Global burden of thyroid cancer among women aged 15 to 49 years, 1990–2021

Abstract

Thyroid cancer disproportionately affects women during their reproductive years, yet global trends, socioeconomic gradients, and health inequalities in this age group remain incompletely characterized. Using Global Burden of Disease Study 2021 estimates, we quantified incidence, prevalence, deaths, and disability-adjusted life years (DALYs) due to thyroid cancer among women aged 15 to 49 years in 204 countries and territories from 1990 to 2021. Temporal patterns were evaluated using estimated annual percentage change (EAPC) and joinpoint regression. Age–period–cohort models, decomposition analysis, Socio-demographic Index (SDI) analyses, slope and concentration indices of inequality, and Bayesian age–period–cohort projections to 2040 were also performed. From 1990 to 2021, the global age-standardized incidence rate increased from 2.18 to 3.37 per 100,000 (EAPC, 1.47%; 95% confidence interval [CI], 1.35–1.59%), and the age-standardized prevalence rate increased from 19.47 to 30.46 per 1,00,000 (EAPC, 1.51%; 95% CI, 1.39–1.64%). The age-standardized mortality rate declined from 0.18 to 0.16 per 1,00,000 (EAPC, −0.35%; 95% CI, −0.38% to −0.31%). The DALY rate was similar at the 2 endpoints (10.31 and 10.38 per 1,00,000), although the overall log-linear trend was slightly negative (EAPC, −0.05%; 95% CI, −0.08% to −0.02%). In 2021, high-SDI settings had the highest incidence and prevalence rates, whereas low- and low-middle-SDI settings carried the highest mortality and DALY rates. Incidence and prevalence were positively associated with SDI, while mortality and DALY rates were negatively associated. Epidemiologic change accounted for 46.35% and 47.03% of the global increases in incident and prevalent cases, respectively, whereas population growth was the principal contributor to increases in DALYs and deaths. By 2040, projected counts rose to 1,16,285 incident cases, 10,68,218 prevalent cases, 3,09,140 DALYs, and 4265 deaths, while model-based rate trajectories declined within the projection period. Among women aged 15 to 49 years, the global thyroid cancer burden is characterized by rising diagnosis and survivorship, comparatively favorable mortality trends, and persistent socioeconomic inequality in fatal and disabling outcomes. High-resource settings require strategies that limit unnecessary detection and overtreatment, whereas lower-resource settings need strengthened diagnostic, surgical, and long-term care pathways.