Increasing Incidence of Thyroid Cancer in the United States, 1973-2002

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Abstract
While the incidence of many head and neck cancers in the United States is decreasing,1 a number of registries have reported that the incidence of thyroid cancer is increasing.2-6 Some investigators have attributed the increase to environmental radiation,5 while others have found no obvious source.3 However, increasing cancer incidence can be either real or apparent because of increased diagnostic scrutiny. Supporting evidence for a real increase in incidence includes an increase in known or suspected risk factors for the cancer. If the increase were real, it would be expected across all stages, as opposed to a shift in the stage distribution toward earlier stages, as might be expected if there were changes in diagnostic criteria or increased diagnostic scrutiny. Moreover, the increase in incidence might be expected to be accompanied by increasing symptoms or associated mortality.