在许多国家，甲状腺癌的发病率一直在上升，主要原因是过度诊断。鉴于这些快速变化，我们的目标是评估甲状腺癌诊断流行的具体特征，提供五大洲国家过度诊断的估计，并确定需要应对策略的领域。从国际研究机构检索到两类数据癌症 (IARC) 全球癌症观察数据库。 1980 年至 2017 年间按性别和 5 岁年龄组划分的所有年龄段甲状腺癌的长期年发病率是从五大洲癌症发病率 (CI5) plus 中提供的连续人口登记处获得的，其中包括 43 个国家和地区的 97 个登记处。选定的国家。从最新一卷 CI5 (CI5-XII) 中包含的所有登记处检索了总体和按亚型分类的性别年龄特异性甲状腺癌病例以及相应的人口计数，其中包括 63 个国家的 385 个登记处。 1980 年至 2022 年的年度死亡率数据来自世界卫生组织，人口计数由联合国人口估计值补充。我们以世界人口为参考，使用直接年龄标准化估计了所有年龄段按性别的甲状腺癌发病率和死亡率的年龄标准化率（ASR）。比较了 1980 年以来 ASR 发病率和死亡率的长期年度趋势。计算了 2013-17 年间甲状腺癌发病率的亚型分布。我们估计了甲状腺癌病例和过度诊断病例的数量，并使用先前开发和验证的方法推断到整个国家。1980年至2017年间，大多数国家的甲状腺癌发病率有所上升，其中韩国、塞浦路斯、厄瓜多尔的发病率最高、中国和土耳其（女性和男性）。直到2010年代初一直呈上升趋势，随后韩国、美国、加拿大和以色列以及法国、意大利、奥地利和爱尔兰等一些西欧国家呈下降趋势。最高和最低发病率之间的差异从 1980 年代初每 100 名女性不到 10·0 到 2012 年每 100 000 名女性 101·4。对于男性来说，最高和最低发病率之间的差异为 2在研究期间，每 100 人中·7 人到每 100 人中 23·5 人。死亡率大幅降低，在整个研究期间，各国最高死亡率和最低死亡率之间的差异约为每 100 000 人 1·0-2·0。 2013-17 年期间，甲状腺乳头状癌导致甲状腺癌发病率 ASR 发生巨大变化。在所有国家中，甲状腺癌的死亡率均随着年龄的增长而增加，而在大多数国家中观察到的特定年龄发病率呈倒U形。各国过度诊断的程度各不相同，从没有过度诊断（乌干达、津巴布韦、特立尼达和多巴哥）到超过 85·0% 的女性甲状腺癌病例被过度诊断（塞浦路斯、中国、韩国和土耳其） 。总体而言，2 297 057 例中有 1 736 133 (75·6%) 归因于过度诊断，其中包括 1 368 181 名女性和 367 952 名男性。尽管甲状腺癌的发病率在一些高收入国家已达到稳定水平或下降，但过度诊断的规模仍然很大，并且甲状腺癌的过度诊断向转型国家迅速扩展，这使其成为需要应对的全球公共卫生挑战。 国家自然科学基金、广东省基础与应用基础研究基金会、中山大学肿瘤防治中心青年英才计划、意大利癌症研究协会和意大利卫生部 (Ricerca Corrente)。版权所有 © 2024 世界卫生组织。由 Elsevier Ltd 出版。保留所有权利，包括文本和数据挖掘、人工智能培训和类似技术的权利。

The incidence of thyroid cancer has been increasing in many countries, mainly due to overdiagnosis. Given these rapid changes, we aim to assess the specific features of the thyroid cancer diagnosis epidemic and provide estimates of overdiagnosis across countries spanning five continents and identify areas in which coping strategies are needed.Two types of data were retrieved from the International Agency for Research on Cancer (IARC) Global Cancer Observatory database. The long-term annual incidence of thyroid cancer by sex and 5-year age group for all ages from 1980 to 2017 was obtained from continuous population-based registries available in the Cancer Incidence in Five Continents (CI5) plus, with 97 registries from 43 countries selected. Sex-age-specific thyroid cancer cases, overall and by subtype, along with corresponding population counts were retrieved from all registries included in the latest volume of CI5 (CI5-XII), with 385 registries in 63 countries. Annual mortality data from 1980 to 2022 were obtained from WHO, with population counts supplemented by UN population estimates. We estimated age-standardised rates (ASRs) of thyroid cancer incidence and mortality for all ages by sex using direct age standardisation, with the world population as a reference. Long-term annual trends of ASRs were compared between incidence and mortality since 1980. Subtype distribution was calculated for thyroid cancer incidence during 2013-17. We estimated the numbers of thyroid cancer cases and overdiagnosed cases and extrapolated to the whole country using a previously developed and validated method.Thyroid cancer incidence rates rose during 1980-2017 for most countries, with the highest rates seen in South Korea, Cyprus, Ecuador, China, and Türkiye for females and males. An upward trend was seen until the early 2010s, followed by a downward trend in South Korea, the USA, Canada, and Israel and some Western European countries, such as France, Italy, Austria, and Ireland. The difference between the highest and lowest incidence rates ranged from less than 10·0 per 100 000 females in the early 1980s to 101·4 per 100 000 females in 2012. For males, the difference between the highest and lowest incidence rates ranged from 2·7 per 100 000 to 23·5 per 100 000 over the study period. Mortality rates were substantially lower, with a difference between the highest and lowest rates across countries of around 1·0-2·0 per 100 000 for both sexes throughout the study period. During 2013-17, papillary thyroid cancer contributed to the large variation in ASRs of thyroid cancer incidence. The mortality rates of thyroid cancer increased with age for all countries, whereas the observed age-specific incidence rates showed an inverted U-shape in most countries. The magnitude of overdiagnosis varied across countries, ranging from no overdiagnosis (in Uganda, Zimbabwe, and Trinidad and Tobago) to more than 85·0% of thyroid cancer cases being overdiagnosed in females (in Cyprus, China, South Korea, and Türkiye). Overall, 1 736 133 (75·6%) of 2 297 057 cases were attributable to overdiagnosis, including 1 368 181 females and 367 952 males.Although the incidence of thyroid cancer has reached a plateau or decrease in some high-income countries, the magnitude of overdiagnosis is still very large and the expansion of overdiagnosis of thyroid cancer to the transitioning countries has been rapid, which makes it a global public health challenge that needs to be addressed.National Natural Science Foundation of China, Guangdong Basic and Applied Basic Research Foundation, Young Talents Program of Sun Yat-sen University Cancer Center, Italian Association for Cancer Research, and the Italian Ministry of Health (Ricerca Corrente).Copyright © 2024 World Health Organization. Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.