Thyroid cancer incidence in children and adolescents

Clinically detected thyroid cancer is rare in children, with one to three cases per 1 million children per year. The disease—a papillary carcinoma in most cases—is frequently more extensive at diagnosis in children than in adults, particularly in children aged younger than 10 years who often have large thyroid tumours with lymph node and lung metastases. 1 Hay ID Johnson TR Kaggal S et al. Papillary thyroid carcinoma (PTC) in children and adults: comparison of initial presentation and long-term postoperative outcome in 4432 patients consecutively treated at the Mayo Clinic during eight decades (1936–2015). World J Surg. 2018; 42: 329-342 Crossref PubMed Scopus (41) Google Scholar The overall prognosis is favourable even in cases of metastatic disease, but the treatment burden can be substantial, and thyroid cancer related deaths that are extremely rare during childhood and adolescence have been reported several decades after initial diagnosis, at an adult age. 2 Schlumberger M De Vathaire F Travagli JP et al. Differentiated thyroid carcinoma in childhood: long term follow-up of 72 patients. J Clin Endocrinol Metab. 1987; 65: 1088-1094 Crossref PubMed Scopus (221) Google Scholar The incidence of clinical thyroid cancer increases with age, and the extent of disease is usually less in adolescents and young adults, who have excellent long-term prognoses. Global patterns and trends in incidence and mortality of thyroid cancer in children and adolescents: a population-based studyThe pattern of thyroid cancer incidence in children and adolescents mirrors the pattern seen in adults, suggesting a major role for overdiagnosis, which, in turn, can lead to overtreatment, lifelong medical care, and side effects that can negatively affect quality of life. We suggest that the existing recommendation against screening for thyroid cancer in the asymptomatic adult population who are free from specific risk factors should be extended to explicitly recommend against screening for thyroid cancer in similar populations of children and adolescents. Full-Text PDF