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The role of race in thyroid cancer: systematic review

  • E Keane (a1), E C Francis (a1), É Ó Catháin (a1) and H Rowley (a1)
Abstract Background:

The incidence of thyroid cancer is increasing. There is conflicting evidence as to why. However, studies suggest that it is not an apparent increase resulting from enhanced diagnostic practices, but a true increase with more affected patients. This study aimed to assess racial variation in thyroid cancer.


A narrative systematic review of the literature was conducted.


Eight retrospective cohort studies were identified, comprising 611 777 adult patients. Variations exist between racial groups, which are also dependent on gender; white patients have a slightly higher male population when compared to their counterparts. Black and white patients have a higher proportion of follicular cancer. Hispanics were younger at the age of diagnosis. Outcomes are greatly affected by socioeconomic status.


This study identified many gaps in the way that these types of data are presented. A more concise manner of reporting, with individual-level risk factors, is recommended.

Corresponding author
Address for correspondence: Ms Emma Keane, Department of ENT/Head and Neck Surgery, University Hospital Waterford, Dunmore Road, Waterford X91 ER8E, Ireland Fax: 00 353 51 848 847 E-mail:
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1 National Cancer Registry Ireland. Cancer in Ireland 2013: Annual Report of the National Cancer Registry. In: [7 March 2017]
2 Levi F, Franceschi S, La Vecchia C, Negri E, Gulie C, Duruz G et al. Prior thyroid disease and risk of thyroid cancer in Switzerland. Eur J Cancer 1991;27:85–8
3 Holm LE, Blomgren H, Löwhagen T. Cancer risks in patients with chronic lymphocytic thyroiditis. N Engl J Med 1985;312:601–4
4 Kitahara CM, Linet MS, Beane Freeman LE, Check DP, Church TR, Park Y et al. Cigarette smoking, alcohol intake, and thyroid cancer risk: a pooled analysis of five prospective studies in the United States. Cancer Causes Control 2012;23:1615–24
5 Brenna AV, Tronko MD, Hatch M, Bogdanova TI, Oliynik VA, Lubin JH et al. I-131 dose response for incident thyroid cancers in Ukraine related to the Chernobyl accident. Environ Health Perspect 2011;119:933–9
6 Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295:2164–7
7 Ahn HS, Kim HJ, Welch HG. Korea's thyroid cancer “epidemic” – screening and overdiagnosis. N Engl J Med 2014;371:1765–7
8 Morris LG, Sikora AG, Tosteson TD, Davies L. The increasing incidence of thyroid cancer: the influence of access to care. Thyroid 2013;23:885–91
9 Yoo F, Chaikhoutdinov I, Mitzner R, Liao J, Goldenberg D. Characteristics of incidentally discovered thyroid cancer. JAMA Otolaryngol Head Neck Surg 2013;139:1181–6
10 Brito JP, Davies L. Is there really an increased incidence of thyroid cancer? Curr Opin Endocrinol Diabetes Obes 2014;5:405–8
11 Stroup D, Berlin JA, Morton SC, Olkin I, Williamson GD, Drummond R et al. ; Meta-analysis Of Observational Studies in Epidemiology (MOOSE) Group. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 2000;283:2008–12
12 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF et al. SEER Cancer Statistics Review, 1975–2008. Bethesda, MD: National Cancer Institute, 2011
13 Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. Ottawa: Ottawa Health Research Institute, 1999
14 Harari A, Li N, Yeh MW. Racial and socio-economic disparities and outcomes of well-differentiated thyroid cancer. J Clin Endocrinol Metab 2014;99:133–41
15 Moo-Young TA, Panergo J, Wang CE, Patel S, Duh HY, Winchester DJ et al. Variations in clinicopathologic characteristics of thyroid cancer among racial ethnic groups: analysis of a large public city hospital and the SEER database. Am J Surg 2013;206:632–40
16 Reitzel LR, Nguyen N, Li N, Xu L, Regan SD, Sturgis EM. Trends in thyroid cancer incidence in Texas from 1995 to 2008 by socioeconomic status and race/ethnicity. Thyroid 2014;24:556–67
17 Brown SR, Lee S, Brown TA, Waddell BE. Effects of race on thyroid cancer in an equal access healthcare system. Am J Surg 2010;199:685–9
18 Findlayson A, Barnes I, Sayeed S, McIver B, Beral V, R Ali R. Incidence of thyroid cancer in England by ethnic group, 2001–2007. Br J Cancer 2014;110:1322–7
19 Galm T, Minhas S, Cullen RJ, Griffiths H. Thyroid cancer: is ethnicity relevant? J Laryngol Otol 2011;125:816–19
20 South African National Cancer Registry Data 1998–2006. In: [7 March 2017]
21 North American Association of Central Cancer Registries. NHAPIIA v13 SAS Code and Related Files 2013. In: [7 March 2017]
22 British Thyroid Association, Royal College of Physicians. Guidelines for the Management of Thyroid Cancer (Perros P, ed.), 2nd edn. Report of the Thyroid Cancer Guidelines Update Group. London: Royal College of Physicians, 2007
23 Kitahara CM, Platz EA, Freeman LE, Hsing AW, Linet MS, Park Y et al. Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies. Cancer Epidemiol Biomarkers Prev 2011;20:464–72
24 Kim HJ, Kim NK, Chol JH, Sohn SY, Kim SW, Jin SM et al. Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer. Clin Endocrinol (Oxf) 2013;78:134–40
25 Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998;22:3947
26 World Health Organization. Obesity in the Pacific: Too Big to Ignore. In: [7 March 2017]
27 Panigrah B, Roman SA, Rosa JA. Medullary thyroid cancer: are practice patterns in the United States discordant from American Thyroid Association guidelines? Ann Surg Oncol 2010;17:1490–8
28 Hollenbeak CS, Wang L, Schneider P, Goldenberg D. Outcomes of thyroid cancer in African Americans. Ethn Dis 2011;21:210–15
29 Vasecchi MG, Steliarova-Foucher E. Cancer registration in developing countries: luxury or necessity? Lancet Oncol 2008;9:159–67
30 Zevallos JP, Xu L, Yiu Y. The impact of socioeconomic status on the use of adjuvant radioactive iodine for papillary thyroid cancer. Thyroid 2014;24:758–63
31 Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst 2010;102:605–13
32 Hall SF, Irish J, Groome P, Griffiths R. Access, excess, and overdiagnosis: the case for thyroid cancer. Cancer Med 2014;3:154–61
33 Hall SF, Walker H, Siemens R, Schneeberg A. Increasing detection and increasing incidence of thyroid cancer. World J Surg 2009;33:2567–71
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  • ISSN: 0022-2151
  • EISSN: 1748-5460
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