Association between socioeconomic position and the risk of thyroid cancer diagnosis: a 10-year follow-up cohort study in china

Jiahao Lin; Miaobian Liang; Lan Wu; Yu Chen; Wenkai Wang; Salvatore Vaccarella; Mengmeng Li

doi:10.1530/endoabs.109.P255

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Endocrine Abstracts (2025) 109 P255 | DOI: 10.1530/endoabs.109.P255

SFEBES2025 Poster Presentations Thyroid (41 abstracts)

Association between socioeconomic position and the risk of thyroid cancer diagnosis: a 10-year follow-up cohort study in china

Jiahao Lin ¹ , Miaobian Liang ² , Lan Wu ¹ , Yu Chen ¹ , Wenkai Wang ³ , Salvatore Vaccarella ⁴ & Mengmeng Li ¹

Author affiliations

¹State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China; ²Department of Gastroenterology, Jiangmen Central Hospital, Pengjiang Branch, NO.2 People’s Hospital of Jiangmen, Jiangmen, China; ³National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; ⁴Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France

Background: The incidence of thyroid cancer has been increasing rapidly in China, which is mainly contributed by overdiagnosis. Among the main drivers of overdiagnosis is the increased access to healthcare system, especially for the advantaged populations. We aimed to explore the association between socioeconomic position (SEP) and thyroid cancer diagnosis in China.

Methods: The China Kadoorie Biobank recruited over 500,000 adults from 10 geographic regions during 2004-2008. SEP-related factors (education attainment, household income, and occupational prestige) and covariates were collected through questionnaires. We assessed the overall SEP levels by point-based scoring method and latent class analysis (LCA), and evaluated their consistency by the Kappa test. Multivariate Cox models were used to estimate the hazard ratios (HRs) of SEP on the risk of being diagnosed with thyroid cancer.

Results: After a median follow-up of 10 years, 520 thyroid cancer cases were diagnosed among 504,456 participants. The point-based scoring method classified 212,345, 145,166, and 146,945 participants into low, medium, and high SEP groups, respectively, and the LCA classified 243,723, 196,460, and 64,273 participants into low, medium, and high SEP groups, respectively (Kappa coefficient 0.36, P < 0.001). The HRs (95%CI) of SEP on thyroid cancer diagnosis are shown in the Table below.


Variable (referent: low)	Medium	High	P for trend
Education	1.58 (1.30, 1.92)	3.87 (2.93, 5.10)	<0.001
Household income	1.68 (1.26, 2.23)	3.13 (2.44, 4.02)	<0.001
Occupation prestige	0.67 (0.42, 1.08)	1.49 (0.91, 2.45)	<0.001
SEP level (point-based scoring method)	1.55 (1.22, 1.96)	2.13 (1.67, 2.71)	<0.001
SEP level (LCA)	1.14 (0.91, 1.41)	1.87 (1.44, 2.43)	<0.001

Conclusions: Higher SEP is associated with an increased risk of thyroid cancer diagnosis in China. Targeted public health strategies, particularly focusing on wealthier and more developed regions, are needed to enhance awareness of thyroid cancer overdiagnosis.