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Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study

BACKGROUND: The incidence of thyroid cancer (TC) has increased rapidly over the past few decades in Korea. This study investigated whether the TC epidemic has been driven by overdiagnosis. METHODS: We calculated the TC screening rate from mid-2008 through mid-2014, and the incidence, postoperative c...

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Autores principales: Kang, Hee-Yeon, Kim, Ikhan, Kim, Yeon-Yong, Bahk, Jinwook, Khang, Young-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661203/
https://www.ncbi.nlm.nih.gov/pubmed/33176753
http://dx.doi.org/10.1186/s12885-020-07597-4
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author Kang, Hee-Yeon
Kim, Ikhan
Kim, Yeon-Yong
Bahk, Jinwook
Khang, Young-Ho
author_facet Kang, Hee-Yeon
Kim, Ikhan
Kim, Yeon-Yong
Bahk, Jinwook
Khang, Young-Ho
author_sort Kang, Hee-Yeon
collection PubMed
description BACKGROUND: The incidence of thyroid cancer (TC) has increased rapidly over the past few decades in Korea. This study investigated whether the TC epidemic has been driven by overdiagnosis. METHODS: We calculated the TC screening rate from mid-2008 through mid-2014, and the incidence, postoperative complication, and mortality rates of TC between 2006 and 2015, using data from the Korea Community Health Survey, the National Health Insurance Database, and the cause-of-death data of Statistics Korea. Trends in age-standardized rates of all indicators were examined, along with income gaps therein. Analyses were conducted for lung cancer and stroke as negative control outcomes. RESULTS: The incidence rate of TC increased from 46.6 per 100,000 to 115.0 per 100,000 between 2006 and 2012, and then decreased to 63.5 per 100,000 in 2015. Despite these remarkable changes in incidence, mortality did not fluctuate during the same period. High income was associated with high rates of screening, incidence, and postoperative complications, while low income showed an association with a high mortality rate. Analyses using negative control outcomes showed that high income was associated with low rates of both incidence and mortality, which contrasted with the patterns of TC. The recent decreases in TC incidence and postoperative complications, which reflect societal concerns about the overdiagnosis of TC, were more pronounced in high-income individuals than in low-income individuals. CONCLUSIONS: The time trends in income gaps in screening, incidence, postoperative complications, and mortality of TC, as well as negative control outcomes, provided corroborating evidence of TC overdiagnosis in Korea. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-020-07597-4.
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spelling pubmed-76612032020-11-13 Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study Kang, Hee-Yeon Kim, Ikhan Kim, Yeon-Yong Bahk, Jinwook Khang, Young-Ho BMC Cancer Research Article BACKGROUND: The incidence of thyroid cancer (TC) has increased rapidly over the past few decades in Korea. This study investigated whether the TC epidemic has been driven by overdiagnosis. METHODS: We calculated the TC screening rate from mid-2008 through mid-2014, and the incidence, postoperative complication, and mortality rates of TC between 2006 and 2015, using data from the Korea Community Health Survey, the National Health Insurance Database, and the cause-of-death data of Statistics Korea. Trends in age-standardized rates of all indicators were examined, along with income gaps therein. Analyses were conducted for lung cancer and stroke as negative control outcomes. RESULTS: The incidence rate of TC increased from 46.6 per 100,000 to 115.0 per 100,000 between 2006 and 2012, and then decreased to 63.5 per 100,000 in 2015. Despite these remarkable changes in incidence, mortality did not fluctuate during the same period. High income was associated with high rates of screening, incidence, and postoperative complications, while low income showed an association with a high mortality rate. Analyses using negative control outcomes showed that high income was associated with low rates of both incidence and mortality, which contrasted with the patterns of TC. The recent decreases in TC incidence and postoperative complications, which reflect societal concerns about the overdiagnosis of TC, were more pronounced in high-income individuals than in low-income individuals. CONCLUSIONS: The time trends in income gaps in screening, incidence, postoperative complications, and mortality of TC, as well as negative control outcomes, provided corroborating evidence of TC overdiagnosis in Korea. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-020-07597-4. BioMed Central 2020-11-11 /pmc/articles/PMC7661203/ /pubmed/33176753 http://dx.doi.org/10.1186/s12885-020-07597-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Kang, Hee-Yeon
Kim, Ikhan
Kim, Yeon-Yong
Bahk, Jinwook
Khang, Young-Ho
Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study
title Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study
title_full Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study
title_fullStr Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study
title_full_unstemmed Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study
title_short Income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in South Korea: a national population-based time trend study
title_sort income differences in screening, incidence, postoperative complications, and mortality of thyroid cancer in south korea: a national population-based time trend study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661203/
https://www.ncbi.nlm.nih.gov/pubmed/33176753
http://dx.doi.org/10.1186/s12885-020-07597-4
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