The burden of high body mass index-attributable thyroid cancer in BRICS countries, 1990–2021: A cross-sectional, population-based analysis of the global burden of disease study 2021
Yu Qian, Song Chen, Nan-peng Wang, Hai-song Duan, Hui Ye, Ye WangObjective
Thyroid cancer incidence has risen steadily, and elevated body mass index (BMI) is a modifiable risk factor for it. We assessed the disease burden of high BMI-attributable thyroid cancer across the BRICS countries (Brazil, Russia, India, China, and South Africa), which have undergone rapid lifestyle transitions, and characterized temporal, age, period, and birth-cohort patterns from 1990 to 2021.
Methods
In this cross-sectional, population-based secondary analysis, we used modelled attributable-burden estimates from the Global Burden of Disease Study 2021 (GBD 2021) to evaluate spatiotemporal trends in disability-adjusted life years (DALYs; the primary endpoint) and mortality attributable to high BMI-related thyroid cancer from 1990 to 2021, applying descriptive analyses, Joinpoint regression, and age–period–cohort (APC) modeling.
Results
In 2021, Russia exhibited the highest age-standardized DALYs rate (ASDR) (2.09 per 100,000 population), followed by South Africa and Brazil, while China and India demonstrated the lowest burden. Although women bore more DALYs overall, men showed more pronounced increasing trends, particularly in China (annual percentage change [AAPC]: 2.31% in men vs. -0.35% in women). DALY rates rose with age in all five countries. Period effects showed sustained increases in China and India but declining trends in Russia. Cohort effects indicated elevated risk among younger birth cohorts in China and India (relative risk [RR] >1.7 for 1997 birth cohort), contrasting with stable or decreasing patterns in Russia and Brazil.
Conclusions
Cross-national and sex-specific disparities exist in the high BMI-attributable thyroid cancer burden among BRICS nations. The pronounced increase among Chinese and Indian male populations and younger birth cohorts highlights the potential value of enhanced public-health investment in obesity prevention, risk-based assessment of thyroid disease, and improved surveillance of high-risk populations, rather than population-wide thyroid cancer screening.