Thyroid Sriplung H, Vatanasapt P

Incidence In this period, papillary carcinoma Compared with other parts of exceeds follicular carcinoma in all Chapter II the world, Thailand is among the registries. The ratio of papillary to low incidence countries for thyroid follicular carcinoma in females var- cancer. It is obvious that thyroid ies from 12.9:1 in Udon Thani to cancer is the cancer of females. 2.2:1 in Chiang Mai. It is approxi- The estimated incidence rate of thy- mately 3:1 to 7:1 in other registries. roid cancer in Thailand is 1.1 and The ratio is different from that re- 4.1 per 100 000 population in males ported in the periods of 1988-1991 19 and females respectively. The and 1992-1994 in the northern and highest incidence of thyroid can- northeastern regions where follicu- cer is observed in the southern re- lar carcinoma was previously pre- gion (Songkhla). The age-specific dominant. The reverse is observed THYROID incidence rates reach a peak or pla- in the periods 1995-1997 to 1998- ICD-10 C73 teau at early adulthood (Figure 2000. The phenomenon may be the 2.19.1). The declining trend with consequence of iodine supplement Hutcha Sriplung, M.D. age in Nakhon Phanom and Udon programme in salt and fish source Patravoot Vatanasapt, M.D. Thani is observed (Figure 2.19.2). throughout the country since 1989. The lack of treatment facilities may Papillary carcinoma is more preva- lead to under-ascertainment of lent in areas sufficient in dietary

cases in the two areas. iodine (William et al., 1977) IV Vol.

: There are two major types of though it is not evident in some ar- thyroid cancers, papillary and fol- eas such as a report from Denmark licular carcinoma (Figure 2.19.3). (Sehestedt et al., 2006).

Figure 2.19.1 Thyriod cancer in different regions, 1998-2000 CANCER IN THAILAND

4.1 Thailand 1.1 4.3 Chiang Mai 1.2 3.3 Lampang 0.7 0.9 Nakhon Phanom 0.1

Udon Thani 1.8 0.6 Female 4.6 Male Khon Kaen 1.2 3.9 Bangkok 1.2 3.7 Rayong 0.9 2.6 Prachuap Khiri Khan 2 5.7 Songkhla 1.3

0123456 ASR (World) 63

p. 63-Blue Sriplung H, Vatanasapt P Thyroid

Figure 2.19.2 Age-specific incidence rates of thyroid cancer, 1998-2000

Male Female

30 30

25 25

20 20

THAILAND CHIANG MAI LAMPANG 15 15 NAKHON PHANOM UDON THANI KHON KAEN

10 10

Incidence per 100 000

5 5

0 0 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ Age

30 30

25 25

Vol. IV Vol.

: 20 20

THAILAND BANGKOK 15 15 RAYONG PRACHUAP KHIRI KHAN SONGKHLA

Incidence per 100 000 10 10

5 5

0 0 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ Age

CANCER IN THAILAND

p. 64-Blue Thyroid Sriplung H, Vatanasapt P

Figure 2.19.3 Histological types of thyroid cancer, 1998-2000

Male

Chiang Mai 15.2 56.5 28.3

Lampang 33.3 16.7 50.0

Nakhon Phanom 100.0

Udon Thani 66.7 33.3

Khon Kaen 14.8 77.8 7.4

Bangkok 16.1 71.0 12.9

Rayong 33.3 66.7

Prachuap Khiri Khan 42.9 57.1

Songkhla 18.2 72.7 9.1

0%0% 20% 20% 40% 40% 60% 60% 80% 80 100%

Follicular carcinoma Papillary carcinoma Other

Female IV Vol.

Chiang Mai 25.6 57.4 16.9

Lampang 14.3 62.9 22.9

Nakhon Phanom 33.3 66.7

Udon Thani 6.1 78.8 15.2

Khon Kaen 20.9 69.1 10.0

Bangkok 11.7 82.8 5.6

Rayong 23.8 66.7 9.5 CANCER IN THAILAND

Prachuap Khiri Khan 6.7 80.0 13.3

Songkhla 26.8 68.8 4.5

0%0% 20% 20% 40% 40% 60% 60% 80% 80 100%

Follicular carcinoma Papillary carcinoma Other

p. 65-Blue