Temporal trends of thyroid cancer between 2010 and 2019 in Asian countries by geographical region and SDI, comparison with global data

Abstract

Objective

This study aims to describe temporal trends of thyroid cancer (ThC) from 2010 to 2019, in Asian countries by geographical region and sociodemographic index, compared with global data.

Method

Annual case data and age‐standardized rates (ASRs) of epidemiological indicators of ThC cancer data were collected from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied. The female/male ratio was calculated by dividing female ASRs by male ASRs. Also, these rates were compared between the age group ≥70 years old and younger age groups.

Results

In 2019, more than 50% of ThC cases and deaths occurred in Asian countries. A total of 53% of ThC patients lived in Asia and more than 60% of the global burden of ThC was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of ThC cancer increased over 1.28‐, 1.26‐, 1.3‐, and 1.2‐fold, in Asia, respectively. During this period, the age‐standardized incidence rate (ASIR) and the age‐standardized prevalence rate (ASPR) of ThC cancer increased by 5% and 8%, respectively, while the age‐standardized death rate (ASDR) and the age‐standardized DALYs rate (DALYs ASR) of ThC cancer decreased by 6% and 4%, respectively. These trends are different from what happens in other continents. In 2019, age‐specific incidence, death, prevalence, and DALY cases of ThC cancer were peaking at 50–54, 75–79, 50–54, and 55–59 years, respectively. In 2019, the highest ASIR and ASPR of ThC cancer was observed in high‐income Asia Pacific countries and the highest ASDR and DALYs ASR in Southeast Asia countries. Only high‐income Asia Pacific countries experienced a decreasing trend in ASIR and ASPR from 2010 to 2019. ASDR and DALYs ASR have the highest decreasing trend in high‐income Asia Pacific. In 2019, among high SDI Asian countries, the Republic of Korea had the highest ASIR and ASPR, and Brunei Darussalam had the highest ASDR and DALYs ASR. The highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer was found in Lebanon and Malaysia (high‐middle SDIs), Vietnam (middle SDIs), and Cambodia and Palestine (low‐middle SDIs). Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer. All indicators for most countries were higher in women than men.

Conclusion

More than half of the burden of thyroid cancer is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America, and Europe, the highest rate of death from thyroid cancer occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of thyroid cancer control in its residents.

More than half of the burden of thyroid cancer is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America and Europe, the highest rate of death from thyroid cancer occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of thyroid cancer control in its residents.

1. INTRODUCTION

Thyroid cancer (ThC) is a common form of endocrine cancer worldwide, ¹ with adult women being the most affected. It ranks fifth among the most frequently diagnosed cancers in women globally and second in women above the age of 50. ¹ Over the past three decades, the incidence of thyroid cancer has been on the rise worldwide. ² The global age‐standardized incidence rate of thyroid cancer increased by 20% from 1990 to 2013, with low‐income countries recording a higher rate than high‐income countries (33% vs. 19%). ³ In 2020, according to GLOBOCAN estimates, there were 586,000 new cases of thyroid cancer globally, making it the ninth most common cancer. ⁴

It's interesting to note that there has been an increasing number of thyroid tumors reported worldwide. While the exact cause is unclear, it is believed to be due to various factors such as general screening, thyroid sonography, and aspiration biopsies that can detect small tumors. ⁵ However, many experts believe these higher‐quality screening methods alone cannot explain the entire trend, and other risk factors are also being studied. ⁶

While certain ThC risk factors like patient age, sex, race or ethnicity, and hereditary predisposition cannot be modified, ⁷ other factors can. These include radiation exposure ⁵ ; iodine intake ⁵ ; thyroid stimulating hormone (TSH) ⁵ ; environmental pollutants like several industrialized food additives, such as nitrates from cured meat and some vegetables, which can challenge iodine uptake and potentially alter thyroid function ⁸ , ⁹ ; BMI ¹⁰ ; lifestyle; and diet. ¹¹

It is necessary to mention the incidence of ThC varies in different geographical regions. Its incidence is more remarkable in high‐income countries compared with low‐income and middle‐income countries for both sexes. ¹² Thus, this study aims to describe temporal trends of ThC from 2010 to 2019, in Asian countries by geographical region and sociodemographic index, compared with global data.

2. METHODS

2.1. Data source

The incidence, mortality, prevalence, and burden data for ThC were extracted from the GBD 2019 study for the following regions: 49 Asian countries, 6 global burden of disease (GBD) regions, worldwide, and 4 continents. Data were extracted from the Global Health Data Exchange (GHDx) using the GBD 2019 query tool (http://ghdx.healthdata.org/gbd‐resultstool) based on the International Classification of Diseases 10 (ICD‐10 code 73 for ThC). In GBD, epidemiological indicators included incidence, death, prevalence, years of life lost (YLL), years lived with disability (YLD), and disability‐adjusted life years (DALY) by time, location, gender, and age group for 204 countries and territories from 1990 to 2019 is estimated to provide a comparative assessment of health loss due to 364 diseases and injuries. ¹³

In this study, the data were extracted for various classifications of Asian countries based on a sociodemographic index (SDI) and six GBD regions of Asia from 2010 to 2019. The data were then compared with worldwide and other continental data, specifically North Africa and the Middle East, where 15 out of 21 GBD countries belong to West Asia. Additionally, two Southeast Asian countries were from Africa. ¹⁴ , ¹⁵

The GBD has developed a standardized international form of quality‐adjusted life year (QALY), known as DALY. DALYs for a given condition within a population are equal to the sum of YLLs and YLDs of known severity and duration. One DALY represents the loss of an equivalent 1 year of full health due to premature death and years lived with a disability of specific severity and duration. “Premature” death is a death that occurs at an age when a person's death is not expected. The expected age of death of a person is calculated based on the expected mortality for a certain age in a population standardized to the population of Japan, which has the longest lifetime at birth in the world. ¹⁵

The SDI is a composite indicator of a country's lag‐distributed income per capita, average educational attainment of people aged 15 years and older, and the total fertility rate (in people aged <25 years). The geometric average of these three indicators is used to calculate the SDI. The SDI reflects the levels of social and economic conditions that can affect health outcomes in a given location. Countries and territories were categorized into five groups based on their SDI values: low SDI (<0.45), low‐middle SDI (≥0.45 and <0.61), middle SDI (≥0.61 and <0.69), high‐middle SDI (≥0.69 and <0.80), and high SDI (≥0.80). ¹⁶

The age‐standardized rate (ASR) is a calculation that takes into account the differences in age distribution between populations by applying the rates for each population to a standardized population. It is a weighted average of the age‐specific rates per 100,000 persons within the corresponding age groups of the WHO standard population. ¹⁷

2.2. Ethical considerations

This study was approved by the Ethics Committee of the Jahrom University of Medical Sciences in Iran (IR.JUMS.REC.1401.094 code). In this study, informed consent was not required due to the use of the anonymous online dataset.

2.3. Statistical analysis

In this study, the incidence, prevalence, deaths, DALY, and age‐standardized rates were expressed per 100,000 population to eliminate the influence of the composition of different age groups within populations. The data are reported as values with 95% confidence intervals (CI). Selected epidemiological indicators are presented separately for each classification system.

The relative difference (%) between years was used to demonstrate the comparative changes in age‐standardized rates. The relative differences were calculated by dividing the value of the absolute difference by the value of the source year, which is multiplied by 100. The F/M ratio was computed by dividing the female ASRs by the male ASRs of each epidemiological index. The definition of what has been used is accessible via https://www.healthdata.org/terms‐defined and https://www.healthdata.org/gbd/.

3. RESULTS

3.1. Incidence rate of ThC in Asia

3.1.1. Compared with global data and continents

In Asia, the number of ThC incidences increased from 98,632 (95% CI: 83,838–104,253) in 2010 to 127,008 (95% CI: 111,149–139,720) in 2019, which is over a 1.28‐fold increase. In 2019, more than 54% (127,008/233,847) of ThC cases happened in Asian countries.

During this period, the ASIR of ThC had a 5% change, increasing from 2.44 (95% CI: 2.07–2.57) per 100,000 in 2010 to 2.56 (95% CI: 2.23–2.82) per 100,000 in 2019. Similarly at the same time, this rate globally increased by 1% and in Africa by 14%. But this rate decreased in America by 1% and in Europe by 3%.

In Asian men, the number of ThC incidences increased from 29,253 (95% CI: 24,129–31,446) in 2010 to 40,021 (95% CI: 33,634–45,216) in 2019, which is approximately a 73.1% increase.

In 2019, more than 31.5% (40,021/127,008) of Asian ThC new cases occurred in Asian men, which included 52.6% (40,021/76,014) of global male ThC incidence cases.

During this period, the ASIR of ThC had a 10% change, increasing from 1.50 (95% CI: 1.23–1.61) per 100,000 in 2010 to 1.65 (95% CI: 1.39–1.86) per 100,000 in 2019. Also at the same time, this rate globally increased by 5%, in America by 3%, and in Africa by 19%, while Europe had a stable trend.

In Asian women, the number of ThC incidences increased from 69,379 (95% CI: 56,407–74,309) in 2010 to 86,988 (95% CI: 73,241–97,296) in 2019, which is over a 1.25‐fold increase. In 2019, approximately 68.5% (86,988/127,008) of new Asian ThC cases occurred in Asian women, which included 55.1% (86,988/157,833) of global female THC incidence cases. During this period, the ASIR of ThC had a 3% change, increasing from 3.38 (95% CI: 2.77–3.62) per 100,000 in 2010 to 3.49 (95% CI: 2.93–3.90) per 100,000 in 2019. At the same time, this rate increased in Africa by 12%, while this rate globally decreased by 1%, in Europe by 5%, and in American countries by 3%. More details are presented in Table 1.

TABLE 1.

The comparing incidence, death, prevalence, and burden rates of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019 (Both genders).

Location	Incidence					Death					Prevalence					DALY
	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
	Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
Global	191,197	2.80	233,847	2.83	0.01	37,268	0.60	45,576	0.57	−0.05	1,496,364	21.47	1,831,760	22.02	0.03	1,045,885	15.65	1,231,841	14.98	−0.04
	(171,483–197,888)	(2.51–2.9)	(211,637–252,807)	(2.56–3.06)	(−0.06–0.09)	(33,797–38,957)	(0.54–0.62)	(41,290–48,775)	(0.51–0.61)	(−0.09–0.01)	(1,342,408–1,549,790)	(19.27–22.23)	(1,656,127–1,985,013)	(19.91–23.86)	(−0.05–0.11)	(943,436–1,104,349)	(14.12–16.52)	(1,113,585–1,327,064)	(13.55–16.14)	(−0.1–0.01)
Continents
Africa	9483	1.44	14,333	1.64	0.14	2738	0.56	3576	0.56	0.00	67,759	8.95	107,585	10.99	0.23	92,094	15.09	119,320	14.92	−0.01
	(7765–10,709)	(1.22–1.61)	(11,677–17,056)	(1.37–1.92)	(0.03–0.28)	(2362–3084)	(0.49–0.63)	(3005–4128)	(0.48–0.64)	(−0.07–0.08)	(54,378–77,060)	(7.39–10.09)	(86,042–128,864)	(9.05–13.02)	(0.08–0.4)	(77,386–104,415)	(12.95–16.99)	(98,903–140,470)	(12.45–17.33)	(−0.1–0.09)
America	37,686	3.78	45,225	3.75	−0.01	5769	0.58	7288	0.57	−0.01	304,159	30.52	362,056	30.27	−0.01	150,721	15.20	183,206	14.90	−0.02
	(36,327–38,642)	(3.65–3.87)	(40,289–50,631)	(3.33–4.19)	(−0.11–0.1)	(5320–5997)	(0.53–0.6)	(6647–7824)	(0.52–0.61)	(−0.06–0.04)	(294,873–311,885)	(29.6–31.3)	(321,836–405,339)	(26.88–33.93)	(−0.11–0.11)	(141,484–159,249)	(14.27–16.06)	(168,386–199,457)	(13.7–16.22)	(−0.08–0.05)
Asia	98,632	2.44	127,008	2.56	0.05	21,405	0.63	26,982	0.59	−0.06	759,981	17.94	982,341	19.42	0.08	624,971	16.10	750,984	15.39	−0.04
	(83,838–104,253)	(2.07–2.57)	(111,149–139,720)	(2.23–2.82)	(−0.04–0.15)	(18,846–22,632)	(0.55–0.66)	(23,978–29,391)	(0.52–0.64)	(−0.13–0.01)	(640,546–805,950)	(15.12–18.98)	(857,344–1,082,418)	(16.93–21.38)	(−0.02–0.19)	(545,913–666,046)	(14.08–17.12)	(665,083–819,813)	(13.6–16.79)	(−0.11–0.03)
Europe	45,168	3.97	47,009	3.84	−0.03	7307	0.54	7670	0.49	−0.09	362,713	32.79	377,694	31.99	−0.02	176,830	14.40	176,829	12.99	−0.10
	(43,086–46,451)	(3.81–4.08)	(42,592–52,230)	(3.48–4.26)	(−0.12–0.07)	(6758–7566)	(0.5–0.56)	(6955–8203)	(0.45–0.52)	(−0.13 to −0.04)	(347,378–373,148)	(31.47–33.73)	(341,009–419,952)	(28.88–35.47)	(−0.11–0.08)	(165,890–187,139)	(13.55–15.32)	(162,099–191,586)	(11.88–14.14)	(−0.15 to −0.04)
Asian GBD regions
Central Asia	975	1.40	1467	1.69	0.21	243	0.43	309	0.45	0.05	7288	9.77	11,454	12.37	0.27	7261	11.16	9231	11.46	0.03
	(925–1032)	(1.33–1.47)	(1306–1650)	(1.51–1.89)	(0.08–0.35)	(233–254)	(0.41–0.45)	(278–341)	(0.4–0.49)	(−0.05–0.14)	(6860–7770)	(9.19–10.39)	(10,131–12,975)	(10.95–13.97)	(0.12–0.43)	(6900–7650)	(10.65–11.73)	(8203–10,321)	(10.27–12.79)	(−0.08–0.13)
East Asia	31,302	1.85	41,580	2.11	0.14	6215	0.43	7621	0.40	−0.08	246,288	14.05	330,694	16.65	0.18	169,689	10.54	197,337	9.86	−0.07
	(28,108–35,140)	(1.67–2.07)	(34,751–50,204)	(1.77–2.54)	(−0.05–0.36)	(5559–6796)	(0.38–0.47)	(6346–8874)	(0.33–0.46)	(−0.21–0.07)	(220,561–279,945)	(12.62–15.94)	(274,743–403,528)	(13.89–20.23)	(−0.02–0.43)	(151,959–186,977)	(9.47–11.6)	(165,224–228,530)	(8.3–11.35)	(−0.2–0.09)
High‐income Asia Pacific	20,055	7.51	15,660	4.98	−0.34	2564	0.68	2754	0.53	−0.22	166,514	64.62	123,548	42.29	−0.35	56,207	17.94	49,019	12.46	−0.31
	(13,617–21,957)	(4.75–8.31)	(13,134–18,056)	(4.19–5.79)	(−0.44 to −0.05)	(1981–2795)	(0.52–0.73)	(2128–3071)	(0.43–0.58)	(−0.26 to −0.1)	(110,557–182,829)	(40.15–71.7)	(105,012–142,979)	(35.62–49.33)	(−0.46 to −0.05)	(41,048–62,003)	(12.37–20.06)	(41,648–54,668)	(10.69–13.99)	(−0.36 to −0.11)
North Africa and Middle East	11,873	2.81	19,253	3.46	0.23	1705	0.54	2290	0.54	0.00	98,458	22.11	163,048	28.17	0.27	54,929	14.62	74,180	14.88	0.02
	(9876–13,126)	(2.45–3.08)	(15,675–22,281)	(2.89–3.96)	(0.11–0.36)	(1548–1994)	(0.49–0.67)	(1981–2669)	(0.47–0.66)	(−0.09–0.08)	(79,166–109,564)	(18.36–24.41)	(130,172–189,792)	(22.9–32.54)	(0.15–0.42)	(48,453–61,216)	(13.2–16.54)	(62,526–86,119)	(12.81–17.09)	(−0.07–0.11)
South Asia	21,321	1.62	31,534	1.90	0.17	6885	0.65	9196	0.65	0.00	147,955	10.15	226,467	12.80	0.26	231,768	18.49	291,575	18.33	−0.01
	(18,203–23,510)	(1.39–1.78)	(26,591–36,439)	(1.61–2.19)	(0.02–0.36)	(6105–7550)	(0.57–0.72)	(7978–10,477)	(0.56–0.74)	(−0.12–0.14)	(123,964–164,187)	(8.54–11.23)	(189,126–263,769)	(10.66–14.9)	(0.08–0.48)	(203,824–253,204)	(16.42–20.24)	(254,403–330,796)	(15.98–20.88)	(−0.13–0.12)
Southeast Asia	18,339	3.32	25,581	3.72	0.12	4624	1.06	5862	1.02	−0.04	136,412	22.74	194,899	26.85	0.18	132,702	26.41	164,304	25.34	−0.04
	(14,850–20,486)	(2.73–3.67)	(20,569–29,886)	(3.01–4.32)	(−0.01–0.28)	(3928–5034)	(0.91–1.15)	(4999–6646)	(0.88–1.15)	(−0.13–0.05)	(108,547–154,350)	(18.3–25.63)	(153,975–230,803)	(21.32–31.59)	(0.03–0.37)	(109,066–146,918)	(22.05–29.03)	(136,534–187,956)	(21.37–28.88)	(−0.14–0.06)

3.1.2. Age distribution

In 2019, age‐specific incidence cases of ThC were peaking at +85 in both males and females. In all age groups, the incidence cases of ThC in females were higher (Figure 1). In 2019, 19,624 new cases of ThC were diagnosed in people aged ≥70 years in Asia, accounting for 15.45% of ThC cases in all ages. This rate was 17.67% in men and 14.43% in women. Meanwhile, in the world, 40,773 new cases of ThC have been diagnosed in people ≥70 years, which includes 17.44% of ThC cases in all ages. This rate was 18.65% in men and 16.85% in women. Overall, 48.13% of new cases of ThC were detected in the elderly aged ≥70 years in Asia (Table 2).

FIGURE 1.

Age‐specific incidence cases of ThC cancer among gein Asia, 2019.

TABLE 2.

Comparison of incidence, death, prevalence, and DALYs number of thyroid cancer in age <70 and ≥70 in Asia with global data.

Location	Measure	Male		Female		Both
		<70	≥70	<70	≥70	<70	≥70
Global	Incidence	61,836	14,178	131,238	26,595	193,073	40,773
		(55,017–67,624)	(12,535–15,467)	(115,909–144,055)	(23,177–29,299)	(174,684–208,931)	(36,131–44,073)
	Death	10,115	8520	13,163	13,778	23,278	22,298
		(9168–11,076)	(7442–9244)	(11,292–14,400)	(11,872–15,017)	(21,116–25,069)	(19,518–23,859)
	Prevalence	507,398	55,344	1,139,795	129,223	1,647,193	184,567
		(450,902–555,879)	(48,199–61,515)	(1,005,830–1,253,793)	(113,353–142,871)	(1,484,083–1,785,830)	(164,339–200,974)
	DALY	385,618	124,224	527,437	194,563	913,055	318,786
		(347,249–421,224)	(110,564–135,121)	(450,033–584,525)	(170,961–211,812)	(819,893–990,759)	(283,892–342,040)
Asia	Incidence	32,947	7073	74,437	12,550	107,384	19,624
		(27,658–37,464)	(6025–7958)	(62,109–83,816)	(10,637–14,334)	(93,399–118,277)	(16,873–21,594)
	Death	6392	5074	8191	7325	14,583	12,399
		(5529–7225)	(4246–5689)	(6691–9235)	(6153–8218)	(12,836–15,995)	(10,705–13,587)
	Prevalence	264,795	20,547	643,274	53,725	908,069	74,272
		(221,360–301,754)	(17,471–23,667)	(537,321–726,363)	(45,037–62,060)	(786,711–1,001,776)	(63,777–83,495)
	DALY	243,304	73,517	329,588	104,575	107,384	178,092
		(209,750–272,823)	(62,506–82,547)	(270,330–372,713)	(88,602–116,807)	(93,399–118,277)	(155,623–194,846)

3.1.3. Within Asian regions

In 2019, the highest ASIR of ThC was observed in high‐income Asia Pacific countries (4.98 (95% CI: 4.19–5.79)), with a 34% decrease compared with 2010. All Asian regions experienced an increasing trend from 12% (Southeast Asia) to 23% (North Africa and Middle East) from 2010 to 2019, except high‐income Asia Pacific countries that reported a decreasing trend of 34%.

In men, the highest ASIR of ThC was observed in high‐income Asia Pacific countries (2.75 (95% CI: 2.21–3.30)), with a 30% decrease compared with 2010. Other Asian regions experienced an increasing trend from 16% (South Asia) to 34% (North Africa and Middle East) from 2010 to 2019.

In women, the highest ASIR of ThC was observed in high‐income Asia Pacific countries (7.20 (95% CI: 5.84–8.59)), with a 35% decrease compared with 2010. Other Asian regions experienced an increasing trend from 9% (East Asia) to 20% (Central Asia and North Africa and the Middle East).

3.1.4. Based on SDI

Among high SDI Asian countries, the Republic of Korea (6.77) and Saudi Arabia (5.98) have the highest ASIR of ThC, and Qatar (2.93) and Cyprus (3.13) have the lowest rate. In this group, Brunei Darussalam (3%), Taiwan (Province of China) (5%), Saudi Arabia (31%), and the United Arab Emirates (11%) reported an upward trend, and other countries reported a downward trend from 2% (Kuwait) to 54% (Republic of Korea) from 2010 to 2019.

Among high‐middle SDI Asian countries, Lebanon (7.95) has the highest ASIR of ThC, and Georgia (2.46) has the lowest rate. In this group, Bahrain and Oman reported an 11% and 13% decrease in ASIR from 2010 to 2019, respectively. Other countries reported an upward trend from 3% (Turkey) to 27% (Lebanon and Sri Lanka).

Among middle SDI Asian countries, Vietnam (7.25) has the highest ASIR of THC, and Uzbekistan (0.93) and the Syrian Arab Republic (0.97) have the lowest rate. In this group, Thailand recorded a downward trend of 4%. Other countries had an upward trend from 6% (Indonesia) to 82% (Armenia) from 2010 to 2019. Among low‐middle SDI Asian countries, Cambodia (3.61) has the highest ASIR of ThC, and Tajikistan (0.48) has the lowest rate. In this group, all countries had an upward trend from 2% (Mongolia) to 49% (Palestine) from 2010 to 2019, except for the Democratic People's Republic of Korea, which experienced a downward trend of 1%. Among low SDI Asian countries, Pakistan (2.96) has the highest ASIR of ThC, and Yemen (1.86) has the lowest rate. In this group, all countries experienced an upward trend of 11% (Afghanistan) to 33% (Nepal) from 2010 to 2019. More details are presented in Table 3.

TABLE 3.

The incidence distribution of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019, by geographical region and SDI.

Location	SDI 2019	Both					Male					Female					F/M Ratio
		2010		2019		% change 1990–2010	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
High SDI
Brunei Darussalam	0.823	14	4.92	20	5.09	0.03	3	2.06	4	2.23	0.08	12	7.73	16	8.00	0.04	3.59
		(12–17)	(4.03–5.7)	(16–25)	(4.08–6.15)	(−0.15–0.25)	(2–3)	(1.7–2.42)	(3–5)	(1.78–2.76)	(−0.16–0.36)	(9–14)	(6.23–9.26)	(12–21)	(6.2–10.12)	(−0.18–0.31)
Cyprus	0.841	50	3.64	56	3.13	−0.14	20	3.12	24	2.86	−0.08	30	4.12	32	3.38	−0.18	1.18
		(41–57)	(3.02–4.11)	(45–68)	(2.55–3.85)	(−0.28–0.03)	(16–25)	(2.42–3.75)	(17–31)	(2.06–3.74)	(−0.3–0.21)	(24–35)	(3.42–4.92)	(25–42)	(2.66–4.58)	(−0.36–0.06)
Israel	0.803	381	4.60	436	4.22	−0.08	134	3.43	157	3.21	−0.06	247	5.65	279	5.14	−0.09	1.60
		(341–424)	(4.09–5.12)	(331–564)	(3.2–5.47)	(−0.31–0.2)	(106–154)	(2.73–3.96)	(114–211)	(2.33–4.32)	(−0.33–0.28)	(213–283)	(4.87–6.51)	(207–370)	(3.83–6.83)	(−0.33–0.22)
Japan	0.87	10,521	4.72	10,134	4.22	−0.11	2912	2.73	2882	2.49	−0.09	7609	6.63	7251	5.90	−0.11	2.37
		(9499–11,241)	(4.38–5.05)	(8281–12,092)	(3.5–5.09)	(−0.25–0.08)	(2550–3202)	(2.44–3.01)	(2207–3695)	(1.93–3.21)	(−0.29–0.16)	(6842–8221)	(6.09–7.17)	(5694–8919)	(4.67–7.36)	(−0.29–0.12)
Kuwait	0.851	87	3.88	149	3.79	−0.02	24	1.82	54	2.47	0.36	62	7.24	95	5.61	−0.22	2.27
		(76–98)	(3.48–4.34)	(120–186)	(3.09–4.67)	(−0.21–0.19)	(20–29)	(1.55–2.1)	(41–73)	(1.87–3.23)	(0.04–0.78)	(53–73)	(6.22–8.33)	(71–129)	(4.37–7.34)	(−0.4–0.01)
Qatar	0.83	34	3.39	59	2.93	−0.14	17	1.88	29	1.76	−0.06	17	7.75	30	6.66	−0.14	3.79
		(27–43)	(2.74–4.08)	(41–85)	(2.19–3.95)	(−0.34–0.13)	(12–23)	(1.33–2.52)	(19–41)	(1.17–2.47)	(−0.37–0.31)	(13–23)	(6–9.88)	(20–49)	(4.74–9.53)	(−0.38–0.21)
Republic of Korea	0.878	9263	14.62	5209	6.77	−0.54	2288	7.19	1321	3.37	−0.53	6975	21.88	3888	10.25	−0.53	3.04
		(2875–10,905)	(4.54–17.21)	(3564–6623)	(4.46–8.69)	(−0.65 to −0.01)	(719–2774)	(2.41–8.57)	(883–1747)	(2.27–4.41)	(−0.65–0)	(2143–8474)	(6.43–26.75)	(2596–5134)	(6.37–13.62)	(−0.66–0.12)
Saudi Arabia	0.805	1037	4.55	2259	5.98	0.31	274	2.17	708	3.23	0.49	763	8.10	1551	10.20	0.26	3.16
		(762–1289)	(3.65–5.39)	(1528–3157)	(4.36–7.91)	(−0.02–0.7)	(215–350)	(1.77–2.69)	(491–1047)	(2.35–4.38)	(0.11–0.95)	(479–973)	(6.03–10)	(886–2292)	(6.88–14.25)	(−0.09–0.7)
Singapore	0.861	257	4.36	298	3.73	−0.14	58	2.04	76	1.94	−0.05	199	6.84	222	5.68	−0.17	2.92
		(225–291)	(3.86–4.91)	(226–381)	(2.85–4.75)	(−0.34–0.1)	(49–69)	(1.74–2.44)	(57–104)	(1.47–2.63)	(−0.27–0.25)	(170–230)	(5.88–7.85)	(166–288)	(4.25–7.44)	(−0.37–0.08)
Taiwan (Province of China)	0.868	1443	4.79	1737	5.01	0.05	452	2.99	578	3.35	0.12	992	6.54	1159	6.61	0.01	1.97
		(1288–1615)	(4.3–5.34)	(1310–2357)	(3.73–6.83)	(−0.22–0.42)	(382–528)	(2.56–3.45)	(424–792)	(2.48–4.56)	(−0.18–0.51)	(864–1149)	(5.71–7.53)	(850–1581)	(4.8–9.16)	(−0.27–0.41)
United Arab Emirates	0.88	189	3.50	444	3.88	0.11	135	2.75	314	3.53	0.28	54	5.15	130	4.95	−0.04	1.40
		(112–270)	(1.94–5.08)	(229–710)	(2.1–5.93)	(−0.16–0.49)	(70–205)	(1.45–4.11)	(147–522)	(1.72–5.61)	(−0.07–0.75)	(36–77)	(2.63–7.95)	(67–207)	(2.58–7.75)	(−0.29–0.41)
High‐middle SDI
Bahrain	0.751	28	3.85	45	3.43	−0.11	7	1.48	14	1.46	−0.01	21	6.97	32	6.53	−0.06	4.46
		(22–33)	(2.61–4.56)	(34–58)	(2.56–4.34)	(−0.3–0.18)	(6–9)	(1.17–1.8)	(9–19)	(1.05–1.93)	(−0.28–0.33)	(15–25)	(4.49–8.54)	(23–42)	(4.63–8.47)	(−0.28–0.27)
Georgia	0.702	102	1.99	123	2.46	0.24	21	0.92	29	1.28	0.40	81	2.90	94	3.50	0.21	2.73
		(89–115)	(1.73–2.25)	(96–150)	(1.9–3.01)	(−0.02–0.54)	(17–25)	(0.73–1.08)	(18–37)	(0.79–1.61)	(0.02–0.78)	(68–93)	(2.46–3.38)	(73–114)	(2.71–4.34)	(−0.07–0.54)
Jordan	0.731	160	3.31	321	3.60	0.09	39	1.58	93	1.88	0.19	121	5.20	229	5.58	0.07	2.97
		(132–194)	(2.77–3.98)	(249–417)	(2.83–4.69)	(−0.13–0.35)	(31–47)	(1.27–1.9)	(67–125)	(1.39–2.53)	(−0.12–0.59)	(96–154)	(4.18–6.45)	(164–319)	(4.04–7.71)	(−0.19–0.42)
Kazakhstan	0.723	407	2.50	580	3.00	0.20	93	1.29	128	1.47	0.14	314	3.51	452	4.29	0.22	2.92
		(369–451)	(2.28–2.77)	(480–701)	(2.48–3.59)	(−0.01–0.45)	(81–110)	(1.13–1.51)	(101–168)	(1.17–1.96)	(−0.09–0.44)	(277–353)	(3.11–3.92)	(369–555)	(3.5–5.23)	(−0.01–0.51)
Lebanon	0.708	261	6.25	431	7.95	0.27	67	3.40	123	4.91	0.44	194	8.77	308	10.67	0.22	2.17
		(208–329)	(4.94–7.89)	(306–582)	(5.67–10.79)	(−0.04–0.61)	(52–85)	(2.62–4.3)	(85–164)	(3.38–6.48)	(0.09–0.89)	(142–254)	(6.49–11.55)	(204–443)	(7.12–15.42)	(−0.11–0.63)
Malaysia	0.737	872	3.67	1379	4.49	0.22	212	1.79	380	2.46	0.38	661	5.60	999	6.63	0.19	2.70
		(762–1014)	(3.22–4.28)	(1025–1813)	(3.35–5.88)	(−0.08–0.59)	(176–256)	(1.5–2.15)	(278–510)	(1.8–3.26)	(0.02–0.83)	(558–788)	(4.77–6.69)	(718–1343)	(4.8–8.9)	(−0.13–0.59)
Oman	0.783	73	3.75	112	3.26	−0.13	21	1.85	37	1.67	−0.09	52	6.59	74	5.97	−0.09	3.57
		(53–86)	(2.9–4.32)	(82–146)	(2.53–3.97)	(−0.28–0.07)	(17–25)	(1.54–2.17)	(25–54)	(1.2–2.21)	(−0.33–0.22)	(34–64)	(4.54–7.92)	(48–102)	(4.25–7.8)	(−0.29–0.2)
Sri Lanka	0.69	579	2.73	886	3.47	0.27	156	1.60	242	2.05	0.28	423	3.73	644	4.74	0.27	2.32
		(503–714)	(2.4–3.35)	(622–1273)	(2.44–4.97)	(−0.1–0.77)	(131–190)	(1.37–1.92)	(164–342)	(1.4–2.87)	(−0.14–0.75)	(355–551)	(3.14–4.84)	(444–949)	(3.27–6.99)	(−0.11–0.82)
Turkey	0.748	2537	3.44	3271	3.54	0.03	783	2.15	1130	2.46	0.15	1754	4.65	2141	4.55	−0.02	1.85
		(2118–3013)	(2.9–4.08)	(2493–4322)	(2.72–4.67)	(−0.23–0.37)	(643–962)	(1.77–2.63)	(837–1599)	(1.83–3.52)	(−0.17–0.54)	(1393–2120)	(3.71–5.6)	(1597–2881)	(3.4–6.13)	(−0.29–0.34)
Middle SDI
Armenia	0.689	46	1.28	91	2.33	0.82	14	0.91	27	1.58	0.74	32	1.59	64	2.95	0.86	1.87
		(42–56)	(1.16–1.55)	(74–110)	(1.92–2.79)	(0.42–1.25)	(12–23)	(0.79–1.38)	(22–33)	(1.27–1.92)	(0.12–1.19)	(28–36)	(1.41–1.79)	(51–78)	(2.39–3.6)	(0.42–1.33)
Azerbaijan	0.683	141	1.59	195	1.75	0.11	33	0.82	50	0.98	0.20	108	2.27	144	2.46	0.08	2.50
		(117–170)	(1.34–1.91)	(149–250)	(1.37–2.23)	(−0.11–0.38)	(26–42)	(0.67–1.03)	(34–69)	(0.69–1.33)	(−0.1–0.56)	(86–135)	(1.83–2.85)	(104–193)	(1.81–3.24)	(−0.18–0.43)
China	0.686	29,177	1.79	39,079	2.05	0.15	11,289	1.44	16,111	1.74	0.20	17,887	2.18	22,968	2.41	0.10	1.39
		(25,992–33,001)	(1.6–2.02)	(32,279–47,658)	(1.7–2.5)	(−0.05–0.38)	(9494–12,803)	(1.21–1.63)	(12,076–20,192)	(1.32–2.16)	(−0.06–0.53)	(15,433–21,440)	(1.88–2.6)	(17,457–30,160)	(1.83–3.17)	(−0.16–0.43)
Indonesia	0.66	5065	2.50	6672	2.66	0.06	1130	1.21	1700	1.44	0.19	3935	3.74	4972	3.83	0.02	2.67
		(3360–6080)	(1.69–2.96)	(4626–8372)	(1.88–3.3)	(−0.15–0.33)	(867–1364)	(0.95–1.44)	(1235–2308)	(1.07–1.9)	(−0.1–0.56)	(2295–4901)	(2.21–4.62)	(3009–6548)	(2.34–4.97)	(−0.22–0.39)
Iran (Islamic Republic of)	0.67	1762	2.54	3198	3.63	0.43	491	1.42	956	2.15	0.51	1270	3.67	2242	5.11	0.39	2.38
		(1242–1943)	(1.81–2.8)	(1999–3649)	(2.31–4.12)	(0.24–0.59)	(373–557)	(1.12–1.59)	(634–1129)	(1.46–2.52)	(0.24–0.78)	(871–1439)	(2.54–4.15)	(1310–2643)	(3.08–5.96)	(0.16–0.59)
Iraq	0.671	686	2.96	1282	4.03	0.36	179	1.63	367	2.39	0.47	507	4.34	915	5.71	0.32	2.39
		(504–921)	(2.21–3.94)	(895–1779)	(2.85–5.49)	(0.03–0.78)	(130–244)	(1.2–2.2)	(252–510)	(1.7–3.24)	(0.08–0.99)	(352–718)	(3.09–6.11)	(597–1329)	(3.85–8.04)	(−0.05–0.79)
Philippines	0.623	2773	3.82	4015	4.30	0.12	637	1.87	984	2.22	0.18	2137	5.69	3031	6.31	0.11	2.85
		(2397–3156)	(3.35–4.35)	(3102–5169)	(3.34–5.5)	(−0.12–0.42)	(537–741)	(1.6–2.16)	(706–1299)	(1.61–2.91)	(−0.16–0.59)	(1766–2533)	(4.74–6.71)	(2181–4159)	(4.57–8.57)	(−0.17–0.5)
Syrian Arab Republic	0.619	124	0.86	138	0.97	0.13	43	0.59	49	0.68	0.16	80	1.16	89	1.25	0.08	1.83
		(88–153)	(0.58–1.07)	(89–190)	(0.63–1.32)	(−0.17–0.48)	(31–56)	(0.41–0.77)	(32–70)	(0.45–0.96)	(−0.19–0.65)	(53–104)	(0.69–1.49)	(52–124)	(0.73–1.72)	(−0.21–0.46)
Thailand	0.687	2261	2.87	2667	2.74	−0.04	599	1.60	796	1.74	0.09	1662	4.01	1871	3.64	−0.09	2.09
		(1843–3372)	(2.35–4.15)	(1794–4452)	(1.86–4.59)	(−0.34–0.35)	(477–793)	(1.28–2.06)	(543–1256)	(1.21–2.74)	(−0.26–0.6)	(1312–2677)	(3.18–6.28)	(1215–3461)	(2.34–6.83)	(−0.39–0.33)
Turkmenistan	0.67	50	1.29	80	1.66	0.29	15	0.81	26	1.09	0.33	35	1.73	54	2.21	0.28	2.03
		(45–55)	(1.18–1.42)	(63–103)	(1.3–2.13)	(0.01–0.67)	(13–17)	(0.71–0.93)	(20–33)	(0.85–1.41)	(0.03–0.73)	(31–40)	(1.55–1.94)	(42–71)	(1.69–2.87)	(−0.02–0.67)
Uzbekistan	0.631	123	0.66	247	0.93	0.41	38	0.44	73	0.61	0.38	86	0.85	174	1.22	0.44	2.01
		(112–136)	(0.61–0.72)	(200–299)	(0.77–1.12)	(0.15–0.71)	(32–43)	(0.38–0.5)	(56–92)	(0.46–0.74)	(0.09–0.72)	(75–97)	(0.76–0.95)	(138–214)	(0.98–1.48)	(0.14–0.78)
Vietnam	0.617	5276	6.08	7789	7.25	0.19	1361	3.57	2146	4.35	0.22	3916	8.44	5643	10.04	0.19	2.31
		(3244–6837)	(4.04–7.73)	(5009–10,487)	(4.77–9.6)	(−0.08–0.54)	(810–1778)	(2.33–4.46)	(1348–2993)	(2.86–5.88)	(−0.08–0.58)	(2177–5287)	(4.94–11.19)	(3281–7827)	(5.93–13.81)	(−0.1–0.59)
Low‐middle SDI
Bangladesh	0.483	1504	1.30	2322	1.54	0.18	375	0.70	551	0.76	0.10	1129	1.93	1772	2.29	0.19	3.00
		(1125–2104)	(1–1.74)	(1587–3465)	(1.06–2.25)	(−0.09–0.53)	(264–517)	(0.49–0.94)	(378–828)	(0.52–1.13)	(−0.18–0.46)	(786–1704)	(1.41–2.77)	(1133–2841)	(1.5–3.63)	(−0.11–0.59)
Bhutan	0.455	10	1.69	14	2.07	0.22	2	0.89	4	1.11	0.24	7	2.61	11	3.12	0.19	2.82
		(7–14)	(1.23–2.34)	(9–21)	(1.43–2.94)	(−0.05–0.55)	(2–4)	(0.56–1.28)	(2–6)	(0.69–1.68)	(−0.06–0.6)	(5–11)	(1.75–3.73)	(7–16)	(2.04–4.74)	(−0.1–0.58)
Cambodia	0.469	298	2.90	495	3.61	0.24	54	1.26	93	1.60	0.26	244	4.18	401	5.25	0.26	3.29
		(185–393)	(1.83–3.79)	(305–676)	(2.26–4.87)	(−0.01–0.56)	(40–73)	(0.94–1.66)	(66–123)	(1.13–2.06)	(−0.02–0.61)	(141–331)	(2.46–5.57)	(226–560)	(2.98–7.3)	(−0.02–0.64)
Democratic People's Republic of Korea	0.558	682	2.41	763	2.39	−0.01	155	1.26	202	1.32	0.05	527	3.51	561	3.49	−0.01	2.64
		(485–959)	(1.76–3.35)	(544–1072)	(1.7–3.37)	(−0.23–0.28)	(101–241)	(0.86–1.9)	(131–305)	(0.89–1.94)	(−0.18–0.36)	(352–791)	(2.33–5.22)	(375–845)	(2.28–5.39)	(−0.26–0.36)
India	0.566	16,357	1.55	23,823	1.81	0.16	4240	0.86	6276	1.00	0.16	12,118	2.27	17,547	2.64	0.16	2.64
		(13,758–18,296)	(1.31–1.74)	(19,467–28,644)	(1.48–2.17)	(−0.03–0.4)	(3620–4793)	(0.73–0.97)	(5050–7557)	(0.8–1.2)	(−0.08–0.44)	(9506–13,963)	(1.78–2.6)	(13,225–22,175)	(1.99–3.32)	(−0.08–0.46)
Kyrgyzstan	0.596	61	1.39	83	1.51	0.09	11	0.57	17	0.65	0.15	50	2.10	67	2.25	0.07	3.46
		(54–68)	(1.25–1.55)	(68–101)	(1.26–1.82)	(−0.11–0.32)	(10–13)	(0.49–0.65)	(13–21)	(0.53–0.8)	(−0.07–0.43)	(43–57)	(1.84–2.4)	(53–83)	(1.81–2.77)	(−0.14–0.33)
Lao People's Democratic Republic	0.49	96	2.35	140	2.61	0.11	20	1.05	30	1.20	0.14	76	3.59	110	3.96	0.10	3.28
		(58–131)	(1.45–3.14)	(86–196)	(1.62–3.55)	(−0.11–0.39)	(13–27)	(0.73–1.41)	(21–41)	(0.86–1.59)	(−0.12–0.52)	(40–108)	(1.93–4.96)	(59–160)	(2.15–5.64)	(−0.14–0.42)
Maldives	0.562	7	2.86	13	3.20	0.12	4	2.97	8	3.52	0.18	3	2.71	5	2.88	0.06	0.82
		(6–8)	(2.5–3.27)	(10–16)	(2.59–3.94)	(−0.09–0.37)	(3–4)	(2.48–3.63)	(6–11)	(2.77–4.48)	(−0.09–0.51)	(3–4)	(2.19–3.23)	(4–6)	(2.2–3.67)	(−0.17–0.35)
Mongolia	0.606	26	1.45	41	1.48	0.02	10	1.01	15	1.09	0.08	17	1.79	26	1.76	−0.02	1.62
		(15–34)	(0.67–1.88)	(22–56)	(0.71–2.03)	(−0.21–0.37)	(5–13)	(0.44–1.35)	(7–22)	(0.51–1.52)	(−0.23–0.46)	(9–22)	(0.73–2.38)	(13–37)	(0.79–2.5)	(−0.27–0.36)
Myanmar	0.521	1045	2.48	1437	2.77	0.12	212	1.15	312	1.37	0.19	833	3.62	1125	3.94	0.09	2.88
		(681–1366)	(1.66–3.18)	(996–1902)	(1.96–3.64)	(−0.14–0.42)	(149–284)	(0.83–1.51)	(225–412)	(1–1.79)	(−0.11–0.59)	(482–1123)	(2.15–4.79)	(709–1528)	(2.51–5.3)	(−0.19–0.45)
Palestine	0.588	52	2.31	110	3.43	0.49	10	0.94	19	1.23	0.32	42	3.55	91	5.57	0.57	4.51
		(44–61)	(1.93–2.68)	(77–139)	(2.41–4.26)	(0.12–0.86)	(8–12)	(0.77–1.12)	(15–24)	(0.96–1.54)	(0.02–0.68)	(34–51)	(2.88–4.23)	(59–118)	(3.65–7)	(0.1–1.04)
Tajikistan	0.539	19	0.44	28	0.48	0.09	7	0.33	10	0.37	0.11	12	0.54	18	0.58	0.07	1.56
		(15–22)	(0.32–0.52)	(22–35)	(0.34–0.6)	(−0.14–0.38)	(5–8)	(0.22–0.42)	(7–13)	(0.24–0.48)	(−0.16–0.45)	(9–14)	(0.37–0.65)	(14–23)	(0.4–0.74)	(−0.18–0.39)
Timor‐Leste	0.514	13	1.82	21	2.38	0.31	2	0.72	4	1.00	0.39	10	2.96	17	3.80	0.28	3.78
		(8–17)	(1.13–2.46)	(13–29)	(1.49–3.27)	(0.02–0.7)	(2–4)	(0.47–1.11)	(3–6)	(0.65–1.43)	(0.08–0.87)	(6–14)	(1.75–4.08)	(10–24)	(2.19–5.4)	(−0.03–0.7)
Low SDI
Afghanistan	0.343	280	2.00	439	2.23	0.11	45	0.73	75	0.83	0.14	235	3.21	364	3.60	0.12	4.33
		(138–460)	(1.1–3.11)	(221–726)	(1.26–3.44)	(−0.14–0.41)	(27–76)	(0.43–1.19)	(47–120)	(0.53–1.29)	(−0.12–0.49)	(94–411)	(1.44–5.36)	(154–635)	(1.72–5.87)	(−0.15–0.44)
Nepal	0.422	299	1.41	490	1.87	0.33	59	0.63	103	0.90	0.43	240	2.13	387	2.70	0.26	2.99
		(225–406)	(1.1–1.89)	(341–681)	(1.34–2.55)	(0.02–0.69)	(38–83)	(0.41–0.86)	(63–150)	(0.56–1.32)	(0.06–0.84)	(173–345)	(1.59–2.96)	(264–566)	(1.89–3.85)	(−0.05–0.65)
Pakistan	0.449	3152	2.57	4885	2.96	0.15	840	1.48	1267	1.67	0.13	2312	3.71	3618	4.29	0.15	2.56
		(2465–3900)	(2.08–3.11)	(3650–6521)	(2.3–3.81)	(−0.13–0.52)	(642–1069)	(1.15–1.86)	(911–1766)	(1.21–2.29)	(−0.21–0.6)	(1677–3034)	(2.79–4.73)	(2410–5381)	(2.95–6.08)	(−0.2–0.69)
Yemen	0.412	213	1.59	356	1.86	0.17	45	0.69	73	0.80	0.16	168	2.49	283	2.91	0.17	3.65
		(138–317)	(1.1–2.26)	(228–517)	(1.26–2.66)	(−0.09–0.49)	(29–69)	(0.46–1.05)	(46–114)	(0.51–1.24)	(−0.13–0.53)	(103–261)	(1.62–3.69)	(167–434)	(1.82–4.32)	(−0.12–0.54)

3.1.5. National comparison

Among Asian countries, 11 countries experienced a decreasing trend in the ThC morbidity rate between 2010 and 2019; the greatest decrease was detected in the Republic of Korea (decrease in ASIR = −0.54 (95% CI: −0.65 to −0.01)), and the greatest increase was detected in Armenia (increase in ASIR = 0.82 (95% CI: 0.42–1.25)) (Figure 2).

FIGURE 2.

The relative change (%) in age‐standardized incidence rate (ASIR), age‐standardized death rate (ASMR), age‐standardized DALYs rate (DALYs ASR), and age‐standardized prevalence rate (ASPR) of ThC cancer in Asian countries from 2010 to 2019.

In 2019, the highest ASIR (per 100,000) of THC was reported in Lebanon (7.95), Vietnam (7.25), the Republic of Korea (6.77), Saudi Arabia (5.98), Brunei Darussalam (5.09), and Taiwan (5.01). The lowest ASIR of ThC was reported in Tajikistan (0.48), Uzbekistan (0.93), and Syrian Arab Republic (0.97).

In 2019, the highest ASIR (per 100,000) of ThC in men was reported in Lebanon (4.91), Vietnam (4.35), the United Arab Emirates (3.53), Maldives (3.52), the Republic of Korea (3.37), Taiwan (3.35), Saudi Arabia (3.23), and Israel (3.21). The lowest ASIR of ThC was reported in Tajikistan (0.37), Uzbekistan (0.61), Kyrgyzstan (0.65), Syrian Arab Republic (0.68), Bangladesh (0.76), Yemen (0.80), Afghanistan (0.83), Nepal (0.90), and Azerbaijan (0.98).

In 2019, the highest ASIR (per 100,000) of ThC in women was reported in Lebanon (10.67), Republic of Korea (10.25), Saudi Arabia (10.20), Vietnam (10.04), and Brunei Darussalam (8.00). The lowest ASIR of ThC was reported in Tajikistan (0.58), Uzbekistan (1.22), the Syrian Arab Republic (1.25), and Mongolia (1.76). Results in detail are presented in Table 3.

3.1.6. Male/female ratio

In 2019, the ASIR of ThC in Maldives was reported to be higher in men than in women. In other countries, the incidence of THC in women was higher than in men. The highest ratio was reported in Palestine (4.51‐fold) and the lowest ratio was recorded in Maldives (0.82‐fold). Similarly, in 2010, this ratio in Maldives was higher in men than in women (Figure 3).

FIGURE 3.

The female/male ratio in age‐standardized incidence rate (ASIR), age‐standardized death rate (ASMR), age‐standardized DALYs rate (DALYs ASR), and age‐standardized prevalence rate (ASPR) of ThC cancer in Asian countries based on SDI, 2019.

3.2. Death rates of THC in Asia

3.2.1. Compared with global data and continents

In Asia, the number of ThC deaths increased from 21,405 (95% CI: 18,846–22,632) in 2010 to 26,982 (95% CI: 23,978–29,391) in 2019, which is over a 1.26‐fold increase. In 2019, more than 59% (26,982/45,576) of ThC deaths happened in Asia countries. During this period, the ASDR of ThC had a 6% change, decreasing from 0.63 (95% CI: 0.55–0.66) per 100,000 in 2010 to 0.59 (95% CI: 0.52–0.64) per 100,000 in 2019. Also, at the same time, this rate globally decreased by 5%, in America by 1%, and Europe by 9%. This rate was stable in Africa at this time (Figure 4 and Table 1).

FIGURE 4.

Temporal trend of incidence, prevalence, death, and DALYs age standard rates (per 100,000 population) of thyroid cancer in Asia compared with global data and other continents from 2010 to 2019.

In Asian men, the number of ThC deaths increased from 8867 (95% CI: 7483–9442) in 2010 to 11,465 (95% CI: 9819–12,908) in 2019, which is over a 1.29‐fold increase. In 2019, 42.49% (11,465/26,982) of Asian ThC deaths occurred in Asian men, which included 61.52% (11,465/18,635) of global male ThC death cases. During this period, the ASDR of ThC had a 2% change, decreasing from 0.55 (95% CI: 0.46–0.59) per 100,000 in 2010 to 0.54 (95% CI: 0.46–0.60) per 100,000 in 2019, while at the same time, this rate globally decreased by 1% and in Europe by 6%. This rate increased in America by 3% and in Africa by 4% (Table 4).

TABLE 4.

The comparing incidence, death, prevalence, and burden rates of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019 (males).

Location	Incidence					Death					Prevalence					DALY
	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
	Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
Global	59,341	1.81	76,014	1.90	0.05	14,744	0.51	18,635	0.51	−0.01	437,780	12.77	562,741	13.70	0.07	420,674	13.14	509,842	12.93	−0.02
	(52,845–62,189)	(1.61–1.9)	(68,232–82,923)	(1.71–2.07)	(−0.04–0.14)	(13,094–15,502)	(0.45–0.54)	(16,822–20,242)	(0.46–0.55)	(−0.09–0.07)	(388,455–457,734)	(11.34–13.35)	(502,727–615,420)	(12.25–14.97)	(−0.03–0.17)	(375,586–445,036)	(11.74–13.89)	(461,647–553,336)	(11.7–14.02)	(−0.1–0.07)
Continents
Africa	2194	0.73	3436	0.86	0.19	936	0.40	1261	0.41	0.04	13,084	3.56	22,404	4.76	0.34	30,806	10.44	41,146	10.74	0.03
	(1898–2481)	(0.63–0.83)	(2928–4020)	(0.75–1.01)	(0.02–0.34)	(801–1097)	(0.34–0.47)	(1092–1497)	(0.36–0.49)	(−0.08–0.16)	(11,304–14,693)	(3.12–4.02)	(18,829–26,306)	(3.99–5.63)	(0.15–0.52)	(26,040–36,106)	(8.93–12.25)	(34,988–48,795)	(9.27–12.77)	(−0.1–0.15)
America	13,672	2.90	17,131	2.99	0.03	2186	0.49	2872	0.50	0.03	108,873	22.81	135,052	23.56	0.03	60,584	13.05	75,968	13.25	0.02
	(13,083–14,218)	(2.76–3.01)	(14,652–20,134)	(2.56–3.51)	(−0.11–0.2)	(2014–2270)	(0.45–0.51)	(2629–3083)	(0.46–0.54)	(−0.03–0.09)	(10,4295–11,3692)	(21.79–23.78)	(11,4872–15,9952)	(20.07–27.88)	(−0.12–0.21)	(57,227–64,251)	(12.29–13.84)	(69,938–82,870)	(12.22–14.45)	(−0.04–0.09)
Asia	29,253	1.50	40,021	1.65	0.10	8867	0.55	11,465	0.54	−0.02	205,125	9.67	285,342	11.18	0.16	256,437	13.54	316,821	13.30	−0.02
	(24,129–31,446)	(1.23–1.61)	(33,634–45,216)	(1.39–1.86)	(−0.05–0.24)	(7483–9442)	(0.46–0.59)	(9819–12,908)	(0.46–0.6)	(−0.14–0.09)	(169,386–221,225)	(7.98–10.41)	(239,841–324,527)	(9.42–12.69)	(0–0.32)	(217,071–275,000)	(11.49–14.46)	(272,355–354,527)	(11.41–14.88)	(−0.14–0.1)
Europe	14,139	2.66	15,321	2.67	0.00	2733	0.49	3009	0.47	−0.06	110,088	20.94	119,171	21.24	0.01	72,276	13.26	75,193	12.37	−0.07
	(12,523–14,790)	(2.37–2.78)	(13,383–17,349)	(2.33–3.01)	(−0.11–0.14)	(2554–2836)	(0.46–0.51)	(2727–3250)	(0.42–0.5)	(−0.11–0)	(96,454–115,495)	(18.39–21.93)	(103,553–136,208)	(18.49–24.17)	(−0.11–0.16)	(67,619–76,240)	(12.41–13.99)	(68,124–83,253)	(11.23–13.7)	(−0.13–0.01)
Asian GBD regions
Central Asia	242	0.77	375	0.96	0.24	86	0.34	115	0.38	0.11	1596	4.40	2627	5.88	0.34	2737	9.09	3629	9.73	0.07
	(224–263)	(0.72–0.83)	(323–424)	(0.83–1.08)	(0.09–0.4)	(81–91)	(0.32–0.36)	(100–129)	(0.33–0.42)	(−0.02–0.23)	(1463–1767)	(4.03–4.87)	(2243–3002)	(5.05–6.7)	(0.16–0.54)	(2579–2933)	(8.55–9.66)	(3132–4089)	(8.44–10.91)	(−0.06–0.2)
East Asia	11,895	1.47	16,891	1.75	0.20	3426	0.53	4355	0.52	−0.03	85,588	9.64	124,587	12.41	0.29	92,052	11.90	111,067	11.64	−0.02
	(10,040–13,394)	(1.23–1.65)	(12,854–20,999)	(1.34–2.17)	(−0.06–0.51)	(2735–3824)	(0.42–0.59)	(3324–5373)	(0.4–0.63)	(−0.22–0.19)	(73,127–97,155)	(8.28–10.92)	(95,008–155,402)	(9.55–15.43)	(0.01–0.64)	(75,140–103,306)	(9.59–13.25)	(85,215–137,095)	(9–14.22)	(−0.22–0.2)
High‐income Asia Pacific	5261	3.94	4283	2.75	−0.30	889	0.58	899	0.44	−0.24	42,007	32.22	32,613	22.20	−0.31	21,442	14.94	18,056	10.26	−0.31
	(3441–5833)	(2.52–4.39)	(3405–5180)	(2.21–3.3)	(−0.43 to −0.03)	(632–942)	(0.4–0.62)	(713–984)	(0.35–0.48)	(−0.3 to −0.1)	(26,849–47,081)	(20.24–36.21)	(25,657–39,972)	(17.78–26.9)	(−0.45 to −0.02)	(14,309–23,288)	(9.71–16.28)	(14,954–20,085)	(8.49–11.51)	(−0.38 to −0.1)
North Africa and Middle East	3134	1.47	5667	1.97	0.34	659	0.41	970	0.44	0.09	24,518	10.61	45,985	15.07	0.42	21,146	10.96	31,063	12.04	0.10
	(2806–3484)	(1.32–1.63)	(4601–6669)	(1.63–2.31)	(0.16–0.51)	(595–761)	(0.37–0.49)	(820–1149)	(0.38–0.54)	(−0.04–0.2)	(21,504–27,385)	(9.44–11.83)	(36,968–54,279)	(12.2–17.8)	(0.22–0.61)	(18,986–23,535)	(9.89–12.32)	(25,897–36,269)	(10.13–14.02)	(−0.04–0.21)
South Asia	5516	0.90	8200	1.04	0.16	2637	0.51	3537	0.52	0.01	30,649	4.30	48,976	5.62	0.31	85,038	13.85	108,134	13.85	0.00
	(4812–6147)	(0.78–1)	(6808–9674)	(0.86–1.22)	(−0.07–0.39)	(2289–2973)	(0.44–0.57)	(2996–4155)	(0.44–0.6)	(−0.17–0.21)	(26,913–34,129)	(3.77–4.77)	(40,189–58,798)	(4.61–6.72)	(0.05–0.58)	(74,075–95,358)	(12.02–15.5)	(91,579–126,638)	(11.71–16.25)	(−0.18–0.19)
Southeast Asia	4400	1.72	6715	2.07	0.20	1469	0.72	2012	0.75	0.04	29,788	10.32	47,234	13.36	0.30	44,013	18.32	58,747	18.99	0.04
	(3678–4926)	(1.47–1.91)	(5439–8040)	(1.7–2.46)	(0–0.42)	(1261–1606)	(0.64–0.79)	(1698–2366)	(0.63–0.88)	(−0.11–0.19)	(24,526–34,014)	(8.53–11.69)	(37,607–57,180)	(10.7–16.09)	(0.06–0.55)	(36,771–48,742)	(15.58–20.1)	(48,885–69,102)	(15.96–22.24)	(−0.11–0.2)

In Asian women, the number of ThC deaths increased from 12,538 (95% CI: 10,640–13,594) in 2010 to 15,517 (95% CI: 13,103–17,318) in 2019, which is over a 1.24‐fold increase. In 2019, approximately 57.51% (15,517/26,982) of Asian ThC deaths occurred in Asian women, which included 42.75% (11,517/26,941) of global female ThC death cases. During this period, the ASIR of ThC had 8% changes, decreasing from 0.69 (95% CI: 0.59–0.75) per 100,000 in 2010 to 0.64 (95% CI: 0.54–0.71) per 100,000 in 2019. At the same time, this rate globally decreased by 6%, in Europe by 11%, and in America and Africa by 3% (Table 5).

TABLE 5.

The comparing incidence, death, prevalence, and burden rates of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019 (females).

Location	Incidence					Death					Prevalence				DALY
	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
	Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
Global	131,855	3.76	157,833	3.74	−0.01	22,525	0.66	26,941	0.62	−0.06	1,058,584	29.97	1,269,019	30.17	0.01	625,211	18.01	721,999	16.94	−0.06
	(116,108–137,983)	(3.32–3.93)	(140,395–173,068)	(3.32–4.1)	(−0.08–0.08)	(19,946–23,888)	(0.59–0.7)	(23,718–29,329)	(0.55–0.68)	(−0.12 to −0.01)	(925,303–1,106,520)	(26.27–31.31)	(1,123,383–1,393,452)	(26.71–33.15)	(−0.07–0.1)	(544,936–672,424)	(15.73–19.36)	(627,829–792,461)	(14.72–18.62)	(−0.13–0.01)
Continents
Africa	7289	2.12	10,897	2.38	0.12	1802	0.72	2316	0.70	−0.03	54,674	14.19	85,181	16.95	0.19	61,288	19.52	78,174	18.83	−0.04
	(5612–8352)	(1.72–2.41)	(8401–13,293)	(1.91–2.83)	(0–0.29)	(1479–2047)	(0.59–0.81)	(1878–2748)	(0.57–0.82)	(−0.11–0.08)	(41,671–63,223)	(11.23–16.2)	(65,133–104,159)	(13.4–20.38)	(0.04–0.38)	(49,174–70,178)	(15.84–22.19)	(62,057–94,510)	(15.07–22.52)	(−0.14–0.09)
America	24,014	4.59	28,094	4.44	−0.03	3584	0.65	4415	0.63	−0.03	195,286	37.67	227,004	36.50	−0.03	90,138	17.06	107,238	16.32	−0.04
	(23,117–24,741)	(4.43–4.73)	(24,531–32,170)	(3.88–5.1)	(−0.16–0.11)	(3291–3752)	(0.6–0.68)	(3969–4801)	(0.57–0.68)	(−0.09–0.03)	(188,596–200,948)	(36.4–38.75)	(197,359–262,528)	(31.72–42.27)	(−0.16–0.12)	(83,896–95,527)	(15.89–18.08)	(96,816–118,462)	(14.72–18.11)	(−0.11–0.03)
Asia	69,379	3.38	86,988	3.49	0.03	12,538	0.69	15,517	0.64	−0.08	554,856	26.34	696,999	27.77	0.05	368,534	18.64	434,163	17.48	−0.06
	(56,407–74,309)	(2.77–3.62)	(73,241–97,296)	(2.93–3.9)	(−0.07–0.15)	(10,640–13,594)	(0.59–0.75)	(13,103–17,318)	(0.54–0.71)	(−0.16–0.01)	(447,358–595,190)	(21.31–28.2)	(582,544–783,841)	(23.15–31.19)	(−0.05–0.19)	(304,476–400,999)	(15.61–20.23)	(362,794–486,695)	(14.65–19.64)	(−0.15–0.03)
Europe	31,028	5.16	31,688	4.92	−0.05	4574	0.56	4661	0.50	−0.11	252,625	43.70	258,523	41.99	−0.04	104,553	15.26	101,636	13.44	−0.12
	(29,881–32,031)	(4.98–5.33)	(28,480–35,551)	(4.42–5.55)	(−0.14–0.07)	(4196–4773)	(0.53–0.59)	(4154–5028)	(0.45–0.54)	(−0.16 to −0.05)	(243,625–261,116)	(42.18–45.23)	(232,371–290,635)	(37.58–47.26)	(−0.13–0.08)	(97,980–111,133)	(14.26–16.34)	(91,856–111,544)	(12.15–14.87)	(−0.17 to −0.05)
Asian GBD regions
Central Asia	733	1.94	1092	2.34	0.20	158	0.48	193	0.49	0.02	5692	14.51	8827	18.14	0.25	4524	12.74	5603	12.79	0.00
	(685–786)	(1.82–2.08)	(956–1242)	(2.05–2.64)	(0.06–0.36)	(148–166)	(0.46–0.51)	(173–215)	(0.44–0.55)	(−0.08–0.12)	(5292–6147)	(13.5–15.65)	(7693–101,23)	(15.8–20.72)	(0.09–0.43)	(4247–4804)	(11.98–13.5)	(4955–6333)	(11.38–14.38)	(−0.1–0.12)
East Asia	19,406	2.28	24,688	2.50	0.09	2788	0.36	3266	0.31	−0.14	160,700	18.61	206,107	20.97	0.13	77,637	9.54	86,270	8.40	−0.12
	(16,919–22,887)	(2–2.68)	(19,158–31,886)	(1.94–3.23)	(−0.15–0.39)	(2434–3291)	(0.32–0.43)	(2627–3999)	(0.25–0.38)	(−0.31–0.06)	(139,603–190,957)	(16.21–21.97)	(159,523–267,428)	(16.27–27.17)	(−0.13–0.44)	(69,274–93,254)	(8.5–11.42)	(70,536–105,550)	(6.89–10.26)	(−0.28–0.07)
High‐income Asia Pacific	14,795	11.01	11,377	7.20	−0.35	1675	0.73	1855	0.59	−0.20	124,506	96.74	90,936	62.48	−0.35	34,765	20.56	30,964	14.39	−0.30
	(9830–16,456)	(6.59–12.46)	(9300–13,534)	(5.84–8.59)	(−0.47–0)	(1296–1866)	(0.57–0.81)	(1366–2114)	(0.47–0.66)	(−0.25 to −0.06)	(80,606–139,206)	(56.95–109.69)	(74,785–108,630)	(50.5–74.44)	(−0.47–0)	(25,512–39,203)	(13.76–23.72)	(25,262–35,199)	(11.97–16.61)	(−0.37 to −0.07)
North Africa and Middle East	8739	4.23	13,586	5.06	0.20	1047	0.68	1319	0.64	‐0.06	73,939	34.35	117,063	42.36	0.23	33,783	18.42	43,117	17.87	−0.03
	(6682–9842)	(3.4–4.73)	(10,441–15,925)	(4.01–5.88)	(0.07–0.35)	(931–1239)	(0.61–0.86)	(1133–1589)	(0.56–0.8)	(−0.14–0.04)	(55,144–83,752)	(26.59–38.72)	(87,911–137,864)	(32.74–49.32)	(0.1–0.39)	(28,203–38,291)	(16.07–21.06)	(35,094–50,876)	(14.91–21.01)	(−0.12–0.08)
South Asia	15,806	2.36	23,334	2.77	0.17	4248	0.79	5658	0.78	−0.01	117,305	16.22	177,491	20.16	0.24	146,730	23.20	183,441	22.81	−0.02
	(12,602–17,797)	(1.91–2.65)	(18,491–27,846)	(2.2–3.32)	(−0.02–0.42)	(3572–4813)	(0.65–0.91)	(4532–6743)	(0.63–0.94)	(−0.18–0.16)	(91,885–132,495)	(12.76–18.29)	(139,963–213,055)	(15.89–24.2)	(0.04–0.51)	(119,881–165,914)	(19.21–26.18)	(147,052–217,443)	(18.27–27.02)	(−0.18–0.16)
Southeast Asia	13,939	4.80	18,866	5.27	0.10	3155	1.33	3850	1.22	−0.08	106,624	34.69	147,665	39.94	0.15	88,689	33.43	105,556	30.87	−0.08
	(10,566–15,808)	(3.69–5.4)	(14,094–22,235)	(3.96–6.19)	(−0.05–0.28)	(2494–3524)	(1.08–1.48)	(3097–4395)	(0.99–1.39)	(−0.18–0.04)	(79,825–122,234)	(26.26–39.68)	(109,364–175,581)	(29.61–47.51)	(−0.01–0.36)	(65,994–100,571)	(25.43–37.65)	(80,215–122,086)	(23.84–35.46)	(−0.19–0.06)

3.2.2. Age distribution

In 2019, age‐specific death cases of ThC were peaking at 85 years and higher in both males and females. In all age groups, death cases of ThC in females were higher than in males, except in ages 75 to 79 years and 80 to 84 years, which was higher in males. In the 0 to 14 years group, males and females almost had the same death rates (Figure 5). In 2019, 12,399 deaths due to ThC in people aged ≥70 years were diagnosed in Asia, accounting for 45.95% of ThC deaths in all ages. This rate was 44.25% in men and 47.21% in women. Meanwhile, in the world, 22,298 deaths due to ThC were diagnosed in people ≥70 years, which includes 17.44% of ThC deaths in all ages. This rate was 18.65% in men and 16.85% in women. Overall, 55.61% of ThC deaths were recorded in the elderly aged ≥70 years in Asia (Table 2).

FIGURE 5.

Age‐specific death cases of ThC cancer among genders in Asia, 2019.

3.2.3. Within Asian regions

In 2019, the highest ASDR of ThC was observed in Southeast Asia regions (1.02 (95% CI: 0.88–1.15)), with a 4% decrease compared with 2010. Also in this period, East Asia and high‐income Asia Pacific had a decreasing trend of 8% and 22%, respectively. However, an increasing trend of 5% was observed in Central Asia. No changes in ASDR of ThC occurred in South Asia and North Africa and the Middle East from 2010 to 2019 (Figure 6 and Table 1).

FIGURE 6.

Temporal trend of incidence, prevalence, death, and DALYs age standard rates (per 100,000 population) of stomach cancer in Asian regions from 1990 to 2019.

In men, the highest ASDR of ThC was observed in Southeast Asia countries (0.75 (95% CI: 0.63–0.88)), with a 4% increase compared with 2010. Also in this period, Central Asia, South Asia, and North Africa and the Middle East had an increasing trend of 11%, 1%, and 9%, respectively. However, a decreasing trend was observed in East Asia (3%) and high‐income Asia Pacific countries (24%).

In women, the highest ASDR of ThC was observed in Southeast Asia countries (1.22 (95% CI: 0.99–1.39)), with an 8% decrease compared with 2010. Also, in this period, all Asian regions had a decreasing trend of 1% (South Asia) to 20% (high‐income Asia Pacific) except Central Asia, which had an increasing trend of 2% (Table 5).

3.2.4. Based on SDI

In 2019, among high SDI Asian countries, Brunei Darussalam (1.25) and the United Arab Emirates (0.82) have the highest ASDR of ThC, and Singapore (0.44) has the lowest rate. In this classification, between 2010 and 2019, all countries recorded a downward trend between 1% (Taiwan (Province of China)) to 43% (Republic of Korea). Among high‐middle SDI Asian countries, Malaysia (0.93) and Bahrain (0.73) have the highest ASDR of ThC and Oman (0.49) has the lowest rate. In this classification, between 2010 and 2019, all countries recorded a downward trend between 3% (Sri Lanka) to 26% (Bahrain) except Georgia, which had an increasing trend of 20%, and Lebanon, which had no changes. Among middle SDI Asian countries, the Philippines and Vietnam have the highest ASDR of ThC (1.34), and the Syrian Arab Republic (0.18) has the lowest rate. In this group, five countries reported a downward trend and seven countries reported an upward trend; the most upward trend was observed by Armenia (65%) and the most downward trend was observed in Thailand (17%) from 2010 to 2019. Among low‐middle SDI Asian countries, Cambodia (1.33) has the highest ASDR of ThC and Tajikistan (0.24) has the lowest rate. In this group, seven countries reported a downward trend and six countries reported an upward trend; Palestine experienced the most upward trend (15%) and Mongolia reported the most downward trend (11%) from 2010 to 2019. Among low SDI Asian countries, Pakistan (1.08) has the highest ASDR of ThC and Yemen (0.54) has the lowest rate. In this group, two countries experienced a downward trend and two countries reported an upward trend from 2010 to 2019. More details are presented in Table 6.

TABLE 6.

The death distribution of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019, by geographical region and SDI.

Location	SDI 2019	Both					Male					Female					F/M Ratio
		2010		2019		% change 1990–2010	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
High SDI
Brunei Darussalam	0.823	2	1.31	3	1.25	−0.04	1	0.87	1	0.90	0.04	1	1.65	2	1.53	−0.08	1.69
		(2–2)	(1.05–1.48)	(2–3)	(1.01–1.45)	(−0.18–0.11)	(1–1)	(0.7–1.01)	(1–1)	(0.71–1.12)	(−0.16–0.27)	(1–2)	(1.23–1.94)	(2–2)	(1.17–1.83)	(−0.23–0.11)
Cyprus	0.841	8	0.61	9	0.49	−0.20	3	0.56	4	0.43	−0.23	5	0.64	5	0.52	−0.19	1.20
		(6–9)	(0.49–0.68)	(7–11)	(0.4–0.57)	(−0.31 to −0.06)	(3–4)	(0.45–0.64)	(3–5)	(0.35–0.52)	(−0.37 to −0.06)	(4–6)	(0.48–0.75)	(4–7)	(0.42–0.63)	(−0.33–0.01)
Israel	0.803	76	0.84	86	0.73	−0.14	29	0.73	34	0.64	−0.12	47	0.93	53	0.79	−0.15	1.23
		(65–83)	(0.72–0.91)	(74–97)	(0.62–0.81)	(−0.22 to −0.05)	(22–32)	(0.56–0.81)	(27–39)	(0.53–0.74)	(−0.24–0.02)	(41–52)	(0.81–1.02)	(44–61)	(0.66–0.91)	(−0.26 to −0.03)
Japan	0.87	1827	0.55	2139	0.49	−0.10	619	0.47	694	0.41	−0.12	1208	0.59	1445	0.54	−0.09	1.30
		(1433–2004)	(0.45–0.59)	(1611–2403)	(0.39–0.54)	(−0.14 to −0.06)	(509–655)	(0.39–0.5)	(562–767)	(0.35–0.46)	(−0.17 to −0.05)	(911–1358)	(0.48–0.65)	(1041–1652)	(0.43–0.6)	(−0.12 to −0.04)
Kuwait	0.851	8	0.62	12	0.56	−0.10	4	0.44	7	0.51	0.17	5	0.94	5	0.64	−0.32	1.25
		(7–9)	(0.55–0.69)	(10–14)	(0.45–0.67)	(−0.24–0.07)	(3–4)	(0.37–0.5)	(5–8)	(0.39–0.65)	(−0.09–0.51)	(4–5)	(0.8–1.07)	(4–7)	(0.5–0.81)	(−0.45 to −0.16)
Qatar	0.83	2	0.75	3	0.58	−0.23	1	0.49	2	0.42	−0.13	1	1.44	1	1.09	−0.25	2.57
		(2–3)	(0.58–0.89)	(2–5)	(0.44–0.75)	(−0.4–0)	(1–2)	(0.33–0.63)	(1–3)	(0.29–0.59)	(−0.39–0.2)	(1–1)	(0.86–1.81)	(1–2)	(0.79–1.48)	(−0.46–0.11)
Republic of Korea	0.878	710	1.19	580	0.68	−0.43	261	0.98	192	0.52	−0.47	449	1.30	388	0.78	−0.40	1.49
		(323–785)	(0.57–1.32)	(426–679)	(0.5–0.79)	(−0.51 to −0.12)	(112–291)	(0.47–1.08)	(143–230)	(0.39–0.61)	(−0.56 to −0.15)	(208–509)	(0.6–1.48)	(272–474)	(0.54–0.95)	(−0.5 to −0.05)
Saudi Arabia	0.805	86	0.74	121	0.66	‐0.12	38	0.57	61	0.56	−0.03	48	0.97	60	0.80	−0.17	1.43
		(73–98)	(0.64–0.83)	(93–154)	(0.52–0.81)	(−0.27–0.06)	(32–45)	(0.49–0.66)	(46–79)	(0.43–0.69)	(−0.22–0.2)	(39–57)	(0.8–1.12)	(44–81)	(0.61–1.06)	(−0.36–0.06)
Singapore	0.861	25	0.53	33	0.44	−0.18	9	0.40	12	0.36	−0.10	16	0.63	20	0.50	−0.21	1.39
		(22–27)	(0.48–0.59)	(28–37)	(0.37–0.5)	(−0.26 to −0.08)	(8–10)	(0.36–0.46)	(10–15)	(0.3–0.44)	(−0.24–0.06)	(14–18)	(0.55–0.71)	(17–24)	(0.42–0.58)	(−0.31 to −0.08)
Taiwan (Province of China)	0.868	166	0.56	217	0.55	−0.01	68	0.46	87	0.48	0.04	98	0.65	130	0.61	−0.06	1.26
		(147–178)	(0.49–0.6)	(166–279)	(0.42–0.71)	(−0.22–0.27)	(59–74)	(0.4–0.51)	(64–114)	(0.36–0.63)	(−0.2–0.35)	(86–107)	(0.56–0.71)	(98–167)	(0.46–0.78)	(−0.26–0.21)
United Arab Emirates	0.88	19	1.00	42	0.82	−0.18	15	0.85	35	0.87	0.02	4	1.29	7	0.67	−0.48	0.77
		(11–27)	(0.49–1.47)	(22–66)	(0.41–1.23)	(−0.37–0.04)	(8–22)	(0.39–1.27)	(16–55)	(0.4–1.38)	(−0.22–0.32)	(2–6)	(0.54–2.16)	(4–12)	(0.33–1.11)	(−0.6 to −0.26)
High‐middle SDI
Bahrain	0.751	3	0.99	5	0.73	‐0.26	1	0.51	2	0.40	−0.21	2	1.47	3	1.10	−0.25	2.73
		(2–4)	(0.58–1.18)	(3–6)	(0.49–0.93)	(−0.42 to −0.06)	(1–1)	(0.39–0.62)	(1–2)	(0.29–0.53)	(−0.43–0.05)	(1–3)	(0.72–1.82)	(2–4)	(0.61–1.44)	(−0.42 to −0.01)
Georgia	0.702	27	0.46	32	0.55	0.20	9	0.36	11	0.48	0.33	19	0.54	21	0.61	0.13	1.29
		(24–30)	(0.41–0.51)	(25–38)	(0.43–0.66)	(−0.03–0.42)	(6–10)	(0.27–0.41)	(6–14)	(0.27–0.58)	(−0.05–0.66)	(16–21)	(0.47–0.61)	(17–25)	(0.49–0.73)	(−0.09–0.37)
Jordan	0.731	19	0.63	34	0.58	−0.08	7	0.45	14	0.41	−0.07	12	0.84	21	0.76	−0.10	1.83
		(17–23)	(0.54–0.75)	(28–43)	(0.47–0.73)	(−0.26–0.11)	(6–9)	(0.37–0.55)	(10–19)	(0.31–0.56)	(−0.3–0.2)	(10–15)	(0.68–1.05)	(15–28)	(0.57–1.02)	(−0.31–0.15)
Kazakhstan	0.723	90	0.63	99	0.58	−0.08	29	0.49	32	0.45	−0.08	60	0.71	66	0.66	−0.07	1.47
		(84–97)	(0.59–0.68)	(83–116)	(0.49–0.68)	(−0.21–0.07)	(27–35)	(0.44–0.6)	(26–42)	(0.37–0.59)	(−0.24–0.13)	(55–66)	(0.66–0.77)	(56–77)	(0.56–0.77)	(−0.21–0.09)
Lebanon	0.708	28	0.67	35	0.67	0.00	13	0.64	17	0.70	0.10	15	0.70	18	0.64	−0.08	0.91
		(23–36)	(0.55–0.86)	(28–46)	(0.52–0.88)	(−0.16–0.17)	(10–17)	(0.5–0.83)	(12–22)	(0.51–0.93)	(−0.12–0.33)	(12–20)	(0.54–0.94)	(14–26)	(0.48–0.9)	(−0.25–0.12)
Malaysia	0.737	171	0.98	234	0.93	−0.06	56	0.61	87	0.67	0.10	115	1.33	147	1.18	−0.11	1.75
		(152–202)	(0.86–1.17)	(180–304)	(0.71–1.19)	(−0.26–0.17)	(47–66)	(0.51–0.72)	(63–115)	(0.48–0.88)	(−0.16–0.42)	(99–140)	(1.12–1.62)	(111–198)	(0.89–1.58)	(−0.31–0.13)
Oman	0.783	6	0.58	7	0.49	−0.15	3	0.45	3	0.40	−0.10	3	0.74	4	0.60	−0.18	1.51
		(5–7)	(0.49–0.64)	(6–9)	(0.41–0.57)	(−0.27 to −0.01)	(2–3)	(0.38–0.52)	(2–4)	(0.31–0.5)	(−0.3–0.12)	(3–4)	(0.58–0.87)	(3–5)	(0.47–0.75)	(−0.34–0.01)
Sri Lanka	0.69	121	0.67	160	0.65	−0.03	44	0.54	57	0.53	−0.03	77	0.77	103	0.74	−0.03	1.41
		(109–146)	(0.6–0.82)	(117–215)	(0.48–0.86)	(−0.28–0.26)	(39–52)	(0.47–0.64)	(39–79)	(0.36–0.72)	(−0.32–0.3)	(67–97)	(0.67–0.99)	(73–143)	(0.54–1.03)	(−0.29–0.28)
Turkey	0.748	399	0.61	455	0.53	−0.13	157	0.50	193	0.48	−0.05	242	0.69	261	0.57	−0.17	1.20
		(346–478)	(0.53–0.74)	(353–635)	(0.41–0.75)	(−0.32–0.1)	(133–207)	(0.42–0.68)	(145–293)	(0.36–0.73)	(−0.29–0.24)	(203–289)	(0.58–0.83)	(200–342)	(0.44–0.75)	(−0.37–0.06)
Middle SDI
Armenia	0.689	14	0.38	25	0.63	0.65	6	0.38	10	0.61	0.60	8	0.38	15	0.64	0.69	1.06
		(13–17)	(0.35–0.46)	(21–30)	(0.52–0.74)	(0.27–0.97)	(5–8)	(0.34–0.5)	(8–12)	(0.47–0.73)	(0–0.97)	(7–9)	(0.34–0.42)	(12–18)	(0.52–0.76)	(0.37–1.02)
Azerbaijan	0.683	34	0.48	41	0.47	−0.02	12	0.37	16	0.39	0.06	22	0.56	25	0.52	−0.06	1.33
		(29–43)	(0.4–0.64)	(33–55)	(0.36–0.64)	(−0.18–0.17)	(10–15)	(0.3–0.48)	(11–22)	(0.28–0.52)	(−0.18–0.37)	(18–30)	(0.46–0.78)	(19–36)	(0.39–0.76)	(−0.26–0.18)
China	0.686	5900	0.42	7239	0.39	−0.08	3315	0.54	4212	0.52	−0.04	2586	0.35	3027	0.30	−0.14	0.58
		(5254–6472)	(0.37–0.46)	(6012–8476)	(0.32–0.45)	(−0.22–0.07)	(2642–3714)	(0.42–0.6)	(3178–5241)	(0.4–0.64)	(−0.22–0.19)	(2244–3082)	(0.31–0.42)	(2395–3759)	(0.24–0.38)	(−0.32–0.07)
Indonesia	0.66	1607	1.02	1998	1.00	−0.02	487	0.65	677	0.70	0.09	1120	1.35	1321	1.25	−0.07	1.78
		(1172–1850)	(0.76–1.16)	(1459–2389)	(0.75–1.18)	(−0.18–0.14)	(396–581)	(0.54–0.76)	(493–891)	(0.53–0.91)	(−0.16–0.36)	(687–1349)	(0.85–1.61)	(828–1665)	(0.8–1.55)	(−0.27–0.16)
Iran (Islamic Republic of)	0.67	220	0.42	341	0.49	0.16	91	0.34	147	0.41	0.21	129	0.50	195	0.56	0.12	1.38
		(180–234)	(0.35–0.45)	(245–375)	(0.36–0.53)	(0.01–0.27)	(80–97)	(0.3–0.36)	(112–163)	(0.32–0.45)	(0.04–0.34)	(98–141)	(0.39–0.55)	(131–220)	(0.39–0.64)	(−0.06–0.24)
Iraq	0.671	97	0.60	159	0.70	0.17	41	0.53	74	0.68	0.28	56	0.67	85	0.72	0.08	1.06
		(75–123)	(0.47–0.77)	(120–201)	(0.54–0.86)	(−0.07–0.43)	(31–54)	(0.4–0.7)	(54–93)	(0.5–0.84)	(−0.03–0.67)	(42–74)	(0.5–0.9)	(63–110)	(0.55–0.92)	(−0.18–0.42)
Philippines	0.623	733	1.31	1010	1.34	0.02	225	0.83	325	0.90	0.08	508	1.70	685	1.69	−0.01	1.88
		(662–809)	(1.19–1.48)	(812–1225)	(1.08–1.63)	(−0.16–0.23)	(196–257)	(0.74–0.96)	(243–421)	(0.68–1.16)	(−0.19–0.4)	(446–580)	(1.5–2)	(513–880)	(1.28–2.16)	(−0.23–0.26)
Syrian Arab Republic	0.619	17	0.18	21	0.18	0.02	8	0.16	11	0.17	0.06	8	0.20	10	0.20	−0.03	1.16
		(11–20)	(0.12–0.22)	(13–28)	(0.12–0.24)	(−0.22–0.31)	(6–11)	(0.12–0.21)	(7–15)	(0.12–0.24)	(−0.24–0.45)	(5–10)	(0.11–0.26)	(5–14)	(0.11–0.27)	(−0.26–0.27)
Thailand	0.687	475	0.70	577	0.58	−0.17	150	0.47	198	0.44	−0.06	325	0.87	379	0.68	−0.21	1.54
		(408–589)	(0.6–0.84)	(433–793)	(0.43–0.79)	(−0.39–0.12)	(124–185)	(0.39–0.58)	(142–275)	(0.32–0.61)	(−0.34–0.32)	(269–421)	(0.72–1.1)	(274–559)	(0.5–1.01)	(−0.42–0.08)
Turkmenistan	0.67	11	0.37	16	0.40	0.09	5	0.33	7	0.37	0.13	7	0.40	9	0.42	0.06	1.13
		(11–12)	(0.34–0.39)	(13–20)	(0.32–0.5)	(−0.12–0.36)	(4–5)	(0.29–0.37)	(6–9)	(0.29–0.47)	(−0.11–0.45)	(6–7)	(0.36–0.43)	(7–11)	(0.33–0.53)	(−0.16–0.34)
Uzbekistan	0.631	34	0.29	54	0.31	0.10	14	0.24	23	0.27	0.16	20	0.31	31	0.34	0.09	1.23
		(32–37)	(0.26–0.31)	(45–65)	(0.26–0.37)	(−0.07–0.29)	(12–16)	(0.19–0.27)	(17–29)	(0.19–0.33)	(−0.05–0.43)	(18–22)	(0.28–0.34)	(26–37)	(0.28–0.4)	(−0.09–0.31)
Vietnam	0.617	971	1.41	1204	1.34	−0.04	359	1.22	474	1.23	0.01	612	1.53	730	1.42	−0.07	1.15
		(803–1137)	(1.19–1.65)	(925–1533)	(1.04–1.69)	(−0.23–0.15)	(258–434)	(0.94–1.46)	(334–613)	(0.92–1.56)	(−0.21–0.25)	(487–751)	(1.21–1.89)	(530–967)	(1.03–1.9)	(−0.29–0.16)
Low‐middle SDI
Bangladesh	0.483	479	0.54	646	0.49	−0.08	193	0.42	253	0.38	−0.10	287	0.67	393	0.62	−0.08	1.63
		(376–617)	(0.43–0.68)	(472–888)	(0.37–0.68)	(−0.26–0.13)	(136–258)	(0.3–0.55)	(177–367)	(0.26–0.55)	(−0.33–0.18)	(213–396)	(0.51–0.91)	(269–589)	(0.42–0.92)	(−0.28–0.2)
Bhutan	0.455	3	0.68	4	0.71	0.03	1	0.51	2	0.56	0.09	2	0.87	2	0.86	−0.01	1.55
		(2–4)	(0.53–0.92)	(3–5)	(0.53–0.97)	(−0.14–0.22)	(1–2)	(0.33–0.72)	(1–2)	(0.35–0.82)	(−0.14–0.36)	(1–3)	(0.64–1.22)	(2–3)	(0.63–1.21)	(−0.19–0.22)
Cambodia	0.469	105	1.27	150	1.33	0.05	26	0.73	38	0.80	0.09	79	1.63	112	1.69	0.03	2.12
		(69–133)	(0.86–1.6)	(100–192)	(0.9–1.67)	(−0.13–0.25)	(19–33)	(0.56–0.94)	(27–48)	(0.58–1)	(−0.13–0.36)	(48–102)	(1.01–2.09)	(65–150)	(1.01–2.22)	(−0.15–0.27)
Democratic People's Republic of Korea	0.558	148	0.58	165	0.52	−0.10	44	0.46	55	0.44	−0.05	104	0.67	110	0.59	−0.12	1.34
		(116–186)	(0.46–0.72)	(130–206)	(0.42–0.65)	(−0.24–0.07)	(31–65)	(0.33–0.65)	(40–76)	(0.32–0.6)	(−0.21–0.16)	(77–139)	(0.5–0.88)	(83–146)	(0.44–0.79)	(−0.29–0.09)
India	0.566	5270	0.62	7075	0.63	0.02	1991	0.48	2687	0.49	0.03	3279	0.75	4388	0.75	0.00	1.53
		(4583–5850)	(0.53–0.68)	(5979–8315)	(0.53–0.73)	(−0.13–0.18)	(1683–2300)	(0.4–0.55)	(2179–3229)	(0.4–0.59)	(−0.18–0.28)	(2665–3769)	(0.61–0.86)	(3319–5468)	(0.58–0.94)	(−0.2–0.22)
Kyrgyzstan	0.596	16	0.43	18	0.40	−0.07	4	0.26	5	0.25	0.00	11	0.56	13	0.51	−0.09	1.99
		(14–17)	(0.39–0.47)	(15–21)	(0.35–0.47)	(−0.21–0.09)	(4–5)	(0.23–0.29)	(4–6)	(0.21–0.3)	(−0.18–0.2)	(10–13)	(0.5–0.62)	(11–15)	(0.43–0.6)	(−0.24–0.09)
Lao People's Democratic Republic	0.49	37	1.16	47	1.11	−0.04	10	0.67	14	0.68	0.02	27	1.59	33	1.50	−0.05	2.20
		(24–48)	(0.76–1.47)	(31–61)	(0.75–1.45)	(−0.2–0.17)	(7–14)	(0.48–0.88)	(10–18)	(0.5–0.87)	(−0.21–0.32)	(15–36)	(0.93–2.09)	(19–45)	(0.89–2.01)	(−0.24–0.17)
Maldives	0.562	2	0.91	2	0.87	−0.05	1	1.12	2	1.12	−0.01	1	0.65	1	0.57	−0.12	0.51
		(1–2)	(0.73–1.06)	(2–3)	(0.68–1.07)	(−0.23–0.15)	(1–1)	(0.89–1.36)	(1–2)	(0.86–1.41)	(−0.23–0.26)	(0–1)	(0.43–0.79)	(0–1)	(0.39–0.72)	(−0.3–0.11)
Mongolia	0.606	10	0.66	13	0.58	−0.11	4	0.52	6	0.50	−0.04	6	0.74	7	0.63	−0.15	1.25
		(4–13)	(0.24–0.85)	(5–17)	(0.22–0.79)	(−0.3–0.16)	(2–5)	(0.22–0.69)	(2–8)	(0.22–0.69)	(−0.29–0.26)	(2–8)	(0.22–1)	(3–10)	(0.2–0.89)	(−0.36–0.14)
Myanmar	0.521	386	1.10	456	1.03	−0.06	106	0.67	134	0.68	0.02	280	1.43	323	1.28	−0.10	1.87
		(276–480)	(0.8–1.36)	(342–565)	(0.79–1.27)	(−0.23–0.13)	(78–140)	(0.51–0.88)	(100–171)	(0.52–0.87)	(−0.21–0.31)	(179–356)	(0.94–1.79)	(217–411)	(0.88–1.61)	(−0.28–0.1)
Palestine	0.588	10	0.63	15	0.73	0.15	3	0.37	4	0.40	0.06	7	0.83	11	1.00	0.20	2.52
		(8–11)	(0.53–0.72)	(11–18)	(0.5–0.89)	(−0.11–0.39)	(2–3)	(0.31–0.44)	(3–5)	(0.31–0.48)	(−0.15–0.32)	(6–8)	(0.67–0.99)	(7–14)	(0.63–1.24)	(−0.14–0.51)
Tajikistan	0.539	8	0.24	10	0.24	0.02	4	0.22	5	0.23	0.06	4	0.25	5	0.25	−0.01	1.07
		(5–10)	(0.14–0.3)	(7–12)	(0.14–0.31)	(−0.19–0.3)	(2–4)	(0.13–0.28)	(3–6)	(0.13–0.3)	(−0.2–0.38)	(2–5)	(0.12–0.32)	(3–7)	(0.13–0.33)	(−0.23–0.27)
Timor‐Leste	0.514	5	0.89	8	1.00	0.12	1	0.46	2	0.57	0.24	4	1.34	6	1.44	0.07	2.54
		(4–7)	(0.63–1.18)	(5–11)	(0.68–1.33)	(−0.09–0.37)	(1–2)	(0.31–0.68)	(1–3)	(0.38–0.78)	(−0.03–0.59)	(2–6)	(0.85–1.84)	(3–8)	(0.89–1.96)	(−0.15–0.32)
Low SDI
Afghanistan	0.343	92	0.90	118	0.89	−0.01	23	0.47	31	0.49	0.03	69	1.30	87	1.26	−0.03	2.60
		(57–133)	(0.6–1.27)	(75–173)	(0.62–1.24)	(−0.19–0.22)	(14–37)	(0.28–0.76)	(20–48)	(0.31–0.72)	(−0.19–0.33)	(35–108)	(0.74–1.99)	(46–137)	(0.76–1.88)	(−0.22–0.23)
Nepal	0.422	103	0.60	154	0.70	0.17	33	0.40	54	0.53	0.30	70	0.79	101	0.86	0.09	1.63
		(83–132)	(0.49–0.75)	(117–207)	(0.53–0.93)	(−0.07–0.42)	(22–45)	(0.26–0.55)	(33–79)	(0.32–0.78)	(−0.05–0.67)	(56–95)	(0.63–1.04)	(75–137)	(0.64–1.16)	(−0.14–0.36)
Pakistan	0.449	1030	1.12	1317	1.08	−0.03	419	0.91	542	0.90	−0.01	610	1.34	775	1.28	−0.05	1.42
		(869–1214)	(0.95–1.31)	(1077–1610)	(0.9–1.32)	(−0.21–0.2)	(325–523)	(0.7–1.14)	(388–723)	(0.65–1.19)	(−0.28–0.36)	(473–756)	(1.07–1.66)	(569–1043)	(0.96–1.69)	(−0.28–0.3)
Yemen	0.412	49	0.51	72	0.54	0.06	16	0.32	23	0.35	0.07	33	0.69	49	0.73	0.05	2.08
		(36–65)	(0.38–0.69)	(52–97)	(0.4–0.73)	(−0.12–0.3)	(11–23)	(0.23–0.48)	(15–36)	(0.23–0.53)	(−0.17–0.37)	(23–46)	(0.5–0.97)	(33–68)	(0.51–1.01)	(−0.15–0.33)

3.2.5. National comparison

Among Asian countries, 32 countries experienced a decreasing trend in the ThC death rate between 2010 and 2019; the greatest increase was detected in Armenia (increase in ASDR = 0.65 (95% CI: 0.27–0.97)) and the greatest decrease was detected in the Republic of Korea (decrease in ASDR = −0.43 (95% CI: −0.51 to −0.12)).

In 2019, the highest ASDR (per 100,000) of ThC was reported in Philippines (1.34), Vietnam (1.34), and Cambodia (1.33). The lowest ASDR of ThC was reported in the Syrian Arab Republic (0.18), Tajikistan (0.24), and Uzbekistan (0.31).

Among Asian men, the highest ASDR (per 100,000) of ThC was reported in Vietnam (1.23), Maldives (1.12), Pakistan (0.90), the Philippines (0.90), and Brunei Darussalam (0.90). The lowest ASDR of ThC was reported in the Syrian Arab Republic (0.17), Tajikistan (0.23), Kyrgyzstan (0.25), and Uzbekistan (0.27).

Among Asian women, the highest ASDR (per 100,000) of ThC was reported in the Philippines (1.69), Cambodia (1.69), Brunei Darussalam (1.53), and Lao People's Democratic Republic (1.50). The lowest ASDR of ThC was reported in the Syrian Arab Republic (0.20), Tajikistan (0.25), China (0.30), and Uzbekistan (0.34). Results in detail are presented in Table 6.

3.2.6. Male/female ratio

In 2019, the ASDR of ThC in the United Arab Emirates, Lebanon, China, and Maldives were reported to be higher in men than in women. In other countries, the incidence of ThC in women was higher than in men. The highest ratio was reported in Bahrain (2.72‐fold) and the lowest ratio was recorded in Maldives (0.51‐fold), while in 2010, the ASDR of ThC in China and Maldives were reported to be higher in men than in women. In other countries, the incidence of ThC in women was higher than in men; the highest ratio was reported in Qatar (2.95‐fold) and the lowest ratio was recorded in Maldives (0.58‐fold). Results in detail are presented in Table 6 and Figure 3.

3.3. Prevalence of THC in Asia

3.3.1. Compared with global data and continents

In Asia, the number of cases who lived with ThC increased from 759,981 (95% CI: 640,546–805,950) in 2010 to 982,341 (95% CI: 857,344–1,082,418) in 2019, which is a 1.3‐fold increase. In 2019, more than 53% (982,341/1,831,760) of ThC prevalence happened in Asian countries. During this period, the ASPR of ThC with an 8% change, increased from 17.94 (95% CI: 15.12–18.98) per 100,000 in 2010 to 19.42 (95% CI: 16.93–21.38) per 100,000 in 2019. Also, at the same time, this rate globally increased by 3% and Africa by 23%. This rate decreased by 1% in America and 2% in Europe (Figure 4 and Table 1).

In Asian men, the number of ThC prevalence increased from 205,125 (95% CI: 169,386–221,225) in 2010 to 285,342 (95% CI: 239,841–324,527) in 2019, which is over a 1.39‐fold increase. In 2019, approximately 29% (285,342/982,341) of patients who lived with ThC in Asia were men, which included 50.7% (285,342/562,741) of global male ThC prevalence cases. During this period, the ASPR of THC had a 16% change, increasing from 9.67 (95% CI: 7.98–10.41) per 100,000 in 2010 to 11.18 (95% CI: 9.42–12.69) per 100,000 in 2019; in the same time, this rate globally increased by 7%, in Africa by 34%, in America by 3%, and in Europe and by 1% (Table 4).

In Asian women, the number of ThC prevalence increased from 554,856 (95% CI: 447,358–595,190) in 2010 to 696,999 (95% CI: 582,544–783,841) in 2019, which is over a 1.25‐fold increase. In 2019, approximately 71% (696,999/982,341) of patients who lived with ThC in Asia were women, which included 54.9% (696,999/1,269,019) of global female ThC prevalence cases. During this period, the ASPR of ThC had a 5% change, increasing from 26.34 (95% CI: 21.31–28.20) per 100,000 in 2010 to 27.77 (95% CI: 23.15–31.19) per 100,000 in 2019; at the same time, this rate globally increased by 1% and in Africa by 19%. This rate decreased in America by 3% and in Europe by 4% (Table 5).

3.3.2. Age distribution

In 2019, age‐specific prevalence cases of ThC were peaking at 55 to 59 years generally and in males, and 60 to 64 in females. In all age groups, the prevalence cases of ThC in females were higher than in males (Figure 7). In 2019, there were 74,272 ThC patients aged ≥70 living in Asia, accounting for 7.56% of all ThC cases of all ages. This rate was 7.2% in men and 7.71% in women. Meanwhile, in the world, 184,567 patients ≥70 years lived with ThC, which includes 10.08% of ThC cases in all ages. This rate was 9.84% in men and 10.18% in women. Overall, 40.24% of ThC patients aged ≥70 years lived in Asia (Table 2).

FIGURE 7.

Age‐specific prevalence cases of ThC cancer among genders in Asia, 2019.

3.3.3. Within Asian regions

In 2019, the highest ASPR of ThC was observed in high‐income Asia Pacific countries (42.29 (95% CI: 35.62–49.33)), with a 35% decrease compared with 2010, while all Asian regions experienced an increasing trend of 18% (Southeast Asia and East Asia) and 27% (Central Asia and North Africa and the Middle East) (Figure 6).

In men, the highest ASPR of ThC was observed in high‐income Asia Pacific countries (22.20 (95% CI: 17.78–26.90)), with a 31% decrease compared with 2010, while all Asian regions experienced an increasing trend of 29% (East Asia) and 42% (North Africa and the Middle East).

In women, the highest ASPR of ThC was observed in high‐income Asia Pacific countries (62.48 (95% CI: 50.50–74.44)), with a 35% decrease compared with 2010, while all Asian regions experienced an increasing trend of 13% (East Asia) and 25% (Central Asia) (Figure 6).

3.3.4. Based on SDI

Among high SDI Asian countries, the Republic of Korea (57.73) and Saudi Arabia (50.55) have the highest ASPR of ThC, and Qatar (22.54) has the lowest rate. In this group, four countries experienced an upward trend from 5% to 38%, and seven countries reported a downward trend from 1% to 55% from 2010 to 2019.

Among high‐middle SDI Asian countries, Lebanon (68.50) had the highest ASPR of ThC, and Georgia (18.91) had the lowest rate. In this group, Bahrain and Oman had a downward trend of 7% and 13%, respectively. Other countries reported an upward trend from 5% (Turkey) to 35% (Sri Lanka).

Among middle SDI Asian countries, Vietnam (57.61) has the highest ASPR of ThC, and Uzbekistan (6.26) has the lowest rate. In this group, all countries experienced an upward trend from 11% (Indonesia) to 87% (Armenia) except Thailand, which reported a downward trend of 1% from 2010 to 2019.

Among low‐middle SDI Asian countries, Palestine (26.33) has the highest ASPR of ThC, and Tajikistan (2.51) has the lowest rate. In this group, all countries reported an upward trend from 1% (Democratic People's Republic of Korea) to 59% (Palestine). Among low SDI Asian countries, Pakistan (19.41) has the highest ASPR of ThC, and Nepal (12.17) has the lowest rate. In this group, all countries experienced an upward trend of 19% (Afghanistan) to 42% (Nepal). More details are presented in Table 7.

TABLE 7.

The prevalence distribution of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019, by geographical region and SDI.

Location	SDI 2019	Both					Male					Female					F/M Ratio
		2010		2019		% change 1990–2010	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
High SDI
Brunei Darussalam	0.823	119	35.34	165	37.47	0.06	20	11.94	30	13.32	0.12	99	59.01	136	62.57	0.06	4.70
		(97–143)	(28.98–41.66)	(129–208)	(29.58–46.51)	(−0.15–0.32)	(16–25)	(9.69–14.47)	(23–39)	(10.17–17.07)	(−0.17–0.48)	(79–122)	(47.57–71.43)	(101–178)	(47.61–80.67)	(−0.18–0.38)
Cyprus	0.841	408	29.37	452	25.61	−0.13	166	24.75	193	23.39	−0.05	242	33.75	258	27.87	−0.17	1.19
		(335–468)	(24.17–33.6)	(365–562)	(20.71–32.17)	(−0.28–0.05)	(126–204)	(18.76–30.38)	(138–256)	(16.6–31.01)	(−0.29–0.26)	(198–291)	(27.81–40.5)	(198–353)	(21.43–38.66)	(−0.37–0.08)
Israel	0.803	2991	36.86	3436	34.09	−0.08	1038	26.72	1223	25.31	−0.05	1954	46.07	2213	42.23	−0.08	1.67
		(2636–3365)	(32.52–41.32)	(2567–4494)	(25.39–44.64)	(−0.31–0.22)	(829–1218)	(21.41–31.34)	(871–1672)	(18.08–34.57)	(−0.33–0.31)	(1663–2264)	(39.22–53.52)	(1640–2947)	(31.12–56.46)	(−0.33–0.24)
Japan	0.87	83,303	39.67	76,771	35.51	−0.10	22,059	21.63	21,079	19.94	−0.08	61,244	57.14	55,691	50.82	−0.11	2.55
		(76,730–89,153)	(36.95–42.52)	(63,058–92,419)	(29.33–42.99)	(−0.25–0.09)	(19,533–24,580)	(19.24–24.18)	(15,911–27,535)	(15.37–25.98)	(−0.29–0.19)	(55,920–66,394)	(52.55–62.13)	(44,003–69,105)	(40.07–63.6)	(−0.29–0.12)
Kuwait	0.851	748	31.56	1306	31.25	−0.01	203	13.74	461	19.24	0.40	545	60.60	845	47.85	−0.21	2.49
		(652–849)	(27.9–35.52)	(1037–1644)	(25.29–38.88)	(−0.2–0.22)	(167–243)	(11.51–16.18)	(338–621)	(14.46–25.61)	(0.04–0.85)	(459–649)	(51.86–70.32)	(626–1155)	(37.09–62.89)	(−0.39–0.03)
Qatar	0.83	301	25.31	525	22.54	−0.11	148	13.60	255	13.01	−0.04	153	59.35	270	52.52	−0.12	4.04
		(236–385)	(20.42–30.82)	(367–757)	(16.34–30.84)	(−0.32–0.18)	(105–204)	(9.58–18.62)	(165–365)	(8.55–18.42)	(−0.37–0.37)	(112–209)	(45.45–76.97)	(177–441)	(36.54–77.33)	(−0.37–0.24)
Republic of Korea	0.878	80,876	126.93	44,075	57.73	−0.55	19,447	59.56	10,884	27.33	−0.54	61,428	193.40	33,191	89.36	−0.54	3.27
		(24,303–95,538)	(37.62–150.47)	(29,771–56,704)	(37.52–74.76)	(−0.66–0)	(5872–23,746)	(18.71–71.94)	(7186–14,581)	(17.89–36.28)	(−0.66–0.03)	(18,340–75,067)	(55.06–238.07)	(21,750–44,233)	(54.62–119.68)	(−0.67–0.14)
Saudi Arabia	0.805	9068	36.64	20,142	50.55	0.38	2303	15.79	6183	25.84	0.64	6765	68.09	13,959	88.58	0.30	3.43
		(6563–11,335)	(28.82–44.17)	(13,443–28,317)	(36.23–67.54)	(0.02–0.81)	(1784–2973)	(12.45–20.07)	(4272–9232)	(18.43–35.92)	(0.19–1.22)	(4161–8664)	(49.04–84.9)	(7901–20,675)	(58.17–125.03)	(−0.07–0.77)
Singapore	0.861	2216	36.67	2537	31.55	−0.14	481	15.91	619	15.38	−0.03	1735	59.04	1918	49.27	−0.17	3.20
		(1920–2526)	(32.06–41.48)	(1912–3263)	(23.94–40.48)	(−0.34–0.11)	(402–574)	(13.33–19.01)	(460–862)	(11.51–21.2)	(−0.27–0.29)	(1466–2020)	(50.22–68.26)	(1417–2510)	(36.47–64.46)	(−0.37–0.1)
Taiwan (Province of China)	0.868	12,132	40.19	14,466	42.24	0.05	3668	24.21	4682	27.28	0.13	8464	55.86	9784	56.76	0.02	2.08
		(10,779–13,697)	(35.93–45.21)	(10,800–19,758)	(31.3–57.91)	(−0.23–0.44)	(3065–4347)	(20.5–28.33)	(3360–6526)	(19.84–37.53)	(−0.19–0.55)	(7286–9896)	(48.44–64.79)	(7085–13,437)	(40.84–78.99)	(−0.27–0.43)
United Arab Emirates	0.88	1653	24.78	3898	29.94	0.21	1181	19.08	2733	26.23	0.37	472	37.43	1165	40.83	0.09	1.56
		(986–2369)	(13.91–36.51)	(1996–6221)	(16.08–45.83)	(−0.11–0.63)	(608–1798)	(10.21–28.77)	(1280–4566)	(12.69–42.64)	(−0.03–0.95)	(318–673)	(20.11–57.52)	(604–1849)	(21.06–63.92)	(−0.2–0.57)
High‐middle SDI
Bahrain	0.751	236	27.73	387	25.92	−0.07	61	9.77	115	10.46	0.07	175	52.91	272	51.73	−0.02	4.94
		(188–283)	(19.19–33.12)	(291–499)	(19.39–33.27)	(−0.27–0.24)	(49–78)	(7.48–12.24)	(79–161)	(7.37–14.11)	(−0.24–0.48)	(129–218)	(35.28–65.52)	(195–373)	(36.98–67.55)	(−0.25–0.31)
Georgia	0.702	740	15.18	906	18.91	0.25	128	5.73	181	8.17	0.43	612	23.34	724	28.44	0.22	3.48
		(629–854)	(13–17.43)	(702–1115)	(14.49–23.27)	(−0.03–0.56)	(101–156)	(4.57–7.01)	(113–234)	(5.24–10.44)	(0.02–0.85)	(509–723)	(19.49–27.56)	(556–904)	(21.98–35.53)	(−0.07–0.57)
Jordan	0.731	1353	26.11	2750	29.21	0.12	310	11.41	769	14.46	0.27	1043	42.00	1982	46.20	0.10	3.19
		(1112–1653)	(21.54–31.75)	(2123–3579)	(22.66–38.04)	(−0.11–0.4)	(243–382)	(8.92–14.1)	(554–1043)	(10.54–19.51)	(−0.08–0.73)	(818–1329)	(33.13–53.18)	(1404–2789)	(33.18–64.57)	(−0.17–0.47)
Kazakhstan	0.723	3132	18.61	4690	23.60	0.27	641	8.10	949	10.17	0.26	2491	27.53	3742	35.25	0.28	3.46
		(2803–3504)	(16.74–20.73)	(3854–5711)	(19.37–28.71)	(0.04–0.58)	(542–773)	(6.87–9.78)	(736–1267)	(7.93–13.51)	(−0.02–0.66)	(2170–2829)	(24.13–31.13)	(3035–4606)	(28.58–43.44)	(0.02–0.6)
Lebanon	0.708	2206	52.94	3727	68.50	0.29	522	26.73	1019	40.26	0.51	1684	76.12	2708	93.81	0.23	2.33
		(1713–2776)	(41.22–66.77)	(2593–5084)	(48.1–93.3)	(−0.03–0.66)	(393–676)	(20.3–34.33)	(693–1370)	(27.55–53.79)	(0.11–1.02)	(1214–2217)	(54.89–100.68)	(1767–3910)	(61.51–136.48)	(−0.11–0.66)
Malaysia	0.737	6868	26.60	11,091	34.64	0.30	1560	11.88	2889	17.67	0.49	5308	42.02	8202	52.72	0.25	2.98
		(5928–8086)	(23.06–31.21)	(8112–14,685)	(25.42–45.81)	(−0.03–0.73)	(1274–1923)	(9.73–14.65)	(2060–3931)	(12.61–24.07)	(0.07–1.02)	(4418–6407)	(35.14–50.65)	(5776–11,152)	(37.37–72.03)	(−0.09–0.74)
Oman	0.783	636	30.46	984	26.47	−0.13	180	13.68	322	12.35	−0.10	457	55.72	662	50.81	−0.09	4.12
		(457–754)	(23.08–35.47)	(721–1300)	(20.14–32.74)	(−0.29–0.09)	(138–218)	(11.11–16.44)	(214–475)	(8.68–16.95)	(−0.35–0.27)	(296–566)	(37.76–67.52)	(425–911)	(35.73–67.23)	(−0.3–0.23)
Sri Lanka	0.69	4513	20.34	7099	27.54	0.35	1120	10.66	1831	15.03	0.41	3394	29.14	5268	38.80	0.33	2.58
		(3877–5548)	(17.47–25.09)	(4928–10,294)	(19.14–39.71)	(−0.05–0.91)	(908–1395)	(8.73–13.15)	(1212–2610)	(10.04–21.33)	(−0.06–1.01)	(2796–4422)	(24.11–38.02)	(3585–7785)	(26.51–57.1)	(−0.08–0.94)
Turkey	0.748	20,738	27.56	27,170	29.04	0.05	6163	16.26	9131	19.38	0.19	14,575	38.31	18,039	38.20	0.00	1.97
		(17,083–24,773)	(22.74–32.69)	(20,659–35,897)	(22.18–38.23)	(−0.22–0.41)	(4977–7681)	(13.14–20.19)	(6728–12,900)	(14.28–27.23)	(−0.16–0.64)	(11,456–17,715)	(30.13–46.46)	(13,388–24,219)	(28.4–51.14)	(−0.28–0.38)
Middle SDI
Armenia	0.689	321	9.06	658	16.98	0.87	88	5.49	174	9.97	0.82	233	12.02	484	22.84	0.90	2.29
		(283–398)	(8.06–11.15)	(531–800)	(13.76–20.58)	(0.46–1.35)	(73–151)	(4.57–9.09)	(135–220)	(7.87–12.52)	(0.18–1.37)	(203–268)	(10.47–13.83)	(387–599)	(18.29–28.19)	(0.43–1.43)
Azerbaijan	0.683	1077	11.28	1531	12.96	0.15	220	4.76	353	6.15	0.29	857	17.24	1179	19.26	0.12	3.13
		(877–1309)	(9.32–13.64)	(1175–1979)	(9.92–16.63)	(−0.1–0.48)	(167–284)	(3.7–6.09)	(236–487)	(4.14–8.52)	(−0.08–0.75)	(665–1086)	(13.68–21.83)	(845–1591)	(14–25.66)	(−0.18–0.51)
China	0.686	228,906	13.51	310,328	16.17	0.20	80,801	9.41	118,423	12.22	0.30	148,106	17.77	191,904	20.21	0.14	1.65
		(204,094–262,191)	(12.05–15.43)	(255,041–382,138)	(13.28–19.83)	(−0.02–0.45)	(68,490–92,183)	(8.02–10.72)	(89,065–149,034)	(9.29–15.34)	(0–0.68)	(127,562–178,960)	(15.29–21.35)	(145,570–253,044)	(15.32–26.45)	(−0.14–0.48)
Indonesia	0.66	35,011	15.27	47,136	16.93	0.11	6747	6.05	10,604	7.75	0.28	28,264	24.47	36,532	26.12	0.07	3.37
		(22,706–42,901)	(9.95–18.62)	(31,955–60,457)	(11.57–21.58)	(−0.14–0.47)	(5129–8258)	(4.59–7.37)	(7512–14,621)	(5.51–10.59)	(−0.06–0.76)	(16,421–35,824)	(14.2–30.78)	(21,901–49,115)	(15.71–35.07)	(−0.21–0.51)
Iran (Islamic Republic of)	0.67	14,839	20.61	27,337	30.19	0.46	3926	10.75	7875	17.03	0.58	10,913	30.53	19,462	43.43	0.42	2.55
		(10,198–16,496)	(14.23–22.97)	(16,709–31,333)	(18.75–34.55)	(0.27–0.64)	(2876–4520)	(8.05–12.32)	(5156–9410)	(11.25–20.26)	(0.3–0.89)	(7365–12,430)	(20.69–34.73)	(11,236–23,044)	(25.73–51.01)	(0.18–0.64)
Iraq	0.671	5726	23.18	10,904	32.60	0.41	1380	11.19	2928	17.32	0.55	4346	35.57	7976	48.33	0.36	2.79
		(4147–7751)	(16.94–31.38)	(7428–15,294)	(22.45–45.18)	(0.05–0.87)	(989–1901)	(7.96–15.52)	(1953–4182)	(11.82–24.13)	(0.1–1.19)	(2993–6172)	(24.61–50.82)	(5088–11,693)	(31.49–68.98)	(−0.03–0.87)
Philippines	0.623	20,333	25.39	29,778	29.61	0.17	4172	10.60	6615	13.29	0.25	16,161	40.05	23,163	45.97	0.15	3.46
		(17,328–23,408)	(21.55–29.28)	(22,714–39,024)	(22.63–38.56)	(−0.11–0.52)	(3403–5012)	(8.64–12.68)	(4667–8845)	(9.32–17.82)	(−0.12–0.75)	(13,215–19,115)	(32.74–47.35)	(16,523–32,079)	(32.84–63.47)	(−0.16–0.59)
Syrian Arab Republic	0.619	1034	6.66	1139	7.63	0.15	345	4.26	381	5.06	0.19	690	9.24	757	10.13	0.10	2.00
		(742–1290)	(4.46–8.39)	(733–1576)	(4.95–10.56)	(−0.16–0.52)	(250–454)	(2.94–5.66)	(245–553)	(3.32–7.24)	(−0.18–0.72)	(465–895)	(5.63–12.11)	(449–1061)	(5.96–14.06)	(−0.21–0.5)
Thailand	0.687	17,508	21.38	20,577	21.14	−0.01	4472	11.30	5944	12.83	0.14	13,036	30.75	14,634	28.84	−0.06	2.25
		(13,893–27,201)	(17.14–32.59)	(13,389–36,196)	(13.94–37.43)	(−0.33–0.4)	(3470–6054)	(8.76–15.31)	(3917–9622)	(8.63–21.08)	(−0.24–0.69)	(10,032–21,892)	(23.76–50.67)	(9177–28,105)	(18.04–56.81)	(−0.4–0.36)
Turkmenistan	0.67	389	9.35	635	12.59	0.35	107	5.10	188	7.34	0.44	282	13.30	447	17.61	0.32	2.40
		(348–435)	(8.43–10.41)	(488–824)	(9.71–16.32)	(0.04–0.77)	(87–128)	(4.18–6.06)	(139–246)	(5.47–9.61)	(0.08–0.89)	(247–322)	(11.73–15.09)	(339–588)	(13.34–23.15)	(0.01–0.77)
Uzbekistan	0.631	890	3.92	1911	6.26	0.60	244	2.15	508	3.43	0.60	646	5.51	1402	8.79	0.60	2.57
		(799–1004)	(3.53–4.38)	(1534–2330)	(5.03–7.65)	(0.26–0.99)	(203–291)	(1.78–2.56)	(384–639)	(2.54–4.31)	(0.21–1.08)	(558–748)	(4.81–6.32)	(1094–1738)	(6.94–10.84)	(0.22–1.03)
Vietnam	0.617	42,287	46.42	64,088	57.61	0.24	10,065	23.76	16,543	30.94	0.30	32,222	67.91	47,545	83.48	0.23	2.70
		(23,507–56,042)	(27.31–60.81)	(38,833–87,569)	(35.62–77.76)	(−0.06–0.64)	(5609–13,667)	(14.38–31.61)	(9828–23,789)	(18.97–43.49)	(−0.05–0.76)	(16,521–44,547)	(36.38–92.91)	(25,548–66,947)	(45.23–116.31)	(−0.1–0.66)
Low‐middle SDI
Bangladesh	0.483	10,582	8.08	17,036	10.74	0.33	1984	3.14	3184	4.19	0.33	8598	13.15	13,852	17.02	0.29	4.07
		(7607–15,478)	(5.99–11.46)	(11,359–25,991)	(7.25–16.19)	(0–0.79)	(1338–2898)	(2.14–4.53)	(2117–4996)	(2.78–6.51)	(−0.04–0.83)	(5822–13,468)	(9.22–19.61)	(8655–22,397)	(10.87–27.25)	(−0.06–0.8)
Bhutan	0.455	68	10.59	104	13.97	0.32	14	4.24	23	5.98	0.41	54	17.98	82	22.86	0.27	3.82
		(45–99)	(7.25–15.11)	(65–159)	(9.08–20.68)	(−0.02–0.76)	(9–21)	(2.61–6.42)	(13–36)	(3.42–9.57)	(−0.02–0.92)	(33–80)	(11.4–26.6)	(48–132)	(13.97–35.73)	(−0.08–0.75)
Cambodia	0.469	1977	17.09	3474	23.33	0.37	301	5.80	573	8.43	0.46	1676	26.25	2901	36.12	0.38	4.28
		(1186–2710)	(10.18–23.31)	(2075–4924)	(13.94–32.81)	(0.05–0.81)	(209–422)	(4.02–8.17)	(396–784)	(5.82–11.37)	(0.06–0.99)	(928–2362)	(14.71–36.76)	(1606–4192)	(20.01–52.12)	(0.03–0.87)
Democratic People's Republic of Korea	0.558	5250	18.14	5900	18.38	0.01	1119	8.20	1482	8.98	0.09	4130	27.80	4419	28.24	0.02	3.14
		(3608–7563)	(12.55–25.97)	(4056–8544)	(12.54–26.97)	(−0.24–0.35)	(713–1777)	(5.26–12.93)	(923–2287)	(5.66–13.83)	(−0.2–0.5)	(2644–6319)	(17.63–42.25)	(2815–6826)	(17.99–44.66)	(−0.27–0.43)
India	0.566	113,286	9.78	169,543	12.14	0.24	23,802	4.19	37,508	5.41	0.29	89,483	15.61	132,035	19.11	0.22	3.53
		(93,562–127,781)	(8.1–11)	(136,587–205,896)	(9.79–14.74)	(0.02–0.51)	(20,423–26,877)	(3.6–4.72)	(29,944–45,585)	(4.33–6.6)	(0.03–0.61)	(69,006–103,229)	(12.1–17.96)	(99,160–167,160)	(14.36–24.16)	(−0.03–0.56)
Kyrgyzstan	0.596	456	9.76	654	11.18	0.14	76	3.24	119	4.11	0.27	380	15.53	536	17.42	0.12	4.23
		(397–521)	(8.55–11.09)	(526–798)	(9.05–13.56)	(−0.08–0.43)	(63–92)	(2.68–3.91)	(92–151)	(3.21–5.2)	(−0.02–0.63)	(325–445)	(13.31–18.13)	(423–671)	(13.85–21.74)	(−0.13–0.43)
Lao People's Democratic Republic	0.49	608	12.74	952	15.56	0.22	101	4.31	170	5.68	0.32	507	20.99	782	25.32	0.21	4.46
		(351–870)	(7.35–18.01)	(559–1416)	(9.29–22.83)	(−0.07–0.6)	(65–143)	(2.8–6.06)	(110–241)	(3.81–8.08)	(−0.04–0.87)	(256–749)	(10.67–30.73)	(414–1201)	(13.29–38.03)	(−0.11–0.65)
Maldives	0.562	52	19.65	103	23.32	0.19	26	19.02	62	24.26	0.28	26	20.33	41	22.56	0.11	0.93
		(44–60)	(16.89–22.97)	(80–135)	(18.53–29.4)	(−0.04–0.48)	(21–33)	(15.26–24.03)	(47–88)	(18.38–31.96)	(−0.04–0.68)	(21–32)	(16.35–24.87)	(30–55)	(16.9–29.3)	(−0.16–0.43)
Mongolia	0.606	167	8.03	281	9.07	0.13	57	4.96	97	5.99	0.21	111	10.60	184	11.47	0.08	1.92
		(109–214)	(4.35–10.61)	(166–388)	(4.92–12.68)	(−0.17–0.54)	(29–79)	(2.3–6.9)	(51–142)	(2.97–8.69)	(−0.16–0.74)	(67–146)	(5.2–14.17)	(106–269)	(5.94–16.55)	(−0.23–0.51)
Myanmar	0.521	6774	14.44	9942	17.84	0.24	1119	5.17	1844	7.23	0.40	5654	22.64	8098	26.98	0.19	3.73
		(4192–9188)	(9.04–19.43)	(6626–13,643)	(11.95–24.42)	(−0.1–0.67)	(737–1556)	(3.51–7.18)	(1260–2609)	(4.98–10.15)	(−0.02–1)	(3145–7906)	(12.65–31.37)	(4914–11,395)	(16.41–37.86)	(−0.15–0.69)
Palestine	0.588	414	16.51	922	26.33	0.59	76	5.93	150	8.59	0.45	339	26.54	771	44.19	0.66	5.15
		(344–492)	(13.85–19.5)	(636–1173)	(18.46–32.91)	(0.18–1.04)	(60–93)	(4.69–7.37)	(115–191)	(6.54–11.02)	(0.09–0.92)	(272–414)	(21.59–31.82)	(503–1010)	(29.19–56.37)	(0.15–1.22)
Tajikistan	0.539	115	2.16	188	2.51	0.16	36	1.30	59	1.55	0.19	80	3.02	129	3.43	0.13	2.21
		(97–137)	(1.77–2.6)	(147–242)	(1.95–3.21)	(−0.11–0.5)	(28–44)	(0.98–1.64)	(43–77)	(1.11–2.06)	(−0.14–0.64)	(64–98)	(2.38–3.73)	(98–170)	(2.59–4.48)	(−0.15–0.51)
Timor‐Leste	0.514	75	9.87	136	14.33	0.45	12	3.01	23	4.78	0.59	63	17.02	113	24.29	0.43	5.08
		(38–107)	(5.23–14.03)	(75–197)	(8.19–20.65)	(0.06–1.07)	(6–19)	(1.45–4.75)	(12–35)	(2.59–7.16)	(0.15–1.4)	(32–92)	(8.85–24.76)	(60–168)	(12.92–35.99)	(0.03–1.08)
Low SDI
Afghanistan	0.343	1924	11.53	3253	13.74	0.19	246	2.93	472	3.84	0.31	1678	19.70	2781	23.72	0.20	6.17
		(793–3380)	(5.1–19.41)	(1487–5607)	(6.66–23.08)	(−0.1–0.6)	(140–433)	(1.65–5.08)	(281–779)	(2.31–6.34)	(−0.04–0.85)	(586–3057)	(7.44–34.68)	(1077–5042)	(9.72–41.39)	(−0.1–0.63)
Nepal	0.422	2031	8.60	3423	12.17	0.42	286	2.63	526	4.19	0.59	1745	14.06	2896	18.87	0.34	4.51
		(1446–2921)	(6.24–12.18)	(2327–4897)	(8.24–17.14)	(0.05–0.93)	(172–427)	(1.59–3.87)	(310–806)	(2.48–6.4)	(0.14–1.23)	(1205–2569)	(9.91–20.64)	(1923–4306)	(12.51–27.7)	(−0.03–0.86)
Pakistan	0.449	21,988	15.36	36,361	19.41	0.26	4563	6.53	7734	8.51	0.30	17,425	24.68	28,626	30.68	0.24	3.60
		(16,616–28,109)	(11.84–19.39)	(25,890–50,429)	(14.17–26.2)	(−0.1–0.76)	(3359–6032)	(4.86–8.6)	(5418–11,109)	(5.94–12.17)	(−0.12–0.92)	(12,163–23,458)	(17.52–32.6)	(18,610–43,193)	(20.43–45.46)	(−0.18–0.89)
Yemen	0.412	1638	10.92	2806	13.26	0.21	301	3.87	511	4.71	0.22	1337	18.04	2295	21.71	0.20	4.61
		(1019–2478)	(6.97–16.26)	(1699–4195)	(8.36–19.62)	(−0.1–0.61)	(190–469)	(2.45–6.03)	(315–816)	(2.87–7.47)	(−0.14–0.71)	(779–2137)	(11.02–27.83)	(1288–3605)	(12.85–33.28)	(−0.13–0.63)

3.3.5. National comparison

Among Asian countries, 10 countries experienced a decreasing trend in the ThC prevalence rate between 2010 and 2019; the greatest increase was detected in Armenia (increase in ASPR = 0.87 (95% CI: 0.46–1.35)) and the greatest decrease was detected in the Republic of Korea (decrease in ASPR = −0.55 (95% CI: −0.66–0.00)) (Figure 2).

In 2019, the highest ASPR (per 100,000) of ThC was reported in Lebanon (68.50), the Republic of Korea (57.73), Vietnam (57.61), and Saudi Arabia (50.55). The lowest ASPR of ThC was reported in Tajikistan (2.51), Uzbekistan (6.26), the Syrian Arab Republic (7.63), and Mongolia (9.07).

In Asian men, the highest ASPR (per 100,000) of ThC was reported in Lebanon (40.26), Vietnam (30.94), the Republic of Korea (27.33), and Taiwan (Province of China) (27.28). The lowest ASPR (per 100,000) of ThC was reported in Tajikistan (1.55), Uzbekistan (3.43), and Afghanistan (3.84).

In women, the highest ASPR (per 100,000) of ThC was reported in Lebanon (93.81), Republic of Korea (89.36), Saudi Arabia (88.58), and Vietnam (83.48) The lowest ASPR (per 100,000) of ThC was reported in Tajikistan (3.43), Uzbekistan (8.79), Syrian Arab Republic (10.13), and Mongolia (11.47). Results in detail are presented in Table 7.

3.3.6. Male/female ratio

In 2010, the ASPR of ThC in women was higher than in men in all countries, and in 2019, the ASPR of ThC in Maldives was reported to be higher in men than in women. In other countries, the prevalence of ThC in women was higher than in men. The highest ratio was reported in Afghanistan (6.17‐fold) and the lowest ratio was recorded in Maldives (0.93‐fold) (Figure 3).

3.4. Burden of THC in Asia

3.4.1. Comparison with global data and continents

In Asia, the number of ThC DALYs increased from 624,971 (95% CI: 545,913–666,046) in 2010 to 750,984 (95% CI: 665,083–819,813) in 2019, which is a 1.2‐fold increase. In 2019, approximately 61% (750,984/1,231,841) of ThC DALYs happened in Asian countries. During this period, the DALYs ASR of ThC had a 4% change, decreasing from 16.10 (95% CI: 14.08–17.12) per 100,000 in 2010 to 15.39 (95% CI: 13.60–16.79) per 100,000 in 2019. In the same period, this rate globally decreased by 4%, in Africa by 1%, in America by 2%, and in Europe by 10% (Figure 4 and Table 1).

In Asian men, the number of ThC DALYs increased from 256,437 (95% CI: 217,071–275,000) in 2010 to 316,821 (95% CI: 272,355–354,527) in 2019, which is over a 1.24‐fold increase. In 2019, approximately 42% (316,821/750,984) of ThC DALYs in Asia occurred in men, which included 62.14% (316,821/509,842) of global male ThC DALYs cases. During this period, the DALYs ASR of ThC had a 2% change, decreasing from 13.54 (95% CI: 11.49–14.46) per 100,000 in 2010 to 13.30 (95% CI: 11.41–14.88) per 100,000 in 2019. In the same period, this rate globally decreased by 2%, in Europe by 7%. This rate increased in Africa and America by 3% and 2%, respectively (Table 4).

In Asian women, the number of ThC DALYs increased from 368,534 (95% CI: 304,476–400,999) in 2010 to 434,163 (95% CI: 362,794–486,695) in 2019, which is approximately a 1.18‐fold increase. In 2019, more than 57% (434,163/750,984) of DALYs related to ThC in Asia were women, which included 60.13% (434,163/721,999) of global female ThC DALYs cases. During this period, the DALYs ASR of ThC had a 6% change, decreasing from 18.64 (95% CI: 15.61–20.23) per 100,000 in 2010 to 17.48 (95% CI: 14.65–19.64) per 100,000 in 2019. At the same time, this rate globally decreased by 6%, in American and African countries by 4%, and in European countries by 12% (Table 5).

3.4.2. Age distribution

In 2019, DALY cases of ThC were peaking at 75 to 79 generally and in females, and 85 years and higher in males. In all age groups, DALY cases of ThC in females were higher than in females, except in ages 80 to 84 years and 85 years and higher, which in males was higher (Figure 8). In 2019, 178,092 DALYs were attributed to ThC in Asians aged ≥70 years, accounting for 62.38% of the burden of ThC in all ages. This rate was 23.20% in men and 24.09% in women. Meanwhile, in the world, 318,786 DALY cases were diagnosed due to ThC in people ≥70 years old, which includes 25.88% of the burden caused by ThC in all ages. This rate was 24.36% in men and 26.95% in women. In general, 55.87% of the burden caused by ThC has been borne by the elderly ≥70 years (Table 2).

FIGURE 8.

Age‐specific DALYs cases of ThC cancer among genders in Asia, 2019.

3.4.3. Within Asian regions

In 2019, the highest DALYs ASR of ThC was observed in Southeast Asia countries (25.34 (95% CI: 21.37–28.88)), with a 4% decrease compared with 2010. Central Asia and North Africa and the Middle East experienced an increasing trend of 3% and 2%, respectively. Other regions recorded a decreasing trend of 1% (South Asia) to 31% (high‐income Asia Pacific) (Figure 6 and Table 1).

In men, the highest DALYs ASR of ThC was observed in Southeast Asia countries (18.99 (95% CI: 15.96–22.24)) with a 4% increase compared with 2010. Central Asia and North Africa and the Middle East had an increasing trend of 7% and 10%. South Asia had a stable trend. High‐income Asia Pacific countries and East Asia countries reported a decreasing trend of 31% and 2%, respectively (Table 4).

In women, the highest DALYs ASR of ThC was observed in Southeast Asia countries (30.87 (95% CI: 23.84–35.46)), with an 8% decrease compared with 2010. Central Asia had a stable trend and other regions recorded a decreasing trend of 2 (South Asia) to 12% (East Asia) (Table 5).

3.4.4. Based on SDI

In 2019, among high SDI Asian countries, Brunei Darussalam (26.03) and the United Arab Emirates (22.60) have the highest DALYs ASR of ThC, and Singapore (10.43) and Japan (10.96) have the lowest rate. In this group, all countries experienced a downward trend from 2% (Taiwan (Province of China)) to 52% (Republic of Korea) from 2010 to 2019. Among high‐middle SDI Asian countries, Malaysia (23.10) and Lebanon (20.19) have the highest DALYs ASR of ThC, and Oman (11.85) has the lowest rate. In this group, Malaysia had a stable trend. Five countries experienced a downward trend and three countries reported an upward trend from 2010 to 2019. In middle SDI Asian countries, Vietnam (36.32) and the Philippines (34.27) have the highest DALYs ASR of ThC, and the Syrian Arab Republic (4.62) and Uzbekistan (7.42) have the lowest rate. In this group, seven countries experienced an upward trend from 3% (Philippines) to 61% (Armenia), and Vietnam, Indonesia, and Azerbaijan reported a decreasing trend of 4%, China by 7%, and Thailand by 16% from 2010 to 2019.

Among low‐middle SDI Asian countries, Cambodia (32.50) has the highest ASPR of THC, and Tajikistan (5.35) has the lowest rate. In this group, eight countries reported a downward trend from 1% (India) to 10% (Mongolia), and five countries experienced an upward trend from 1% (Tajikistan) to 15% (Timor‐Leste and Palestine) from 2010 to 2019.

Among low SDI Asian countries, Pakistan (32.29) has the highest DALY ASR of ThC, and Yemen (14.19) has the lowest rate. In this group, Nepal and Yemen reported an increasing trend of 14% and 8%, and Pakistan and Afghanistan experienced a downward trend of 2% and 3%, respectively, from 2010 to 2019. More details are presented in Table 8.

TABLE 8.

The DALY distribution of thyroid cancer in Asian countries in 2010 and 2019 and the temporal trends between 2010 and 2019, by geographical region and SDI.

Location	SDI 2019	Both					Male					Female					F/M Ratio
		2010		2019		% change 1990–2010	2010		2019		% change 2010–2019	2010		2019		% change 2010–2019
		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000		Number	ASR per 1,000,000	Number	ASR per 1,000,000
High SDI
Brunei Darussalam	0.823	58	27.08	81	26.03	−0.04	18	17.38	25	17.43	0.00	40	35.78	56	34.02	−0.05	1.95
		(49–67)	(22.05–30.92)	(66–96)	(21.17–30.3)	(−0.18–0.11)	(15–21)	(14.59–20.13)	(20–32)	(14.17–21.21)	(−0.19–0.24)	(31–48)	(27.44–42.26)	(43–69)	(26.45–41.69)	(−0.21–0.13)
Cyprus	0.841	195	13.95	211	11.38	−0.18	88	13.53	99	11.36	−0.16	107	14.26	112	11.32	−0.21	1.00
		(157–220)	(11.32–15.62)	(173–252)	(9.38–13.59)	(−0.3 to −0.04)	(67–101)	(10.41–15.44)	(76–121)	(8.7–13.91)	(−0.31–0.02)	(81–125)	(11.04–16.75)	(88–139)	(8.97–14.08)	(−0.36 to −0.01)
Israel	0.803	1665	19.47	1826	16.65	−0.14	686	17.51	775	15.34	−0.12	979	20.99	1051	17.67	−0.16	1.15
		(1454–1811)	(17.01–21.21)	(1597–2064)	(14.51–18.81)	(−0.24 to −0.04)	(539–769)	(13.77–19.66)	(648–900)	(12.79–17.77)	(−0.24–0.02)	(863–1083)	(18.58–23.25)	(891–1226)	(14.99–20.67)	(−0.27 to −0.03)
Japan	0.87	33,764	12.50	34,347	10.96	−0.12	12,742	10.71	12,651	9.29	−0.13	21,022	13.99	21,697	12.37	−0.12	1.33
		(29,178–36,742)	(11.09–13.64)	(28,947–38,324)	(9.64–12.28)	(−0.17 to −0.06)	(11,084–13,590)	(9.49–11.44)	(10,750–14,165)	(8.18–10.51)	(−0.19 to −0.04)	(17,676–23,206)	(12.3–15.49)	(17,539–24,613)	(10.7–14.18)	(−0.17 to −0.04)
Kuwait	0.851	243	14.40	372	12.70	−0.12	102	9.79	193	11.30	0.15	141	22.07	179	14.78	−0.33	1.31
		(218–270)	(12.9–15.87)	(303–459)	(10.41–15.31)	(−0.26–0.06)	(89–116)	(8.51–11.1)	(146–249)	(8.63–14.44)	(−0.11–0.49)	(122–162)	(19.27–24.89)	(139–236)	(11.69–19.07)	(−0.46 to −0.16)
Qatar	0.83	91	15.36	137	11.47	−0.25	56	10.73	86	8.61	−0.20	34	27.62	52	20.50	−0.26	2.38
		(71–112)	(12.27–18.29)	(99–194)	(8.71–15.23)	(−0.41 to −0.03)	(40–74)	(7.41–13.92)	(56–123)	(5.84–12.04)	(−0.43–0.11)	(26–45)	(20.55–34.54)	(35–81)	(15.04–27.84)	(−0.45–0.06)
Republic of Korea	0.878	21,708	34.42	13,779	16.56	−0.52	8442	27.77	5065	12.69	−0.54	13,266	39.86	8714	19.92	−0.50	1.57
		(8014–25,086)	(12.96–39.75)	(9787–16,466)	(11.45–19.76)	(−0.59 to −0.12)	(3056–9637)	(10.76–31.45)	(3588–6223)	(9.06–15.36)	(−0.63 to −0.15)	(4991–15,930)	(14.57–48.25)	(5787–10,851)	(12.82–24.67)	(−0.6 to −0.02)
Saudi Arabia	0.805	3337	19.49	5380	18.92	−0.03	1365	14.16	2475	15.02	0.06	1972	27.20	2905	24.82	−0.09	1.65
		(2700–3966)	(16.71–22.2)	(3862–7281)	(14.49–24)	(−0.22–0.19)	(1130–1655)	(11.99–16.64)	(1801–3381)	(11.39–19.17)	(−0.17–0.33)	(1350–2456)	(21.97–32.35)	(1896–4176)	(18.01–32.91)	(−0.31–0.18)
Singapore	0.861	677	12.84	811	10.43	−0.19	240	9.37	314	8.27	−0.12	437	16.12	497	12.61	−0.22	1.52
		(604–764)	(11.54–14.33)	(693–964)	(8.95–12.38)	(−0.28 to −0.08)	(211–278)	(8.27–10.77)	(261–395)	(6.92–10.3)	(−0.25–0.04)	(379–497)	(13.98–18.21)	(411–590)	(10.45–14.97)	(−0.32 to −0.08)
Taiwan (Province of China)	0.868	4330	14.46	5301	14.22	−0.02	1808	12.23	2239	12.56	0.03	2522	16.58	3062	15.68	−0.05	1.25
		(3903–4716)	(13.07–15.75)	(4010–6962)	(10.86–18.68)	(−0.24–0.26)	(1595–2011)	(10.84–13.54)	(1649–2958)	(9.33–16.53)	(−0.23–0.35)	(2230–2826)	(14.7–18.51)	(2284–4018)	(11.62–20.74)	(−0.28–0.24)
United Arab Emirates	0.88	907	24.78	1873	22.60	−0.09	732	22.47	1531	24.00	0.07	174	28.58	343	18.71	−0.35	0.78
		(520–1303)	(12.92–36.04)	(966–2948)	(11.68–34.23)	(−0.31–0.19)	(386–1092)	(11.33–33.27)	(716–2473)	(11.72–37.34)	(−0.2–0.43)	(111–244)	(12.95–45.48)	(174–544)	(9.26–30)	(−0.5 to −0.05)
High‐middle SDI
Bahrain	0.751	99	19.40	142	14.63	−0.25	36	10.50	57	8.44	−0.20	63	29.42	85	23.00	−0.22	2.72
		(73–116)	(12.35–23.01)	(109–183)	(10.42–18.65)	(−0.4 to −0.04)	(29–44)	(8.23–12.46)	(41–78)	(6.16–11.06)	(−0.41–0.08)	(41–77)	(16.38–35.9)	(59–111)	(14.13–30.05)	(−0.39–0.03)
Georgia	0.702	706	13.01	825	15.42	0.19	224	9.62	295	12.66	0.32	482	15.74	530	17.72	0.13	1.40
		(626–780)	(11.5–14.38)	(635–991)	(11.96–18.55)	(−0.04–0.43)	(173–259)	(7.47–11.06)	(173–362)	(7.58–15.48)	(−0.04–0.63)	(416–543)	(13.55–17.9)	(421–643)	(13.81–21.56)	(−0.11–0.38)
Jordan	0.731	619	15.60	1084	14.39	−0.08	230	11.05	444	10.63	−0.04	390	20.56	640	18.54	−0.10	1.74
		(532–728)	(13.36–18.32)	(877–1371)	(11.71–18.22)	(−0.25–0.13)	(190–270)	(9.11–13.17)	(326–588)	(7.84–14.21)	(−0.28–0.26)	(315–483)	(16.72–25.45)	(470–866)	(13.71–24.97)	(−0.3–0.16)
Kazakhstan	0.723	2778	17.85	3031	16.32	−0.09	983	14.20	1051	12.69	−0.11	1796	20.46	1980	19.00	−0.07	1.50
		(2597–3019)	(16.7–19.44)	(2540–3620)	(13.77–19.41)	(−0.22–0.09)	(890–1137)	(12.93–16.8)	(843–1374)	(10.32–16.51)	(−0.27–0.12)	(1645–1976)	(18.73–22.52)	(1631–2391)	(15.74–22.93)	(−0.22–0.11)
Lebanon	0.708	798	18.98	1070	20.19	0.06	335	16.61	467	19.20	0.16	464	21.09	603	21.16	0.00	1.10
		(663–982)	(15.84–23.4)	(817–1377)	(15.5–25.89)	(−0.14–0.28)	(269–422)	(13.29–20.95)	(332–604)	(13.77–25.01)	(−0.08–0.42)	(365–596)	(16.64–27.18)	(441–844)	(15.43–29.61)	(−0.23–0.27)
Malaysia	0.737	4829	23.02	6583	23.10	0.00	1652	15.10	2520	17.26	0.14	3177	30.80	4063	29.00	−0.06	1.68
		(4314–5629)	(20.45–27.08)	(5087–8478)	(17.83–29.86)	(−0.21–0.26)	(1421–1965)	(12.91–17.93)	(1861–3351)	(12.68–22.87)	(−0.15–0.49)	(2738–3784)	(26.58–36.92)	(3018–5446)	(21.68–38.89)	(−0.28–0.22)
Oman	0.783	223	15.09	284	11.85	−0.21	95	11.05	129	8.93	−0.19	128	20.70	155	16.28	−0.21	1.82
		(173–254)	(12.4–16.94)	(216–359)	(9.68–14.02)	(−0.34 to −0.06)	(78–109)	(9.35–12.73)	(93–182)	(6.74–11.3)	(−0.38–0.04)	(87–153)	(14.93–24.36)	(107–204)	(12.08–20.28)	(−0.37 to −0.01)
Sri Lanka	0.69	3245	16.11	4189	16.20	0.01	1210	13.00	1539	13.10	0.01	2036	18.72	2650	18.73	0.00	1.43
		(2926–3853)	(14.57–19.27)	(3009–5766)	(11.67–22.22)	(−0.27–0.35)	(1041–1426)	(11.31–15.19)	(1040–2127)	(8.9–18.02)	(−0.31–0.36)	(1767–2527)	(16.31–23.74)	(1883–3765)	(13.37–26.47)	(−0.28–0.36)
Turkey	0.748	10,722	15.32	12,071	13.45	−0.12	4568	13.35	5526	12.61	−0.06	6154	16.93	6544	14.06	−0.17	1.12
		(9360–12,666)	(13.36–18.02)	(9272–16,054)	(10.35–17.88)	(−0.33–0.14)	(3886–5552)	(11.35–16.6)	(4158–8042)	(9.57–18.49)	(−0.3–0.27)	(5100–7361)	(14.03–20.24)	(4951–8494)	(10.66–18.19)	(−0.37–0.1)
Middle SDI
Armenia	0.689	327	8.97	578	14.43	0.61	141	8.99	242	14.03	0.56	186	8.87	336	14.62	0.65	1.04
		(301–426)	(8.3–11.6)	(479–688)	(11.99–17.07)	(0.2–0.94)	(124–217)	(7.94–13.47)	(198–292)	(11.37–16.82)	(−0.02–0.92)	(168–208)	(8.07–9.83)	(272–405)	(11.95–17.53)	(0.31–0.98)
Azerbaijan	0.683	1070	12.97	1300	12.47	−0.04	391	10.10	518	10.48	0.04	679	15.38	782	14.15	−0.08	1.35
		(918–1285)	(11.21–16.09)	(1033–1661)	(9.96–16.22)	(−0.2–0.16)	(319–485)	(8.21–12.64)	(359–705)	(7.42–13.99)	(−0.21–0.35)	(559–844)	(12.87–19.69)	(573–1048)	(10.57–18.95)	(−0.29–0.17)
China	0.686	160,968	10.37	187,319	9.70	−0.07	88,822	11.92	107,110	11.64	−0.02	72,146	9.21	80,208	8.11	−0.12	0.70
		(14,3708–178,093)	(9.27–11.43)	(156,236–219,112)	(8.11–11.27)	(−0.21–0.09)	(72,504–99,841)	(9.63–13.3)	(81,449–133,260)	(8.91–14.29)	(−0.22–0.2)	(63,840–87,579)	(8.18–11.1)	(64,737–99,491)	(6.55–10.07)	(−0.29–0.08)
Indonesia	0.66	45,923	24.89	55,359	23.79	−0.04	14,358	15.93	19,316	16.95	0.06	31,565	33.10	36,043	30.02	−0.09	1.77
		(32,903–53,740)	(17.99–28.73)	(40,142–67,329)	(17.49–28.57)	(−0.21–0.13)	(11,456–17,244)	(12.81–18.95)	(14,091–25,688)	(12.47–22.23)	(−0.19–0.36)	(18,835–38,661)	(20.04–40.14)	(22,173–46,237)	(18.54–37.95)	(−0.29–0.17)
Iran (Islamic Republic of)	0.67	6928	11.27	10,469	13.16	0.17	2851	9.15	4474	11.12	0.22	4076	13.43	5995	15.19	0.13	1.37
		(5232–7503)	(8.61–12.17)	(6928–11,742)	(8.93–14.62)	(0.01–0.26)	(2280–3050)	(7.59–9.73)	(3132–5029)	(7.97–12.44)	(0.04–0.34)	(2873–4529)	(9.71–14.89)	(3638–6924)	(9.52–17.42)	(−0.04–0.25)
Iraq	0.671	3386	16.90	5290	19.13	0.13	1371	14.10	2309	17.24	0.22	2015	19.76	2981	21.12	0.07	1.23
		(2583–4337)	(12.94–21.71)	(3807–6979)	(14.14–24.62)	(−0.11–0.42)	(1010–1804)	(10.42–18.35)	(1638–3082)	(12.46–22.32)	(−0.08–0.62)	(1466–2686)	(14.52–26.16)	(2047–4097)	(14.96–28.14)	(−0.2–0.41)
Philippines	0.623	21,800	33.39	29,535	34.27	0.03	7066	22.09	10,064	23.88	0.08	14,734	43.41	19,470	43.37	0.00	1.82
		(19,658–24,027)	(30.02–36.76)	(23,648–35,586)	(27.58–41.26)	(−0.17–0.23)	(6165–8033)	(19.28–25.28)	(7623–13,035)	(18.17–30.75)	(−0.19–0.4)	(12,727–16,763)	(37.67–49.51)	(14,511–25,065)	(32.54–55.48)	(−0.23–0.28)
Syrian Arab Republic	0.619	543	4.44	619	4.62	0.04	272	4.19	312	4.51	0.08	271	4.81	307	4.79	0.00	1.06
		(381–664)	(2.93–5.45)	(396–840)	(2.99–6.27)	(−0.23–0.37)	(200–345)	(2.97–5.41)	(207–437)	(3.03–6.22)	(−0.22–0.49)	(171–345)	(2.71–6.11)	(175–423)	(2.69–6.52)	(−0.26–0.31)
Thailand	0.687	11,838	15.88	13,375	13.40	−0.16	4121	11.61	5013	10.88	−0.06	7717	19.40	8362	15.45	−0.20	1.42
		(9995–16,178)	(13.52–21.16)	(9579–19,927)	(9.65–20.03)	(−0.39–0.14)	(3393–5324)	(9.67–14.74)	(3508–7664)	(7.71–16.62)	(−0.35–0.33)	(6360–11,494)	(16.1–28.01)	(5898–13,949)	(10.9–25.83)	(−0.44–0.11)
Turkmenistan	0.67	396	10.95	550	12.05	0.10	176	9.99	256	11.40	0.14	220	11.70	294	12.50	0.07	1.10
		(366–429)	(10.19–11.81)	(436–698)	(9.6–15.28)	(−0.12–0.39)	(156–198)	(8.91–11.13)	(202–331)	(8.99–14.62)	(−0.11–0.46)	(200–244)	(10.71–12.85)	(228–379)	(9.78–16)	(−0.17–0.36)
Uzbekistan	0.631	1020	6.21	1731	7.42	0.20	449	5.53	763	6.77	0.22	571	6.59	967	7.84	0.19	1.16
		(947–1097)	(5.74–6.68)	(1429–2084)	(6.07–8.77)	(−0.01–0.42)	(398–496)	(4.86–6.13)	(587–943)	(5.02–8.22)	(−0.02–0.51)	(518–633)	(5.95–7.23)	(789–1175)	(6.48–9.36)	(−0.03–0.44)
Vietnam	0.617	29,405	37.74	36,453	36.32	−0.04	11,205	32.11	14,687	32.14	0.00	18,200	42.51	21,766	40.08	−0.06	1.25
		(21,578–35,904)	(29.3–45.44)	(26,526–47,439)	(27.08–46.92)	(−0.24–0.19)	(7248–13,888)	(22.22–39.16)	(9690–19,722)	(22.11–41.97)	(−0.24–0.27)	(12,470–23,011)	(30.34–52.94)	(14,617–29,047)	(27.31–52.85)	(−0.27–0.19)
Low‐middle SDI
Bangladesh	0.483	16,099	14.80	19,906	13.76	−0.07	5910	10.88	7139	9.94	−0.09	10,189	18.99	12,766	17.59	−0.07	1.77
		(12,379–21,148)	(11.58–18.99)	(14,232–28,069)	(9.9–19.08)	(−0.26–0.17)	(4191–8019)	(7.75–14.48)	(4979–10,641)	(6.96–14.74)	(−0.33–0.2)	(7391–14,873)	(14.11–26.39)	(8454–19,874)	(11.75–27.01)	(−0.3–0.23)
Bhutan	0.455	94	17.67	114	17.99	0.02	35	12.72	44	13.62	0.07	59	23.24	71	22.73	−0.02	1.67
		(69–127)	(13.31–23.85)	(80–164)	(12.9–25.45)	(−0.18–0.24)	(22–50)	(8.11–18.33)	(27–68)	(8.4–20.47)	(−0.17–0.36)	(40–83)	(16.44–32.14)	(47–105)	(15.64–32.9)	(−0.23–0.23)
Cambodia	0.469	3012	31.56	4174	32.50	0.03	768	18.40	1106	19.68	0.07	2244	41.16	3068	42.02	0.02	2.14
		(1944–3906)	(20.61–40.45)	(2685–5483)	(20.95–42.23)	(−0.16–0.26)	(565–1022)	(13.61–24.1)	(781–1432)	(14.09–25.11)	(−0.17–0.35)	(1323–2999)	(24.34–54.07)	(1719–4212)	(23.89–56.81)	(−0.17–0.3)
Democratic People's Republic of Korea	0.558	4392	16.02	4718	14.60	−0.09	1422	12.20	1718	11.71	−0.04	2970	19.19	3000	17.28	−0.10	1.47
		(3318–5664)	(12.3–20.48)	(3560–6067)	(11.06–18.82)	(−0.25–0.12)	(963–2156)	(8.51–17.81)	(1156–2473)	(8.24–16.47)	(−0.22–0.19)	(2128–4096)	(13.64–26.36)	(2145–4158)	(12.25–24.21)	(−0.28–0.15)
India	0.566	173,924	17.32	217,465	17.20	−0.01	63,503	12.94	80,375	12.97	0.00	110,421	21.73	137,090	21.41	−0.01	1.65
		(150,428–192,558)	(15.07–19.19)	(181,112–254,846)	(14.37–20.14)	(−0.16–0.15)	(54,426–73,117)	(10.99–14.85)	(64,969–97,045)	(10.48–15.62)	(−0.2–0.25)	(88,326–127,264)	(17.45–25.06)	(104,668–170,556)	(16.41–26.51)	(−0.21–0.21)
Kyrgyzstan	0.596	458	11.29	537	10.56	−0.06	134	6.99	170	6.98	0.00	324	14.63	367	13.31	−0.09	1.91
		(420–495)	(10.29–12.2)	(454–637)	(8.99–12.44)	(−0.21–0.09)	(119–150)	(6.23–7.87)	(139–205)	(5.79–8.35)	(−0.18–0.2)	(288–359)	(13.02–16.21)	(298–443)	(10.95–16)	(−0.25–0.09)
Lao People's Democratic Republic	0.49	1116	29.39	1367	27.73	−0.06	324	17.16	417	17.10	0.00	792	40.77	950	37.74	−0.07	2.21
		(710–1473)	(18.88–38.16)	(882–1838)	(18.23–36.56)	(−0.23–0.16)	(221–435)	(11.9–22.75)	(291–556)	(12.12–22.6)	(−0.24–0.31)	(428–1103)	(22.82–55.46)	(527–1334)	(21.37–52.31)	(−0.26–0.17)
Maldives	0.562	40	19.02	60	18.32	−0.04	26	23.40	43	23.34	0.00	13	13.82	17	12.30	−0.11	0.53
		(35–45)	(16.25–21.59)	(49–74)	(14.73–22.41)	(−0.22–0.18)	(22–31)	(19.72–27.82)	(34–55)	(18.26–29.8)	(−0.22–0.26)	(10–16)	(10.22–16.56)	(13–22)	(9.15–15.31)	(−0.29–0.11)
Mongolia	0.606	291	16.73	390	15.02	−0.10	135	14.95	189	14.26	−0.05	156	17.80	201	15.17	−0.15	1.06
		(140–369)	(6.8–21.52)	(184–526)	(6.37–20.31)	(−0.3–0.19)	(63–179)	(6.38–19.77)	(87–264)	(6.32–19.77)	(−0.31–0.27)	(65–207)	(6.11–23.91)	(86–285)	(5.75–21.36)	(−0.36–0.15)
Myanmar	0.521	11,022	27.89	12,605	25.52	−0.09	3133	17.29	3836	17.24	0.00	7889	36.58	8769	32.00	−0.13	1.86
		(7630–14,080)	(19.65–35.13)	(9186–16,043)	(18.89–32.17)	(−0.26–0.14)	(2263–4153)	(12.76–22.96)	(2815–4998)	(12.72–22.5)	(−0.23–0.31)	(4791–10,399)	(22.61–47.56)	(5710–11,425)	(20.98–41.44)	(−0.32–0.1)
Palestine	0.588	276	14.37	444	16.59	0.15	81	8.58	121	9.02	0.05	194	19.22	323	23.53	0.22	2.61
		(232–315)	(12.03–16.38)	(316–548)	(11.76–20.3)	(−0.11–0.42)	(67–95)	(7.03–10.17)	(95–148)	(7.11–10.95)	(−0.17–0.31)	(159–232)	(15.58–22.7)	(204–408)	(14.81–29.53)	(−0.13–0.56)
Tajikistan	0.539	213	5.27	290	5.35	0.01	103	5.06	144	5.28	0.04	110	5.46	146	5.39	−0.01	1.02
		(164–249)	(3.57–6.33)	(216–364)	(3.53–6.75)	(−0.2–0.3)	(73–124)	(3.24–6.25)	(102–185)	(3.37–6.77)	(−0.2–0.37)	(79–131)	(3.31–6.7)	(107–187)	(3.37–6.94)	(−0.24–0.26)
Timor‐Leste	0.514	145	21.13	211	24.23	0.15	37	10.70	60	13.57	0.27	107	31.74	151	34.93	0.10	2.57
		(92–195)	(13.99–28.48)	(138–286)	(15.76–32.56)	(−0.08–0.43)	(24–57)	(7.09–16.08)	(38–85)	(8.88–19.33)	(−0.03–0.67)	(64–150)	(19.19–43.86)	(89–212)	(21.06–48.81)	(−0.14–0.4)
Low SDI
Afghanistan	0.343	3166	24.93	4229	24.18	−0.03	766	12.65	1110	12.90	0.02	2400	36.33	3119	34.89	−0.04	2.70
		(1784–4811)	(15.1–37.14)	(2421–6523)	(15.22–35.44)	(−0.21–0.22)	(464–1282)	(7.56–20.82)	(706–1742)	(8.22–19.93)	(−0.21–0.34)	(1081–3947)	(17.9–58.19)	(1471–5216)	(18.18–54.8)	(−0.24–0.22)
Nepal	0.422	3324	16.40	4680	18.69	0.14	977	10.25	1498	13.04	0.27	2347	22.20	3182	23.57	0.06	1.81
		(2549–4373)	(12.9–21.24)	(3430–6331)	(13.92–25.09)	(−0.11–0.4)	(629–1373)	(6.67–14.29)	(918–2188)	(7.97–19.06)	(−0.05–0.64)	(1765–3257)	(17.29–30.19)	(2296–4500)	(17.28–32.79)	(−0.19–0.35)
Pakistan	0.449	38,327	33.09	49,409	32.29	−0.02	14,613	25.49	19,078	25.34	−0.01	23,714	41.17	30,331	39.53	−0.04	1.56
		(31,722–45,824)	(27.77–39.04)	(39,271–60,858)	(26.35–39.3)	(−0.22–0.22)	(11,327–18,156)	(19.77–31.67)	(13,760–25,597)	(18.18–33.71)	(−0.28–0.39)	(17,633–30,706)	(31.77–51.25)	(21,162–42,069)	(28.81–53.19)	(−0.3–0.33)
Yemen	0.412	1567	13.17	2359	14.19	0.08	508	8.37	752	9.04	0.08	1059	18.00	1606	19.23	0.07	2.13
		(1089–2159)	(9.46–17.8)	(1630–3283)	(10.12–19.22)	(−0.13–0.32)	(346–757)	(5.72–12.42)	(490–1169)	(5.92–14.05)	(−0.18–0.39)	(693–1573)	(12.3–25.24)	(1029–2365)	(12.92–27.26)	(−0.15–0.36)

3.4.5. National comparison

Among Asian countries, 31 countries experienced a decreasing trend in the ThC DALYs ASR between 2010 and 2019; the greatest increase was detected in Armenia (increase in DALYs ASR = 0.61 (95% CI: 0.20–0.94)) and the greatest decrease was detected in the Republic of Korea (decrease in DALYs ASR = −0.52 (95% CI: −0.59 to −0.12)) (Figure 2).

In 2019, the highest DALYs ASR (per 100,000) of ThC was reported in Vietnam (36.32), the Philippines (34.27), Cambodia (32.50), and Pakistan (32.29). The lowest DALYs ASR of ThC was reported in the Syrian Arab Republic (4.62), Tajikistan (5.35), Uzbekistan (7.42), and China (9.70).

In Asian men, the highest DALYs ASR (per 100,000) of ThC was reported in Vietnam (32.14), Pakistan (25.34), and the United Arab Emirates (24.00). The lowest DALYs ASR (per 100,000) of THC was reported in the Syrian Arab Republic (4.51), Tajikistan (5.28), Uzbekistan (6.77), and Kyrgyzstan (6.98).

In women, the highest DALYs ASR (per 100,000) of ThC was reported in the Philippines (43.37), Cambodia (42.02), Vietnam (40.08), Pakistan (39.53), and Lao People's Democratic Republic (37.74). The lowest DALYs ASR (per 100,000) of ThC was reported in the Syrian Arab Republic (4.79), Tajikistan (5.39), Uzbekistan (7.84), and China (8.11). Results in detail are presented in Table 8.

3.5. Male/female ratio

In 2010, only in Armenia, Maldives and China, the DALYs ASR of ThC in males was higher than in women. In 2019, the DALYs ASR of ThC in China, Maldives, and the United Arab Emirates were reported to be higher in men than in women. In other countries, the incidence of ThC in women was higher than in men. The highest ratio was reported in Bahrain (2.72‐fold) and the lowest ratio was recorded in Maldives (0.53‐fold) (Figure 3).

4. DISCUSSION

This study determined the time trend of the incidence, mortality, and burden of ThC from 2010 to 2019 in 49 Asian countries. Also, this time trend was determined based on geographic region and SDI and compared with global data. The results showed that from 2010 to 2019, the number of new cases of thyroid cancer increased 1.28 times, the number of deaths increased 1.26 times, and the prevalence of thyroid cancer increased 1.39 times. In contrast, thyroid cancer's DALY increased 1.2 times. Also, from 2010 to 2019, ASIR increased by 5%, ASDR decreased by 6%, ASPR increased by 16%, and Dalys ASR of ThC cancer decreased by 4%.

The results showed that in 2019, more than 54% of ThC cases occurred in Asian countries. In 2019, more than 31.5% of new ThC cases occurred in men, and more than 68.5% of new cases occurred in Asian women. From 2010 to 2019, the number of new cases increased by 1.25 times in women and men by 1.38. In the investigated Asian countries, from 2010 to 2019, ASIR of ThC increased by 5%. This increase was higher in men than in women (5% vs. 3%). In this period, ASIR of ThC increased globally and in Africa, but in America and Europe, it decreased.

According to the results, in 2019, the newest cases of ThC were reported in men and women +85. In the same year, the highest ASIR of ThC was generally observed in high‐income Asia‐Pacific countries. Also, ASIR of ThC was higher in males than females in Maldives and more elevated in females than males in other countries.

The incidence of thyroid cancer varies significantly based on geographic location, especially in women. ¹⁸ The highest incidence is observed in high‐income countries such as the Republic of Korea, Canada, Italy, France, Israel, Croatia, Austria, the United States, and some middle‐to‐high‐income countries such as Turkey, Brazil, Costa Rica, and China. ¹⁸ , ¹⁹ It is high in some countries and island regions, including Cyprus, Cape Verde, French Polynesia, New Caledonia, and Puerto Rico. ¹⁸ This variation appears to be mainly attributable to geographic differences in access to care and diagnostic procedures, although environmental exposures may also play a role. ²⁰

Many exogenous factors are related to the development of thyroid cancer, the most important of which are iodine deficiency and radiation, but other factors may also play a role in the development of this disease, including diet, exposure to endocrine‐disrupting chemicals (EDCs) or xenobiotics, or other related influences from volcanic areas. ²¹

The best‐studied risk factor for differentiated thyroid carcinomas is radiation exposure, which increases the risk of thyroid malignancy from 5% to 50%. ¹⁷ , ²² Other risk factors include estrogen, ²³ smoking, ²⁴ diabetes, ²⁵ insulin resistance, ²⁶ obesity, ²⁷ metabolic syndrome,²⁸ insulin resistance, ²³ and physical activity. ²⁹ In a population‐based cohort study conducted in Korea, smoking and alcohol were shown to be inversely associated with thyroid cancer, with a significant interaction between these variables. ³⁰

The results showed that in 2019, more than 59% of ThC deaths occurred in Asian countries. The number of ThC deaths in 2019 increased by 1.26 times, but the ASDR of ThC decreased by 6%. From 2010 to 2019, the number of deaths in men increased by 1.29 times and women by 1.24 times. In the investigated Asian countries, from 2010 to 2019, the ASDR of THC decreased by 6%. This decrease was more significant in women than men (8% vs. 2%). ThCs ASDR declined in America, Europe, and globally during this period, while it has been stable in Africa. Death from thyroid cancer is related to age, gender, and stage of the disease. Age is an important risk factor for death. ³¹ According to the results of this study, most cases of ThC death were reported in women and men aged 85 and older. Also, in most age groups, death cases of ThC were higher in women than in men. Males have been shown to have more prolonged survival than females. ³¹ Also, in most studies, age has been reported as one of the most critical and influential risk factors for disease survival in ThC patients. ³² It should be noted that the 5‐year survival rate of ThC is generally 98.1%. ³³ Fortunately, the 5‐year survival of ThC is high, so if the prevalence of thyroid cancer is high, it can be due to the increase in new cases or the high survival rate of thyroid cancer.

From 2010 to 2019, according to the results, the number of cases living with ThC increased by 1.3 times. In 2019, more than 53% of ThC prevalence occurred in Asian countries. The number of patients who lived with ThC has risen 1.39 times in men and 1.25 times in women. Also, the ASPR of ThC increased by 8% in the period under review. ASPR of ThC increased in Asian men and women from 2010 to 2019, but this increase was more tremendous in men than in women, with a 16% increase in men and a 5% increase in women. ThC ASDR increased globally and in Africa during this period, but this amount decreased in America and Europe. The highest age‐specific prevalence of cases of ThC were reported in men aged 55 to 59 and women aged 60 to 64. Also, in all age groups, the prevalence of cases of ThC was higher in women than in men.

In this review, ThC DALYs were also evaluated. The results showed that ThC DALYs increased 1.2 times from 2010 to 2019. Also, in 2019, about 61% of ThC DALYs occurred in Asian countries. During this period, Dalys ASR of ThC decreased by 4%. DALY ASR of ThC decreased in men and women, although this reduction was greater in women than in men, so it decreased by 6% in women and 2% in men. This amount decreased globally and in Europe, while it increased in America and Africa. Also, DALY cases of ThC in most age groups (except 80–84 years old and 85 years old and above) were more in women than in men.

The relationships between gender, obesity, and ThC have been widely investigated. ³⁴ Worldwide, obesity and ThC are more common in women than men. ²³ , ³⁵ The results of a meta‐analysis showed that obesity is associated with ThC. ³⁶ It has also been shown that the body mass index is higher in women than men. ³⁷ , ³⁸ , ³⁹ , ⁴⁰ On the other hand, hyperinsulinemia, as a result of insulin resistance, is associated with obesity and has been suggested as a link between obesity and cancer development. ⁴¹ , ⁴² , ⁴³ The prevalence of diabetes is also higher in women than in men. ³⁷ , ³⁸ , ³⁹ , ⁴⁰ Therefore, it can be said that obesity and diabetes are related to the higher prevalence of ThC in women.

In this study, also we have conducted further analysis, specifically focusing on the differentiation between the elderly and non‐elderly groups. The results showed that 48.13% of new cases of ThC was in elderly aged ≥70 years in Asia. Also, 55.61% of THC deaths, 40.24% of ThC patients, and 55.87% of the burden caused by ThC were recorded in the elderly aged ≥70 years in Asia. It should be noted that ThC is the only malignancy in which age increase is considered a prognostic indicator in the majority of staging systems. ⁴⁴ Although the mortality rate starts to climb at age 45, the rate of recurrence is even higher starting at age 60. ⁴⁴

A higher cancer recurrence rate has been demonstrated in children and young adults aged over 20, but with a better survival rate over the evaluable time period. ⁴⁵ In another study, it was found that participants who were 70 years or older were more likely to die from thyroid cancer and that the proportion of death increased by years ⁴⁶ The decrease in death among other age groups may be due to improved treatment and aging of the population. ⁴⁷

The responsiveness to radioactive iodine (RAI) is related to better survival in young individuals. ⁴⁸ , ⁴⁹ According to another study, the 5‐year survival rate for younger, older, and super‐elders was 90.3%, 76.8%, and 57.8%, respectively. ⁵⁰ Alternatively, elderly patients have a tendency to present at advanced stages and have more aggressive histology. ⁵¹ So, ThC death in this age group is higher other groups.

Age is associated with changes in thyroid physiology, including a rise in thyroid‐stimulating hormone (TSH) and a drop in the rate of thyrocyte proliferation. Aging has a negative impact on both normal thyroid tissue and thyroid cancer, and those older than 45 have a worse prognosis. ⁵²

Again, ThC stands out from other malignancies in that age is a significant predictor in most staging systems. Preventing premature death is greatly assisted by early detection and screening.

It should be considered that timely interventions are necessary to prevent ThC, especially in women and people at risk. On the other hand, the effect of ThC screening should be considered. However, there are no direct studies on whether screening causes overdiagnosis; ecological and cross‐sectional data suggest that ThC screening leads to an increase in disease incidence without a change in mortality. ⁵³ The conclusion of a systematic review in the United States showed that the incidence of ThC is increasing over time without changing the mortality rate. ⁵⁴ Finally, it should be kept in mind that although the survival of ThC is high, ThC is the most common endocrine cancer in the world, leading to a significant burden of this disease.

5. CONCLUSION

More than half of the burden of ThC is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America, and Europe, the highest rate of death from ThC occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of ThC control in its residents.

6. LIMITATION

Given the difficulties of using online databases, including the quality of data reported by low‐income countries, the results of this study should be interpreted with caution.

AUTHOR CONTRIBUTIONS

AM, HS, FR, and LA designed and conceived the study. AM and ZP collected the data. LA, AM, HS, and ZP analyzed the data. AM, SD, FR, LA, and ZP drafted the manuscript. HS and AM provided administrative support. FR and AM provided oversight. All authors contributed to the article and approved the submitted version.

ACKNOWLEDGEMENTS

N/A.

FUNDING INFORMATION

This research received no external funding.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

ETHICS STATEMENT

The study was approved by the ethics committee of the Jahrom University of Medical Sciences (ethics committee approval code IR.JUMS.REC.1401.094). As we used routinely collected anonymized electronic data, patient consent was not required. All procedures were performed by the relevant guidelines and regulations.

Rezaei F, Mazidimoradi A, Pasokh Z, Dehghani SP, Allahqoli L, Salehiniya H. Temporal trends of thyroid cancer between 2010 and 2019 in Asian countries by geographical region and SDI, comparison with global data. Aging Med. 2023;6:386‐426. doi: 10.1002/agm2.12277

DATA AVAILABILITY STATEMENT

The data presented in this study are available on request from the corresponding author.