机构：[1]Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,[2]Department of Cancer Prevention, Institute of Cancer and Basic Medicine (IBMC), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, Hangzhou, China,浙江省肿瘤医院[3]Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,[4]Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,河北医科大学第四医院[5]Henan Cancer Prevention and Control Office, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China,河南省肿瘤医院[6]Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming, China,[7]Office of Cancer Prevention and Treatment, Hubei Cancer Hospital, Wuhan, China,[8]Heilongjiang Cancer Center, Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin, China,[9]Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China,[10]Scientific Research Education Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China,北京大学深圳医院深圳市康宁医院深圳市南山区人民医院深圳医学信息中心中国医学科学院肿瘤医院深圳医院[11]Information Management and Big Data Center, The Tumor Hospital Affiliated to Xinjiang Medical University, Ürümqi, China,[12]Science and Education Department, The Fifth People’s Hospital of Qinghai, Xining, China,[13]Medical Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China,北京大学深圳医院深圳市康宁医院深圳市南山区人民医院深圳医学信息中心中国医学科学院肿瘤医院深圳医院[14]Human Resources Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
BackgroundThyroid cancer (TC), was the fastest-rising tumor of all malignancies in the world and China, predominantly differentiated thyroid cancer (DTC). However, evidence on TC stage distribution and influencing factors of late-stage were limited in China. MethodsWe carried out a retrospective study and enrolled TC patients who were first diagnosed and hospitalized in 8 hospitals in China in 2017. Logistic regression was used to evaluate associations between influencing factors and DTC stage. We extracted eligible primary DTC records newly diagnosed in 2017 from the USA's Surveillance, Epidemiology, and End Results (SEER) database. We compared clinicopathological features and surgical treatment between our DTC records and those from the SEER database. ResultsA total of 1970 eligible patients were included, with 1861 DTC patients with known stage. Among patients >= 45 years old, males (OR = 1.76, 95%CI 1.17-2.65) and those with new rural cooperative medical scheme insurance (NCMS) (OR = 1.99, 95%CI 1.38-2.88) had higher risks of late-stage DTC (stage III-IV). Compared with SEER database, over-diagnosis is more common in China [more DTC patients with onset age< 45 years old (50.3 vs. 40.7%, P < 0.001), with early-stage (81.2 vs. 76.0%, P < 0.001), and with tumors<2cm (74.9 vs. 63.7%, P < 0.001)]. Compared with the USA, TC treatment is more conservative in China. The proportion of lobectomy in our database was significantly higher than that in the SEER database (41.3 vs. 17.0%, P < 0.001). ConclusionsUnique risk factors are found to be associated with late-stage DTC in China. The differences in the aspect of clinicopathological features and surgical approaches between China and the USA indicate that potential over-diagnosis and over-surgery exist, and disparities on surgery extent may need further consideration. The findings provided references for other countries with similar patterns.
基金：
The National Key Research and Development Program of
China, Grant/Award Number: 2018YFC1311704.
第一作者机构：[1]Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,[2]Department of Cancer Prevention, Institute of Cancer and Basic Medicine (IBMC), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, Hangzhou, China,
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Zhu Juan,Sun Kexin,Wang Jian,et al.Clinicopathological and surgical comparisons of differentiated thyroid cancer between China and the USA: A multicentered hospital-based study[J].FRONTIERS IN PUBLIC HEALTH.2022,10:doi:10.3389/fpubh.2022.974359.
APA：
Zhu, Juan,Sun, Kexin,Wang, Jian,He, Yutong,Li, Daojuan...&Wei, Wenqiang.(2022).Clinicopathological and surgical comparisons of differentiated thyroid cancer between China and the USA: A multicentered hospital-based study.FRONTIERS IN PUBLIC HEALTH,10,
MLA：
Zhu, Juan,et al."Clinicopathological and surgical comparisons of differentiated thyroid cancer between China and the USA: A multicentered hospital-based study".FRONTIERS IN PUBLIC HEALTH 10.(2022)
