(619) Evolving Trends in Thyroid Cancer Management and Demographics: A SEER-Based Analysis

Introduction: Thyroid cancer management in the United States has evolved over the past two decades alongside changes in diagnostic practices and treatment guidelines. While prior studies have focused on incidence, national trends in stage at diagnosis, treatment modality, and patient demographics remain incompletely characterized.

Methods: A retrospective population-based analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Patients diagnosed with malignant thyroid cancer between 2000 and 2022 were identified. Demographic characteristics, stage at presentation, and treatment modality were extracted. Temporal trends were analyzed using Joinpoint segmented regression to estimate annual percent change (APC) with 95% confidence intervals.

Results: A total of 385,934 patients were included, of whom 74.9% were female. The proportion of patients aged 60–69 increased significantly over time (APC +2.24%; p< 0.001). The proportion of non-Hispanic White patients declined (APC −1.16%; p< 0.001), while Hispanic and Asian/Pacific Islander patients increased (APC +2.39% and +2.24%, respectively; p< 0.001). Localized-stage disease declined modestly from 2004–2022 (APC −0.37%; p< 0.001), while regional lymph node involvement increased (APC +3.85%; p< 0.001). Surgery-only management increased from 2006–2022 (APC +0.96%; p< 0.001), whereas combined surgery and radiation therapy declined from 2006-2013 (APC –1.42%; p< 0.001) and 2013–2022 (APC −4.04%; p< 0.001).

Conclusions: From 2000–2022, thyroid cancer management in the United States shifted toward surgical monotherapy with reduced use of adjuvant radiation. Concurrent changes in stage distribution and patient demographics highlight evolving patterns of presentation and treatment that warrant continued evaluation.