Geographic influences in the global rise of thyroid cancer

Nat Rev Endocrinol. 2020 Jan;16(1):17-29. doi: 10.1038/s41574-019-0263-x. Epub 2019 Oct 15.


The incidence of thyroid cancer is on the rise, and this disease is projected to become the fourth leading type of cancer across the globe. From 1990 to 2013, the global age-standardized incidence rate of thyroid cancer increased by 20%. This global rise in incidence has been attributed to several factors, including increased detection of early tumours, the elevated prevalence of modifiable individual risk factors (for example, obesity) and increased exposure to environmental risk factors (for example, iodine levels). In this Review, we explore proven and novel hypotheses for how modifiable risk factors and environmental exposures might be driving the worldwide increase in the incidence of thyroid cancer. Although overscreening and the increased diagnosis of possibly clinically insignificant disease might have a role in certain parts of the world, other areas could be experiencing a true increase in incidence due to elevated exposure risks. In the current era of personalized medicine, national and international registry data should be applied to identify populations who are at increased risk for the development of thyroid cancer.

Publication types

  • Review

MeSH terms

  • Age Distribution
  • Environmental Exposure / adverse effects*
  • Feeding Behavior / physiology
  • Global Health / economics*
  • Global Health / trends
  • Humans
  • Incidence
  • Income* / trends
  • Registries
  • Risk Factors
  • Sex Distribution
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / economics*
  • Thyroid Neoplasms / epidemiology*