Thyroid cancer: Epidemiology, diagnosis, and treatment

BACKGROUND: 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. METHODS: This narrative review is based on publications retrieved by a search of PubMed. RESULTS: 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. CONCLUSION: 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.