Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
چکیده
Thyroid cancer is the most common of the endocrine malignancies and it represents 4 cm among men (1988–2005: APC 3.7) and women (1988–2005: APC 5.7) [4]. These data suggested that increased diagnostic scrutiny is not the only explanation, and environmental influence should also be considered. The only established environmental risk factor for thyroid carcinoma is exposure to ionizing radiation, and the risk, particularly of papillary carcinoma, is greater in subjects of younger age at exposure. An increased incidence of thyroid cancer in children and adolescents was observed in Ukraine, Belarus and certain regions of Russia as early as 4 years after the Chernobyl accident. The pre-Chernobyl incidence of thyroid cancer in Ukrainian children was very low (0.5–1.0 per 1 000 000 children). Following the explosion of the Chernobyl nuclear reactor in 1986, a dramatic increase in the incidence of benign and malignant thyroid tumors (80 times more) was observed in children born or conceived around the time of the accident in a wide area surrounding the reactor [5]. Despite increasing incidence, the mortality from thyroid cancer has tended to decline over the last three decades. It is unclear how much of the decline in mortality is due to better diagnosis rather than to improved treatment of thyroid neoplasm. The age-adjusted death rate was 0.5 per 100 000 men and women per year, increasing from 0.1% under age 20%–30% in the seventh and the eighth decades [2].