cancer fell from 5.7% to 2.1% (P < 0.001). Ten-year DSS improved from 85.4% to 95.6%, and was adversely influenced by anaplastic histology (hazard ratio [HR] = 8.7; P < 0.001), male gender (HR = 1.8; P = 0.001), TNM stage IV (HR = 8.4; P = 0.001), incomplete surgical resection (HR = 2.4; P = 0.002), and age at diagnosis (HR = 1.05 per year; P < 0.001). There was a 373% increase in the incidence of thyroid cancer in Manitoba with a marked improvement in the thyroid cancer-specific survival that was independent of changes in patient demographics, tumor stage, or treatment practices, and is largely attributed to the declining proportion of anaplastic thyroid cancers. This article shows there is an increase in the incidence of thyroid cancers of all sizes in a population cohort in Canada. The improvement in thyroid cancer survival is due to reduced proportion of anaplastic thyroid cancer. en_US
dc.description.sponsorship This study was supported by the University of Manitoba Research Grant and the Department of Surgery, University of Manitoba Research Grant. en_US
dc.language.iso en en_US
dc.publisher John Wiley & Sons Ltd. en_US
dc.subject Anaplastic en_US
dc.subject Epidemiology en_US
dc.subject Incidence en_US
dc.subject Outcome en_US
dc.subject Survival en_US
dc.subject Trend en_US
dc.title The changing face of thyroid cancer in a population-based cohort en_US
dc.type Article en_US
dc.identifier.doi http://dx.doi.org/10.1002/cam4.103


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