甲状腺癌的流行病学现状及其影响因素研究进展

张芷悦; 何慧婧; 单广良; 林岩松

doi:10.19401/j.cnki.1007-3639.2025.01.003

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甲状腺癌的流行病学现状及其影响因素研究进展

专家述评 | 更新时间：2025-12-31

- 甲状腺癌的流行病学现状及其影响因素研究进展
- Research progress in epidemiology and risk factors of thyroid cancer
- 中国癌症杂志 2025年35卷第1期页码：21-29
- 作者机构：
  
  1. 中国医学科学院基础医学研究所/北京协和医学院基础学院流行病与卫生统计学系，北京 100005
  2. 北京大学医学人文学院，北京 100191
  3. 中国医学科学院北京协和医学院北京协和医院核医学科，疑难重症及罕见病国家重点实验室，核医学分子靶向诊疗北京市重点实验室，北京 100730
- 作者简介：
  
  [ "张芷悦（ORCID: 0000-0001-5638-008X），学士。" ]
  [ "何慧婧，博士，副研究员，硕士研究生导师，中国医学科学院基础医学研究所/北京协和医学院基础学院流行病与卫生统计学系。主持国家自然科学基金（面上项目、青年项目）、北京市自然科学基金（青年项目）、北京市首都卫生发展科研专项等多项国家和省部级项目。近5年以第一作者或通信作者在SCI收录期刊上发表论文20余篇。中国初级卫生保健基金会京津冀鲁基层卫生专业委员会副主任委员，中国医药质量管理协会临床研究质量与评价专业委员会常务委员，中华预防医学会公共卫生伦理专业委员会委员，北京医学会健康管理学分会委员，中国科协财政项目评审专家。《中华放射肿瘤学杂志》《中华流行病学杂志》通讯编委、副主编。参编教材与专著多部。" ]
  林岩松（ORCID: 0000-0001-6095-4728），博士，主任医师。
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2025.01.003
  中图分类号： R736.1
- 收稿：2024-12-04，
  
  修回：2025-01-23，
  
  纸质出版：2025-01-30
- 稿件说明：
移动端阅览
张芷悦, 何慧婧, 单广良, 等. 甲状腺癌的流行病学现状及其影响因素研究进展[J]. 中国癌症杂志, 2025,35(1):21-29.

Zhiyue ZHANG, Huijing HE, Guangliang SHAN, et al. Research progress in epidemiology and risk factors of thyroid cancer[J]. China Oncology, 2025, 35(1): 21-29.
张芷悦, 何慧婧, 单广良, 等. 甲状腺癌的流行病学现状及其影响因素研究进展[J]. 中国癌症杂志, 2025,35(1):21-29. DOI： 10.19401/j.cnki.1007-3639.2025.01.003.

Zhiyue ZHANG, Huijing HE, Guangliang SHAN, et al. Research progress in epidemiology and risk factors of thyroid cancer[J]. China Oncology, 2025, 35(1): 21-29. DOI： 10.19401/j.cnki.1007-3639.2025.01.003.

摘要

甲状腺癌是内分泌系统和头颈部最常见的恶性肿瘤，包括甲状腺乳头状癌（papillary thyroid cancer，PTC）、甲状腺滤泡癌（follicular thyroid cancer，FTC）、甲状腺髓样癌（medullary thyroid cancer，MTC）和甲状腺未分化癌（anaplastic thyroid cancer，ATC）等类型。近几十年，甲状腺癌的发病率迅速增长。从地区分布看，甲状腺癌的发病率在经济发达地区较高；发病率上升较快的主要是一些高收入国家，但在一些中等收入国家也出现了快速增长；从人群看，女性甲状腺癌的发病率显著高于男性。中国甲状腺癌的发病率近年来也呈明显上升趋势，但死亡率则稳定在较低水平；城市甲状腺癌的发病率高于农村地区，东部沿海地区发病率高于中、西部地区。甲状腺癌的病因复杂多样，主要危险因素包括遗传易感性、辐射暴露、碘摄入水平、内分泌紊乱、环境污染和生活方式等。其中，辐射暴露（尤其是儿童时期暴露于电离辐射）是甲状腺癌公认的重要诱因。此外，碘摄入不足或过量均可影响甲状腺功能，增加癌变风险。在遗传学方面，甲状腺癌的家族聚集性和基因（如

BRAF

、

RET/PTC

等）突变在疾病发生中的作用已被广泛研究，而环境污染和现代生活方式的改变也可能在某种程度上促进了疾病的发生、发展。因此，对有甲状腺癌家族史的人群开展早期筛查，减少不必要的医疗辐射暴露，及时干预肥胖等与生活方式密切相关的危险因素，可能对甲状腺癌的预防有积极意义。甲状腺癌患者大多数预后良好，预后影响因素主要有病理学分型（PTC预后较好，而MTC和ATC预后较差）、临床分期（TNM分期Ⅰ、Ⅱ期预后较好，Ⅲ、Ⅳ期较差）、生理因素（女性总体预后优于男性）、遗传学因素和环境因素等。了解甲状腺癌的流行病学现状，探索其发病和预后的影响因素，对于甲状腺癌的预防、治疗和健康管理有重要意义。未来可基于甲状腺癌危险因素进行高危人群的识别和干预研究，从而预防肿瘤，减少疾病负担，提高患者的生存质量。

Abstract

Thyroid cancer is the most common malignant tumor of the endocrine system and head and neck region

mainly including papillary thyroid cancer (PTC)

follicular thyroid cancer (FTC)

medullary thyroid cancer (MTC) and anaplastic thyroid cancer (ATC). Over the past few decades

the global incidence of thyroid cancer has risen rapidly

nearly doubling in some developed countries. Geographically

thyroid cancer incidence is higher in economically developed regions. Although the fastest increase in incidence has been observed in high-income countries

certain middle-income countries have also reported significant growth. Demographically

the incidence rate is notably higher in women than in men. In China

the incidence of thyroid cancer has increased significantly in recent years

while the mortality rate has remained stable at a low level. Urban areas report higher incidence rates than rural areas

and eastern coastal regions have higher rates compared to central and western regions. The etiology of thyroid cancer is multifaceted

with major risk factors including genetic predisposition

radiation exposure

iodine intake levels

endocrine disruptions

environmental and lifestyle factors. Among these

radiation exposure (particularly ionizing radiation during childhood) is a recognized critical risk factor. In addition

both insufficient and excessive iodine intake can disrupt thyroid function

thereby increasing disease risk. Genetic factors

such as familial clustering and gene (

BRAF

RET/PTC

etc.) mutations

have been widely studied

whil

e environmental pollution and modern lifestyles may also contribute to disease onset. Therefore

it is beneficial to conduct early screening for people with a family history of thyroid cancer

reduce unnecessary medical radiation exposure and conduct intervention on lifestyle-related risk factors such as obesity to prevent and control thyroid cancer. Most patients with thyroid cancer have a favorable prognosis. The main factors influencing the prognosis include pathological typing (PTC has a relatively better prognosis

while MTC and ATC have poorer prognoses)

clinical staging (patients at TNM stages Ⅰ and Ⅱ have better prognoses

while those at stages Ⅲ and Ⅳ have worse ones)

physiological factors (the overall prognosis of females is superior to that of males)

genetic factors and environmental factors. Understanding the epidemiological trends and identifying factors influencing the onset and prognosis of thyroid cancer are essential for its prevention

treatment and health management. Future research should focus on identifying high-risk populations and developing targeted interventions to prevent and control thyroid cancer

reduce its disease burden

improve quality of life for patients

and lower healthcare costs.

关键词

Keywords

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