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Revisiting overdiagnosis and fatality in thyroid cancer.

重新审视甲状腺癌的过度诊断和死亡率。

Abstract

Objectives: To examine the rates of incidence and fatality in cohorts of patients diagnosed with thyroid cancer from 1975 to 1999. Methods: This study uses National Cancer Institute's Surveillance, Epidemiology and End Results data and derives hazard functions in order to examine the fatality in thyroid cancer. Results: The study documents forms of rapidly evolving and fatal tumors as well as forms of tumor that evolve more slowly to cause death. It demonstrates that the incidences of nonfatal forms of thyroid cancer have risen dramatically in the years from 1975 to 1999-mostly due to papillary carcinomas-but that the incidences of fatal forms of thyroid cancer have remained nearly constant. Conclusions: The results of this study support the notion that many thyroid cancers are part of a reservoir of nonfatal tumors that are increasingly being overdetected and overdiagnosed.

摘要

目的:调查1975-1999年诊断的各组甲状腺癌患者的发病率和死亡率。
方法:本研究使用国家癌症研究所的监测,流行病学及预后的数据,并得出危险函数,以调查甲状腺癌的死亡率,
结果:本研究整理了快速进展并致死的肿瘤类型和缓慢进展引起死亡的肿瘤类型。这份资料显示了在1975年到1999年,主要由于乳头状癌发病率提高,使非致死性甲状腺癌的发病率显著提高,而致死性甲状腺癌的发病率仍然几乎持平。
结论:本研究结果支持这样的观点:许多甲状腺癌是非致死性肿瘤的一部分,正在不断被过度检查和过度诊断。

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