SAT-373 - State-Level, Age, and Sex Disparities in Thyroid Cancer Burden in the United States: A Global Burden of Disease 2023 Analysis

Background
Thyroid cancer incidence has increased steadily in the United States over recent decades, with substantial geographic and demographic heterogeneity. A contemporary state-level analysis incorporating age, sex, and risk factor patterns is essential to characterize disease burden and temporal trends.
Methods
Age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASDR), and disability-adjusted life-year (DALY) rates per 100,000 population were extracted from the Institute for Health Metrics and Evaluation Global Burden of Disease (GBD) 2023 study using the IHME Results Tool. Analyses included all 50 U.S. states and the District of Columbia. State-level variation, age- and sex-specific patterns, and sex-based prevalence differences were examined. Risk factor attribution focused on high body-mass index (BMI). Temporal trends were assessed using estimated annual percent change (EAPC) with 95% confidence intervals (CI).
Results
Marked interstate variation was observed. Incidence rates were highest in Oregon (7.39), North Dakota (7.26), and New Mexico (7.25), and lowest in Michigan (3.82), Utah (4.46), and Connecticut (4.57). Prevalence was highest in North Dakota (74.77), Oregon (63.47), and California (62.68), and lowest in Michigan (32.35), Utah (38.03), and Mississippi (38.87). Mortality rates were highest in New Mexico (0.55), Hawaii (0.51), and North Dakota (0.49), and lowest in Maryland (0.36), Rhode Island (0.37), and Massachusetts (0.38). DALY rates were highest in New Mexico (17.06), North Dakota (15.75), and Hawaii (15.35).
Age-specific analyses showed that prevalence peaked at ages 60–69 years, while mortality and DALY rates were highest among individuals aged ≥80 years in both sexes. Females exhibited higher prevalence across most age groups; however, male-predominant prevalence was observed in Connecticut, Iowa, and Kentucky. The largest sex-based prevalence differences occurred in South Dakota and California, while the smallest were observed in Louisiana and Alabama.
From 1990 to 2023, thyroid cancer burden increased significantly, with EAPC for ASIR of 1.73% (95% CI 1.54–1.92) and ASPR of 1.78% (95% CI 1.57–1.99). DALY and mortality rates also increased (AS DALY rate EAPC 1.35%, 95% CI 1.28–1.42; ASDR EAPC 1.35%, 95% CI 1.28–1.42).
Conclusion
Thyroid cancer burden in the United States demonstrates pronounced state-level, age-related, and sex-based disparities, with sustained increases in incidence, prevalence, mortality, and DALYs over time. These findings highlight the importance of targeted prevention strategies, risk factor modification, and region-specific public health planning, particularly in high-burden states and older populations.

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