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Early mortality critically impedes improvements in thyroid cancer survival through a half century

Publication at Faculty of Medicine in Pilsen |
2023

Abstract

Objectives: We analyze survival in thyroid cancer from Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE) over a 50-year period (19712020), and additionally consider concomitant changes in incidence and mortality. Design: Population-based survival study.

Methods: Relative 1-, 5/1 (conditional)-, and 5-year survival data were obtained from the NORDCAN database for years 1971-2020. Incidence and mortality rates were also assessed.

Results: A novel consistent observation was that 1-year survival was worse than 5/1-year survival but the difference between these decreased with time. Relative 1-year survival in thyroid cancer (mean for the 4 countries) reached 92.7% for men and 95.6% for women; 5-year survival reached 88.0% for men and 93.7% for women.

Survival increased most for DK which started at a low level and reached the best survival at the end. Male and female incidence rates for thyroid cancer increased 3- and 4-fold, respectively.

In the same time, mortality halved for men and for women, it decreased by 2/3. Conclusions: We documented worse relative survival in the first year than in the 4 subsequent years, most likely because of rare anaplastic cancer.

Overall survival in thyroid cancer patients increased in the Nordic countries in the course of 50 years; 5-year survival was close to 90% for men and close to 95% for women. Even though overdiagnosis may explain some of 5-year survival increase, it is unlikely to influence the substantial increase in 1-year survival.

The unmet need is to increase 1-year survival by diagnosing and treating aggressive tumors before metastatic spread.