The number of thyroid cancer surgery recently declined as the incidence of thyroid cancer decreased, which, in turn, reduced the rate of hypoparathyroidism, a severe complication that can occur after thyroid surgery, researchers found.

The research team, led by Professor Lee Si-hoon of Department of Endocrinology at Gachon University Gil Medical Center, collected the entire population's number and type of thyroid cancer surgery and the incidence of thyroid cancer and postoperative hypoparathyroidism from 2007 to 2016.

Thyroid cancer has recorded the fastest increase rate of all cancers since 2000 worldwide. Especially in 2012, the comparison of the thyroid cancer rate by country showed that Korean men and women showed four and five times more likely to develop thyroid cancer than their U.S. counterparts. Such statistics are known to be related to a high screening rate.

As more people became aware of the situation since 2012, doctors have used ultrasound screening for thyroid more selectively.

They also made and used a new treatment guideline, easing the criteria for conducting fine needle aspiration cytology to suspicious nodules measuring larger than 1 centimeter in diameter.

The result showed that the incidence of thyroid cancer and surgery, which had been continuously increasing, began to decrease after its peak in 2012, and the incidence of postoperative hypoparathyroidism decreased as well.

Out of 100,000 people, the incidence of thyroid cancer increased from 38.3 in 2007 to a peak of 73 in 2012 but fell back to 44.1 in 2016. People with hypoparathyroidism patients also rose from 2.6 in 2007 to 7 in 2012 but declined to 3.3 in 2016.

Source: Department of Endocrinology at Gachon University Gil Medical Center

Likewise, the share of people who underwent thyroidectomy climbed from 34.8 in 2007 to peak at 70 in 2012 but dropped to 22.2 in 2016. The declining number of thyroid cancer patients led to fewer people having a thyroidectomy, which, in turn, reduced the cases of hypoparathyroidism. The changes in thyroid surgical pattern, including the increase in partial thyroidectomy, also seem to be related to the result.

"Our study is significant, as it tried to grasp the situation of public health and medical practices by using big data to suit the trend of the Fourth Industrial Revolution, and exert some direct influence on establishing public health policy,” Professor Lee said.

The study, supported by National Research Information, was conducted to assist the making of national health policy and academic research using a database of national information service, run by National Health Insurance Service.

Researchers wrote the report titled the “Incidence of Hypoparathyroidism After Thyroid Cancer Surgery in South Korea, 2007-2016,”' after manually reviewing and verifying the actual hospital records. It was published in the latest issue of The Journal of the American Medical Association (JAMA) side by side with a similar report on the U.S. situation.

JAMA, along with the New England Journal of Medicine (NEJM) and Lancet, is one of the world's three best-known medical journals with an impact factor of 51.3.

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