INCIDENCE AND MORTALITY FOR MALIGNANT TIREOID NEOPLASM IN LATIN AMERICA
Thyroid neoplasms; Trends; Predictions; Mortality.
Introduction: Thyroid neoplasm accounts for approximately 2% of all cancers in the world; although rare, is the most common endocrine neoplasm, presenting a rapid rise in incidence in the last decades. Objective: To analyze the trend and projections of incidence and mortality from thyroid cancer (C73) in Latin American countries. Methods: Ecological study of time series. For the countries of Latin America, incidence data were extracted from the International Agency for Research on Cancer (IARC) in the period 1990-2007; mortality data were obtained from the World Health Organization (WHO) for the period 1995-2013; for Brazil, mortality data were collected from the Mortality Information System (SIM) for the period 2001-2015. The incidence and mortality trends were analyzed by the Joinpoint regression, and Nordpred, in the R program, was used to calculate the mortality projections in Brazil. The mean annual percentage change (APC and AAPC) and the 95% confidence interval (95% CI) were calculated for incidence and mortality. Results: The mean incidence rate for thyroid cancer was higher in Quito (Ecuador), in the age group above 60 years; the rates were 30.8 and 10.3 deaths per 100,000 inhabitants for women and men, respectively. Increased incidence trends were detected for women and trend for stability were verified in Cali, Goiania and Quito for men, in the age group of 60 years. Mortality rates were higher among women; the majority of countries showed a trend towards stability for mortality. The trend of increase occurred in three countries for women: Ecuador (APC = 3.28 CI 95% 1.36, 5.24), Guatemala (CI = 6.14 CI 95% 2.81, 9.58) and Mexico (APC = 0.67, 95% CI 0.16, 1.18). In Brazil, ASW was recorded as 0.48 deaths / 100,000 inhabitants for women and 0.27 deaths / 100,000 inhabitants for men, with a tendency to decrease for women (APC = -1.6 95% -2.5; 0.6) and stability for males (APC = -0.5 CI95% -1.5; 0.5). Mortality rates for females in Brazil will decrease by 2030. For males, this same characteristic will be observed, but the Northeast and North Regions will show higher rates, and these numbers will be explained mainly by the variation in demographic structure Brazilian. Conclusions: Thyroid cancer presented a heterogeneous incidence among genders, with a marked increase for women in Cali (Colombia), Costa Rica, Goiania (Brazil) and Quito (Ecuador). The trend of stability in mortality has been verified for most Latin American countries and may be related to limited access to diagnosis and new therapies that have an impact on the most aggressive and highly lethal subtypes. In Brazil, mortality due to thyroid cancer presented a reduction, being more pronounced for females.