ArticleThyroid : official journal of the American Thyroid Association2013
The increasing incidence of thyroid cancer: the influence of access to care.
Article in Thyroid : official journal of the American Thyroid Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 240 papers, 7 of them syntheses that pooled it.
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Who cites it
240 citing papers in PubMed, 7 syntheses or guidelines pooled it, 513 citations in OpenAlex.
- Pooled it
- The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.Endocrine journal · 2025Guideline
- Association Between Environmental Air Pollution and Thyroid Cancer and Nodules: A Systematic Review.Thyroid : official journal of the American Thyroid Association · 2024Pooled it
- The risk of central nodal metastasis based on prognostic factors of the differentiated thyroid carcinoma: a systematic review and meta-analysis study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Pooled it
- Risk and Prognostic Factors for BRAFBioMed research international · 2022Pooled it
- Risk Factors for TERT Promoter Mutations with Papillary Thyroid Carcinoma Patients: A Meta-Analysis and Systematic Review.Computational and mathematical methods in medicine · 2022Pooled it
- Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2020Pooled it
- The Diagnostic Performance of Afirma Genomic Sequencing Classifier in Black and Hispanic Patients With Indeterminate Thyroid Nodules.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Article
- Total thyroidectomy versus limited thyroidectomy for isthmic papillary thyroid carcinoma: a systematic review and meta-analysis of oncologic outcomes and surgical morbidity.Journal of endocrinological investigation · 2026Review
- Evaluation and Management of Thyroid Nodules: A Joint Consensus Statement From the British Thyroid Association (BTA), British Association of Endocrine and Thyroid Surgeons (BAETS) and Collaborating Bodies.Clinical endocrinology · 2026Article
- Global burden of thyroid cancer in males: a comprehensive analysis of incidence, mortality, and risk factors from 1990 to 2040.Frontiers in oncology · 2026Article
- The TIF-1γ autoantigen in patients with dermatomyositis and thyroid cancer: from case series to preliminary mechanistic exploration.Frontiers in immunology · 2026Article
- Longitudinal investigation of psychological adaptation and its determinants in primary caregivers following thyroid cancer surgery.Frontiers in medicine · 2026Article
- Feasibility and Short-Term Outcomes of Radiofrequency Ablation for Low-Risk Papillary Thyroid Carcinoma in an Outpatient Endocrinology Setting in the USA.Clinical medicine insights. Endocrinology and diabetes · 2026Article
- Molecular Mechanisms of Thyroid Hormone Signaling in Thyroid Cancer: Oncogenesis, Progression, and Therapeutic Implications.Biomedicines · 2025Review
- Age-Specific Risk of Second Primary Malignant Neoplasm After Radioactive Iodine Treatment for Differentiated Thyroid Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
- Role of radiofrequency ablation in the treatment of symptomatic distant metastasis of thyroid cancer.Skeletal radiology · 2025Article
- High-Dose Radioiodine Therapy Did Not Result in Better Thyroglobulin Decline in Patients with Extra-Thyroid Tumor Extension of Papillary Thyroid Cancer.World journal of nuclear medicine · 2025Article
- Increased malignancy risk in patients with lymphangioleiomyomatosis: findings from a Chinese cohort.Orphanet journal of rare diseases · 2025Article
180 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe rapidly rising incidence of papillary thyroid cancer may be due to overdiagnosis of a reservoir of subclinical disease. To conclude that overdiagnosis is occurring, evidence for an association between access to health care and the incidence of cancer is necessary.
methodsWe used Surveillance, Epidemiology, and End Results (SEER) data to examine U.S. papillary thyroid cancer incidence trends in Medicare-age and non-Medicare-age cohorts over three decades. We performed an ecologic analysis across 497 U.S. counties, examining the association of nine county-level socioeconomic markers of health care access and the incidence of papillary thyroid cancer.
resultsPapillary thyroid cancer incidence is rising most rapidly in Americans over age 65 years (annual percentage change, 8.8%), who have broad health insurance coverage through Medicare. Among those under 65, in whom health insurance coverage is not universal, the rate of increase has been slower (annual percentage change, 6.4%). Over three decades, the mortality rate from thyroid cancer has not changed. Across U.S. counties, incidence ranged widely, from 0 to 29.7 per 100,000. County papillary thyroid cancer incidence was significantly correlated with all nine sociodemographic markers of health care access: it was positively correlated with rates of college education, white-collar employment, and family income; and negatively correlated with the percentage of residents who were uninsured, in poverty, unemployed, of nonwhite ethnicity, non-English speaking, and lacking high school education.
conclusionMarkers for higher levels of health care access, both sociodemographic and age-based, are associated with higher papillary thyroid cancer incidence rates. More papillary thyroid cancers are diagnosed among populations with wider access to healthcare. Despite the threefold increase in incidence over three decades, the mortality rate remains unchanged. Together with the large subclinical reservoir of occult papillary thyroid cancers, these data provide supportive evidence for the widespread overdiagnosis of this entity.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.