DRAMATIC INCREASE OF THE INCIDENCE OF THYROID CANCER- HOW CAN BE EXPLAINED?
Thyroid cancer (TC) is the most rapidly increasing malignancy in the Western World. In a report based upon the SEER database, the incidence of papillary thyroid cancer (PTC) increased from 4.8 (2002) to 14.9 (2012) per 100.000 (x 3). This increasing incidence is attributed to the:
I.Improved identification of small TC due to more frequent and widespread use of high-resolution ultrasonography, combined with fine-needle aspiration (FNA) cytology.
II.Increased reporting of incidental microcarcinomas (TC < 10 mm) in thyroids removed for presumably benign disease (for example, nodular goiter).
III.Increased iatrogenic (“diagnostic” or therapeutic) radiation exposure (for example in patients with other malignant diseases, such as Hodgkin disease). Children, especially females, are particularly sensitive to external radiation, with the greatest risk for exposures before adolescence.
IV.Exposure to radioactive isotopes, as in nuclear accidents.
V.Other, less well-defined potential causative factors, such as
-changes in the population’s body mass index
-use of fertility drugs
-changes in menstrual cycle

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