Thyroid Cancer: Epidemiology, Diagnosis, and Treatment.

Abstract

Thyroid cancer, including carcinoma, metastases, sarcoma, and lymphoma of the thyroid gland, is much rarer (incidence of thyroid carcinoma, ca. 7 per 100 000 people per year in Germany) than benign nodular thyroid disease (prevalence: ca. 10% in young men to 80% in older women). The incidence of differentiated thyroid carcinoma has risen around the world in recent years. This narrative review is based on publications retrieved by a search of PubMed. In Germany in 2022, approximately 4200 women and 1800 men received a diagnosis of thyroid carcinoma. The relative 10-year survival rate for this disease was 94% in women and 86% in men. Differentiated thyroid carcinoma (DTC), mainly of the papillary subtype (PTC), was the most common type of thyroid carcinoma in Germany (76% in women, 66% in men). Combined surgery and radio-iodine therapy are still the most common treatment for DTC, although initially available prospective studies currently cast doubt on the benefit of radio-iodine therapy in certain risk groups. The option of active surveillance has been introduced for selected patients with a small PTC. The treatment of radio-iodine-refractory, poorly differentiated, and anaplastic thyroid carcinoma has improved with the introduction of targeted molecular therapies and immunotherapeutic drugs. The treatment of thyroid carcinoma has become more individualized, with less aggressive approaches for small tumors and an expansion of systemic options for advanced cases.