SAT-341 State-Level Trends and Disparities in Thyroid Cancer Burden in the United States: 1990-2021

Abstract Disclosure: M. Kurt Yaman: None. S. Cakir Colak: None. B. Ibis: None. M.A. Colak: None. F. Bahar: None. Background: Thyroid cancer is the most common endocrine malignancy, with a rising incidence globally and in the United States. While increased detection through advanced imaging has contributed to the observed rise, true increases in disease prevalence cannot be excluded. Despite its generally favorable prognosis, disparities in incidence, mortality, and disease burden persist across different states and demographic groups. This study examines state-level trends in thyroid cancer incidence, mortality, and disability-adjusted life years (DALYs) in the US from 1990 to 2021. Methods: Age-standardized incidence rates (ASIR), mortality rates (ASMR), DALYs (ASDR), and estimated annual percentage changes (EAPCs) from 1990 to 2021 were obtained from the Global Burden of Disease 2021 database. State-level trends were analyzed to assess regional variations and disparities. Results Incidence: In 2021, the US ASIR was 5.5/100k, higher than the global ASIR (2.9/100k). Between 1990 and 2021, the US ASIR increased by 41%, matching the global trend. The highest incidence was observed in New Mexico (7/100k), while Michigan had the lowest (3.7/100k). New Jersey had the smallest increase (EAPC: 13%), whereas New Mexico showed the highest rise (EAPC: 81%). Mortality: The US ASMR in 2021 was 0.42/100k, lower than the global ASMR (0.53/100k), but it increased slightly by 8%, contrasting with a 7% decline globally. New Mexico had the highest mortality rate (0.53/100k), while Maryland had the lowest (0.37/100k). The greatest improvement was seen in the District of Columbia (EAPC: -19%), whereas the worst increase was in Oklahoma (EAPC: 35%). DALYs: The US ASDR was 12.3/100k in 2021, lower than the global ASDR of 14.6. Gender Differences: Thyroid cancer disproportionately affected females, with a US ASIR of 6.2/100k compared to 4.8/100k in males (female-to-male ratio: 1.3, global ratio: 1.9). However, US male mortality (0.46/100k) was higher than female mortality (0.39/100k), differing from global trends (ASMR female:male 0.58:0.47/100k). Conclusion: While thyroid cancer incidence in the US continues to rise, the increase is modest and parallels global trends. The slight increase in mortality, despite overall favorable outcomes, highlights the need to address disparities in diagnosis, access to care, and treatment. Geographic variations in incidence and mortality suggest differences in healthcare access and environmental factors. Notably, New Mexico exhibited the highest incidence and mortality, while the D.C. showed the greatest mortality improvement. The unexpected trend of higher male mortality in the US, contrary to global patterns, warrants further investigation into potential biological, socioeconomic, or healthcare-related factors. Future efforts should focus on improving equity in early detection and treatment across states and addressing gender disparities in mortality outcomes. Presentation: Saturday, July 12, 2025