Ramy Mohamed Ghazy a, Chenyu Sun b c d, Ayoub Ali Alshaikh a, Tuan Vinh e
Abstract
Background
The burden of pediatric and adolescent thyroid cancer is increasing. This research aimed to study the long-term incidence trends among United States (U.S.) individuals aged 0–19 years from 1999 to 2022, assess heterogeneity by sex, age, race/ethnicity, and state, evaluate COVID-19 pandemic-associated changes, and forecast incidence through 2027
Methods
This population-based longitudinal ecological analysis used the U.S. Cancer Statistics Incidence Database queried via Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER). Cases were defined using ICD-O-3 site code C73.9. Age-adjusted incidence rates per 100,000 were calculated by demographic strata. Joinpoint-type segmented regression and Poisson regression were used to assess temporal trends and estimate annual percent change and incidence rate ratios (IRR). State-level geographic variation was assessed using mapped age-adjusted rates and global spatial autocorrelation (Moran’s I). Forecasts (2023–2027) were generated using Autoregressive Integrated Moving Average (ARIMA) model, Exponential Smoothing State Space (ETS) model, and Poisson regression.
Results
From 1999–2022, 17,538 pediatric thyroid cancer cases were diagnosed. Incidence increased steeply with age, peaking at ages 15–19 (crude rate 2.58/100,000). Females had higher incidence than males (age-adjusted 1.4 vs 0.3/100,000). Rates were highest among White (1.0/100,000) and Asian/Pacific Islander (0.9/100,000) children and lowest among Black/African American children (0.3/100,000). Significant spatial clustering was observed (Moran’s I=0.39, p < 0.001), with higher rates in Northeastern states and lower rates in the South. A marked decline occurred in 2020, consistent with disrupted diagnosis during the COVID-19 pandemic. Poisson models indicated a sustained upward temporal trend (IRR≈1.032 per year, p < 0.001). Forecasts suggested continued increases through 2027 (≈17% rise over 5 years; ≈37% over 10 years).
Conclusions
Pediatric and adolescent thyroid cancer incidence rose steadily in the U.S. from 1999 to 2022, with pronounced socio-demographic heterogeneity and a notable diagnostic disruption in 2020. Continued surveillance and investigation of etiologic drivers and diagnostic intensity are mandatory, alongside efforts to reduce inequities in access to evaluation and care.
