Læknablaðið - 15.10.1986, Blaðsíða 63

LÆKNABLAÐIÐ
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incidentally at autopsy. The incidence of clinical thyroid
cancer was 10.0 females and 3.5 males per 100.000 per
year which seems to be at least 2-3 times as high a figure
as in the other Nordic countries and amongst the highest
incidence figures reported anywhere.
The histological classification was as follows: Papillary
70.4%, follicular 16.0%, anaplastic 7.8%, medullary
3.0% and unclassified 1.7%. No cases of the familial
type were reported.
A considerable increase in the detection rate of papillary
cancer was noted around 1965. The mean size of the
cancer nodules at diagnosis decreased at the same time
and the survival rates of patients improved. The
incidence has decreased again during the last 5 years of
the study.
The number of deaths attributed directly to thyroid
cancer remained similar during these 30 years in spite of
considerable variation in incidence rates.
The mean female:male ratio was 2.9:1 but decreased to
1.7:1 at the end of the period.
The ten years survival rates of women with thyroid
cancer were very different according to the histological
types of cancer; for papillary cancer 78%, follicular
69%, medullary 67% and all patients with anaplastic
cancer were dead within three years of diagnosis.
Amongst men the best survival rate was observed for
follicular cancer 94%, papillary 52% and medullary
33%.
The age of patients at diagnosis seems to be the best
predictor of outcome: Around 1% of those diagnosed
before the age of 40 have died of thyroid cancer, 8% of
those diagnosed between 40 and 50 years of age but 37%
have died of the disease if diagnosed after the age of 50.
HEIMILDIR
1. Bjarnason O, Tulin8us H. Cancer registration in
Iceland 1955-1974. Acta Pathol Microbiol Immunol
Scand (A) 1983; 91: Suppl 281.
2. Cancer Incidence in Five Continents. Volume 4.
International Agency for Research on Cancer.
Lyon 1982. IARC Sci Publ 42.
3. Franssila K, Saxen E, Teppo L, Bjarnason O,
Tulinius H, Norman T, Ringertz N. Incidence of
different morphological types of thyroid cancer in
the Nordic Countries. Acta Path Microbiol Scand
(A) 1981; 89: 49-55.
4. UICC, TNM Classification of Malignant Tumors.
3rd ed. Geneva: International Union Against
Cancer 1978. Enlarged and Revised 1982.
5. Hedinger C, Sobin LH. Histological typing of
thyroid tumors. International Histological
Classification of Tumors No. XI. Geneva: World
Health Organisation, 1974.
6. Tulin8us H, Sigvaldason H. Aldursstöðlun.
Læknablaðið 1978; 64: 133-6.
7. Hagt8ðindi 1977; 63: 130.
8. National Board of Health and Welfare The Cancer
Registry. Cancer Incidence in Sweden 1980. Solna:
Liber Förlag, 1983.
9. Williams ED, Doniach J, Bjarnason O, Michie W.
Thyroid cancer in an iodide rich area. Cancer 1977;
39: 215-22.
10. Bjarnason O. Carcinoma of the thyroid in Iceland.
Proceedings of the XIV. Scandinavian Congress of
Pathology and Microbiology. Oslo:
Universitetsforlaget, 1964; 123-4.
11. Williams ED. The aetiology of thyroid tumors. Clin
Endocrinol Metab 1979; 8: 193-207.
12. Cady B, Sedgwick CE, Meissner WA et al.
Changing clinical, pathologic, therapeutic and
survival patterns in differentiated thyroid
carcinoma. Ann Surg 1976; 184: 541-52.
13. Arellano L, Ibarra A. Occult carcinoma of the
thyroid gland. Pathol Res Pract 1984; 179: 88-91.
14. Harach HR, Franssila KO, Wasenius V-M. Occult
papillary carcinoma of the thyroid. A »normal«
finding in Finland. A systematic autopsy study.
Cancer 1985; 56: 531-8.
15. McConahey WM, Taylor WF, Gorman CA,
Woolner LB. Retrospective study of 820 patients
treated for papillary carcinoma of the thyroid at the
Mayo Clinic between 1946 and 1971. Advances in
Thyroid Neoplasia. Field Educational Italia 1981.
16. Massaferi EL, Young RL, Oertel JE et al. Papillary
thyroid carcinoma: The impact of therapy in 576
patients. Medizine 1977; 56: 171-96.
17. Rasmusson B. Carcinoma of the thyroid. Acta
Radiol (Oncol) 1978; 17: 177-88.
18. Yeung CK, Addison NV.Presentation and
prognosis of malignant tumors of the West Riding
of Yorkshire. Ann R Coll SurgEngl 1983; 65: 1558.
19. Heitz P, Moser H. Thyroid cancer. A study of 573
thyroid tumors and 161 autopsy cases observed over
a thirty year period. Cancer 1976; 37: 2329-37.
20. Kakudo K, Carney A, Sizemore GW. Medullary
carcinoma of thyroid. Biologic behavior of the
sporadic and familial neoplasm. Cancer 1985; 55:
2818-21.
21. Rossi Rl, Nieroda C, Cady B, Wool MS. Malignan-
cies of the thyroid gland. The Lahey Clinic experi-
ence. Surg Clin North Am 1985; 65: 21130.
22. Wanebo HJ, Andrews W, Kaiser DL. Thyroid
cancer: Some basic considerations. Am J Surg 1981;
142: 474-9.
23. Ma aferri EL, Young R. Papillary thyroid carci-
noma. Am J Med 1981; 70: 511-8.
24. Woolner LB, Beahrs OH, Blake BM, McConahey
WM, Keating FR. Classification and prognosis of
thyroid carcinoma. Am J Surg 1961; 102: 354-87.
25. Franssila KO. Prognosis in thyroid carcinoma.
Cancer 1975; 36: 1138-46.
26. Harness JK, Thompson NW, Mcleod MK et al.
Follicular carcinoma of the thyroid gland. Trends
and treatment. Surgery 1984; 96: 972-80.
27. Starnes HF, Brooks DC, Pinkus GS, Brooks JR.
Surgery for thyroid carcinoma. Cancer 1985: 55:
1376-81.
28. Young RL, Ma aferi EL, Rahe JA, Dorfman SG.
Pure follicular thyroid carcinoma: impact of
therapy in 214 patients. J Nucl Med 1980; 21: 733-7.
29. Mckenzie AD. The Natural history of thyroid
cancer. Arch Surg 1971; 102: 274-7.