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Comment on 'Thyroid Cancer 'Epidemic': A Socio-Environmental Health Problem Needs Collaborative Efforts'

机译：评论'甲状腺癌症'流行病'：社会环境健康问题需要合作努力'

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A viewpoint entitled "Thyroid Cancer "Epidemic": A Socio-Environmental Health Problem Needs Collaborative Efforts" was recently published in ES&T by Tang et al., discussing the topic of the relationship between environmental chemical exposure and thyroid cancer development.1 We would like to comment on it from epidemiological and medical points of view. Although the current worldwide incidence of thyroid cancer is rising due to life style changes (e.g., obesity, smoking), it is estimated that in the U.S., for example, overdiagnosis may account for 70-80% of cases in women.2 Tang et al. suggested that it might be a true increase, not an overdiagnosis, from U.S. thyroid cancer mortality analysis (until 2013).3 However, the recent incidence of thyroid cancer has been stabilized in the U.S. since the publication and gradual implementation of the 2009 American Thyroid Association guidelines, which refrains from aggressive ultrasound examinations without clinical symptoms. Hence, the "epidemic" trend has ceased in recent years in the U.S. The relatively rapid stabilization in the number of cases in response to the change in clinical practice indicates that overdiagnosis was a substantial factor of the increase. Changes in case numbers related to changes in exposure to risk factors would occur more slowly due to the long latency period of cancer onset.
机译：题为“甲状腺癌”疫情的观点最近在唐等人的ES＆T发表了一个社会环境健康问题需要协作努力“。，讨论了环境化学曝光与甲状腺癌开发之间关系的主题.1我们希望从流行病学和医学点评论它。虽然目前甲状腺癌的发生率由于生活方式变化（例如，肥胖，吸烟）而上升，但估计，在美国，过度输入可能占70-80％的女性患者al。建议，来自美国甲状腺癌死亡率分析（直到2013年），这可能是一个真正的增加，而不是过度输入的.3然而，由于2009年美国甲状腺的出版和逐步实施，美国最近的甲状腺癌发生率已经稳定在美国关联指南，抑制不含临床症状的侵略性超声检查。因此，“疫情”趋势近年来在美国近年来停止了案件数量相对较快的稳定性，以应对临床实践的变化表明过度诊断是增加增加的重大因素。由于癌症发作的长期延迟时期，与暴露于风险因素的变化有关的情况的变化将更慢。

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