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Korea's thyroid cancer rate more than doubled between 2006 and 2012 and then fell by almost half by 2015 while deaths did not move, and the rise and fall were steepest among the better-off, which the authors read as evidence of overdiagnosis.
A national time-trend study using the Korea Community Health Survey, the National Health Insurance database and Statistics Korea cause-of-death data. Age-standardised thyroid cancer incidence rose from 46.6 per 100,000 in 2006 to 115.0 in 2012 and fell to 63.5 in 2015, while mortality did not fluctuate. Higher income was associated with higher rates of screening, incidence and post-operative complications, and lower income with higher mortality; lung cancer and stroke, used as negative controls, showed the opposite pattern. The fall in incidence and complications after 2012, which the authors link to public concern about overdiagnosis, was more pronounced among high-income people.
Finding more of a cancer is not the same as saving lives from it. In Korea, screening produced a surge in thyroid cancer diagnoses and operations without changing how many people died, and the surge reversed when doctors and the public questioned it.
Shares Korea's thyroid-cancer "epidemic"--screening and overdiagnosis, Overdiagnosis and false alarms, Thyroid cancer.
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