Thyroid Cancer Survival – Population based study – EUROCARE-5 Dr Dominic Agius Head Malta National Cancer Registry 20th October, 2017

Overview Over last 25 years: Relative survival from thyroid cancer by sex, country, age, period and histological type Thyroid cancer incidence – increased Mortality trends – stable

Methods Data from 29 countries 1.One and five year Relative Survival Rates for adult patients diagnosed in 2000-2007 and followed-up till end of 2008 2. Trends in Relative Survival Rates in1999-2007 period 3. 10-year Relative Survival Rates in 2005-2007

Results (incidence) Overall 5-yr Relative Survival Women – 88%; Men – 81% Strong correlation by country between survival and incidence rates and histological type: Highest incidence, survival, papillary type (79%) in Southern Europe. Lowest in UK and Ireland – papillary type (58%); Follicular type (23% - 15% in Europe)

Results (incidence cont.) Thyroid cancer: Survival – Incidence Females

Results (incidence cont.) Thyroid cancer: Survival – Incidence Men

Results (Histology) 5-yr Relative Survival vs histology Papillary (98% in woman; 94% in men) Follicular (92% in women; 87% in men) Medullary (88% in women; 75% in men) Anaplastic (14% in women; 12% in men)

5-yr RS for papillary thyroid cancer by period and region - women Results (Histology) 5-yr RS for papillary thyroid cancer by period and region - women

5-yr RS for follicular thyroid cancer by period and region – women Results (Histology) 5-yr RS for follicular thyroid cancer by period and region – women

Thyroid cancer: 5-yr RS by age Results (Age) Thyroid cancer: 5-yr RS by age Age (yr) Women Men 15-44 >99% 97% 45-54 >95% 90% 55-64 93% 84% 65-74 82% 70% 75+ 57% 51%

10-yr RS conditional on surviving 5 yrs Results – 10-yr RS Ten-year relative survival (10-yr RS, %), and 10-year relative survival conditional on surviving five years (10-yr/5-yr) 10-yr RS % 10-yr RS conditional on surviving 5 yrs Women 89.4 (88.6-90) 97.5 (96-99) Men 79.2 (77.5-80.7) 94.6 (90.9-98.5)

Thyroid cancer survival trends 5-yr RS over period 1999-2007 All thyroid cancers +5% Papillary thyroid cancer +2% Follicular thyroid cancer +4% In women only, medullary and anaplastic cancers +7%

Conclusions Trends in thyroid cancer survival and country differences seem to be explained by: Varying histological case-mix Age distribution of cases Results could inform management strategies aimed at reducing unnecessary and harmful treatments that negatively impinge on patients’ quality of life

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