Impact of social and economic factors on global thyroid cancer incidence and mortality

Yi Chiung Hsu, Sheena Yi Hsin Cheng, Ming Nan Chien, Shih Ping Cheng

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: The incidence of thyroid cancer has increased substantially over the past few decades and is partially explained by overdiagnosis. Geographical variations in incidence rates were reported to be related to national development status. This study aimed to gain deeper insights into global thyroid cancer burden by incorporating additional social and economic factors to account for cross-national disparities. Methods: We performed a multivariate analysis of age-standardized incidence and mortality data from the GLOBOCAN 2020 database for 126 countries that had more than 100 incident cases of thyroid cancer. The human development index (HDI), current health expenditure, and additional Global Health Observatory indicators were extracted from multiple sources. Results: Age-standardized incidence was highly correlated with HDI (standardized coefficient beta = 0.523, 95% confidence interval [CI] = 0.275–0.771) among the countries studied. The prevalence of raised fasting blood glucose was associated with age-standardized mortality (beta = 0.277, 95% CI = 0.038–0.517). Generally, the mortality-to-incidence ratio was higher in males than in females. In multivariate analysis, HDI (beta = − 0.767, 95% CI = − 0.902 to − 0.633), current health expenditure (beta = 0.265, 95% CI = 0.137–0.394), and fine particulate matter (PM2.5) concentrations (beta = 0.192, 95% CI = 0.086–0.298) were associated with mortality-to-incidence ratios. Conclusions: National developments gauged by HDI explain the majority of the variation in incidence rates of thyroid cancer but play a smaller role in disparities in mortality rates. The association between air pollution and thyroid cancer outcomes warrants further investigation.

Original languageEnglish
Pages (from-to)4185-4193
Number of pages9
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number9
StatePublished - Sep 2023


  • Fine particulate matter
  • Human development index
  • Mortality-to-incidence ratio
  • Thyroid cancer


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