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Unravelling the rise in thyroid cancer incidence and addressing overdiagnosis

Nature Reviews Endocrinology (2025)Cite this article

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Abstract

The global incidence of thyroid cancer has risen sharply since the 1980s, whereas thyroid cancer mortality rates have remained relatively stable. Much of the increase in incidence can be attributed to overdiagnosis of small and indolent papillary thyroid cancers, which has largely been driven by widespread (and sometimes inappropriate) use of imaging studies, especially thyroid and neck ultrasonography. To a lesser extent, increases in the incidence rate of advanced-stage thyroid cancer over the past four decades have also contributed to the observed trends. This Review describes changes in the incidence of thyroid cancer over the past 40 years, outlines well-known and potential risk factors, including obesity and environmental exposures, and explores strategies to address the public-health issues of overdiagnosis and the consequent overtreatment of thyroid cancer.

Key points

  • Between 1980 and 2017, global thyroid cancer incidence rates increased while mortality rates remained relatively stable.

  • Radiation exposure is the only well-established modifiable risk factor for thyroid cancer.

  • Emerging data suggest that obesity and environmental exposures might also contribute to thyroid cancer development.

  • Overdiagnosis of small indolent thyroid cancers, largely driven by increased use of thyroid ultrasonography, accounts for much of the global rise in thyroid cancer incidence.

  • Multilevel interventions are necessary to address the public-health issue of thyroid cancer overdiagnosis and subsequent overtreatment.

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Fig. 1: The global incidence of thyroid cancer.
Fig. 2: Factors that contribute to the rise in diagnoses of thyroid cancer.
Fig. 3: Thyroid ultrasonography is the main driver of overdiagnosis and overtreatment.

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  1. Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA

    Debbie W. Chen & Megan R. Haymart

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  1. Debbie W. Chen
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  2. Megan R. Haymart
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Chen, D.W., Haymart, M.R. Unravelling the rise in thyroid cancer incidence and addressing overdiagnosis. Nat Rev Endocrinol (2025). https://doi.org/10.1038/s41574-025-01168-y

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