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      Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960–2014: a nationwide study

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          Abstract

          Recent studies have shown a significant increase in the temporal trend of medullary thyroid carcinoma (MTC) incidence. However, it remains unknown to which extent sporadic medullary thyroid carcinoma (SMTC) and hereditary MTC (HMTC) affect the MTC incidence over time. We conducted a nationwide retrospective study using previously described RET and MTC cohorts combined with review of medical records, pedigree comparison and relevant nationwide registries. The study included 474 MTC patients diagnosed in Denmark between 1960 and 2014. In the nationwide period from 1997 to 2014, we recorded a mean age-standardized incidence of all MTC, SMTC and HMTC of 0.19, 0.13 and 0.06 per 100,000 per year, respectively. The average annual percentage change in incidence for all MTC, SMTC and HMTC were 1.0 ( P = 0.542), 2.8 ( P = 0.125) and −3.1 ( P = 0.324), respectively. The corresponding figures for point prevalence at January 1, 2015 were 3.8, 2.5 and 1.3 per 100,000, respectively. The average annual percentage change in prevalence from 1998 to 2015 for all MTC, SMTC and HMTC was 2.8 ( P < 0.001), 3.8 ( P < 0.001) and 1.5 ( P = 0.010), respectively. We found no significant change in the incidence of all MTC, SMTC and HMTC possibly due to our small sample size. However, due to an increasing trend in the incidence of all MTC and opposing trends of SMTC (increasing) and HMTC (decreasing) incidence, it seems plausible that an increase for all MTC seen by others may be driven by the SMTC group rather than the HMTC group.

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          Most cited references38

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          Thyroid cancer gender disparity.

          Cancer gender disparity in incidence, disease aggressiveness and prognosis has been observed in a variety of cancers. Thyroid cancer is one of the fastest growing cancer diagnoses worldwide. It is 2.9-times more common in women than men. The less aggressive histologic subtypes of thyroid cancer are more common in women, whereas the more aggressive histologic subtypes have similar gender distribution. The gender disparity in incidence, aggressiveness and prognosis is well established for thyroid cancer but the cause of the disparity is poorly understood. The aim of this article is to evaluate the current evidence on the cause of thyroid cancer gender disparity. Dietary and environmental factors do not appear to have a significant role in thyroid cancer gender disparity. Common somatic mutations in BRAF, rearranged in transformation/papillary thyroid carcinomas (RET/PTC) and neurotrophin receptor-tyrosine kinase (NTRK) also do not account for the gender disparity in thyroid cancer. While reproductive factors would seem a logical hypothesis to account for the gender disparity, there appears to be no conclusive effect on the risk of developing thyroid cancer. Recent studies on estrogen receptor status in thyroid cancer show a difference in the receptor subtypes expressed based on the histology of thyroid cancer. Moreover, the response to estrogen is dependent on the specific estrogen receptor expressed in thyroid cancer cells. However, what determines the tumor-specific sex hormone receptor expression is unclear. No established molecular factors appear to explain gender differences in thyroid cancer. Therefore, the application of high-throughput genomic and proteomic approaches to the study of thyroid cancer gender disparity could be helpful for better understanding the molecular basis for gender differences in thyroid and other cancers.
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            The Danish Pathology Register.

            The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established. DPR contains patient, pathology, and workload data. All records are subject to error tracing. The DPR covers all pathology data in Denmark. The data is used by the pathologists in the daily diagnostic process. The National Board of Health uses the data in the Danish Cancer Registry and DPR is unique for research as data can be linked to tissue biobanks and clinical databases.
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              Recent incidences and differential trends of thyroid cancer in the USA.

              The incidence rate of thyroid cancer has been rising rapidly in recent decades; however, its trend remains unclear. To investigate this, we analyzed the database of the Surveillance, Epidemiology and End Results (SEER) 13, 1992-2012 in the USA, particularly focusing on conventional papillary thyroid cancer (CPTC) and follicular variant of PTC (FVPTC). Of the 75,992 thyroid cancers, 61.3% were CPTC and 25.7% were FVPTC, and their incidence rates (IRs) were significantly increased from 1992 to 2012 (P all 0.05), which jumped to 6.8% (P < 0.05) after 1996, whereas the APC of FVPTC before 2000 was 6.6% (P < 0.05), which dropped to 4.8% (P < 0.05) after 2000. IRs and incidence trends of PTC were uneven among different ethnic/demographic groups, as exemplified by the lower IRs of both PTC variants in the Black females than in non-Hispanic White females but higher AAPCs of incidence in the former than in the latter. Interestingly, the data also suggest that the rise in the IRs of PTC is becoming plateaued in the most recent 2 years. These novel observations are helpful in understanding the incidence and incidence trends of thyroid cancer.
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                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                June 2018
                14 May 2018
                : 7
                : 6
                : 829-839
                Affiliations
                [1 ]Department of ORL Head & Neck Surgery Odense University Hospital, Odense, Denmark
                [2 ]Department of Clinical Research University of Southern Denmark, Odense, Denmark
                [3 ]Department of Clinical Medicine and Endocrinology Aalborg University Hospital, Aalborg, Denmark
                [4 ]Department of Internal Medicine and Endocrinology Aarhus University Hospital, Aarhus, Denmark
                [5 ]Center for Rare Diseases Aarhus University Hospital, Aarhus N, Denmark
                [6 ]Department of Medical Endocrinology Copenhagen University Hospital, Copenhagen, Denmark
                [7 ]Department of ORL Head & Neck Surgery Aarhus University Hospital, Aarhus, Denmark
                [8 ]Department of ORL Head & Neck Surgery Aalborg University Hospital, Aalborg, Denmark
                [9 ]Department of ORL Head & Neck Surgery Copenhagen University Hospital, Copenhagen, Denmark
                [10 ]Department of ORL Head & Neck Surgery Zealand University Hospital, Køge, Denmark
                [11 ]Department of Oncology Herlev Hospital, Herlev, Denmark
                [12 ]Odense Patient data Explorative Network (OPEN) Odense University Hospital, Odense, Denmark
                [13 ]Department of Molecular Medicine Aarhus University Hospital, Aarhus, Denmark
                [14 ]Center for Genomic Medicine Copenhagen University Hospital, Copenhagen, Denmark
                [15 ]Department of Clinical Genetics Odense University Hospital, Odense, Denmark
                Author notes
                Correspondence should be addressed to J S Mathiesen: jes_mathiesen@ 123456yahoo.dk
                Article
                EC180157
                10.1530/EC-18-0157
                6000757
                29760189
                89a94960-29ac-4fa7-8a50-d2a0445dda55
                © 2018 The authors

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 26 April 2018
                : 14 May 2018
                Categories
                Research

                sporadic medullary thyroid carcinoma,hereditary medullary thyroid carcinoma,incidence,prevalence,denmark

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