The burden of thyroid cancer is associated with the level of national development in Asia: Evidence from 1990–2021 for 47 countries

Objective The aim was to examine the temporal patterns of the thyroid cancer (TC) burden and its association with the national development level. Methods The estimates of the incidence and mortality of TC for 47 countries were obtained from the Global Burden of Disease 2021 study for the period from 1990 to 2021. The human development level of each country was measured using the human development index (HDI), Social Progress Imperative (SPI) index, Nutrition and Medical Care (NMC) index, Density of Doctors per 100,000 people (DOD) and Personal Healthcare Spending (PHS) as summary indicators of health, education, and income reflecting the national development level. The associations between the burden of TC and these indices were measured via a scatterplot matrix, correlation heatmap and principal component analysis (PCA) plot. The mortality-to-incidence ratio (MIR) was employed as a proxy for the survival rate of patients with TC. Results The total number of TC-related deaths increased from 10,477 [95% uncertainty interval (UI), 9,394–12,252] in 1990 to 27,187 [95% UI, 23,128–30,091] in 2021 across all age groups. Asia accounted for 62.8% of the TC cases worldwide in 2021. In the working-age population, this mean number of deaths was 2,729 [3,243–2,394], and the incidence of TC increased from 1.41 cases per 100,000 people [1.23–1.63] in 1990 to 3.36 cases per 100,000 people [2.81–3.90] in 2021. In terms of TC incidence, very high- and high-HDI countries accounted for nine of the top ten countries. The total incidence rate of TC in the working-age population was positively correlated with four indicators, namely, the HDI (Corr = 0.365 ^* ), IHDI (Corr = 0.336 ^* ), SPI index (Corr = 0.384 ^* ), and NMC index (Corr = 0.332 ^* ), of which the incidence rate among males (Corr = 0.594 ^*** , 0.541 ^*** , 0.544 ^*** and 0.616 ^*** ), in particular, was strongly correlated with the indicators of social development. In terms of mortality, the HDI (Corr=-0.401*), IHDI (Corr=-0.387*), NMC index (Corr=-0.437**) and PHS (Corr=-0.446**) were negatively correlated with the total mortality rate. The global MIR decreased from 0.135 in 1990 to 0.068 in 2021. As seen from the data, Asia's working-age population presented a 21.1% increase in TC mortality and a 138% increase in TC incidence. Conclusion The increasing burden of TC within the working-age population across Asia has resulted in an overall increase in the incidence of TC, especially in developed countries, although the overall prognosis has gradually improved. Fewer developed countries should invest more in international cooperation and local research and development, including the management of primary healthcare systems and the development of high-level healthcare centres.