{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T18:16:09Z","timestamp":1774030569080,"version":"3.50.1"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ganzhou Science and Technology Bureau of Jiangxi Province","award":["GZ2018ZSF025"],"award-info":[{"award-number":["GZ2018ZSF025"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>The global incidence of thyroid cancer (TC) has risen markedly, ranking as the tenth most common malignancy in 2020. Simultaneously, obesity now affects over one billion individuals worldwide, with its prevalence more than doubling since 1990. Emerging evidence suggests a significant association between high body mass index (BMI) and elevated TC risk, potentially mediated by mechanisms such as chronic inflammation and insulin resistance. This study aims to evaluate the global burden of thyroid cancer attributable to high BMI (TC-HBMI) from 1990 to 2021, examine temporal trends, and project future burden through 2036. We utilized data from the Global Burden of Disease Study 2021 to assess deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASRs). Temporal trends were examined using estimated annual percentage change (EAPC), joinpoint regression, and decomposition analysis. Inequality and future burden assessments were conducted through slope and concentration indices, frontier analysis, and Bayesian age-period-cohort modeling.<\/jats:p>","DOI":"10.1371\/journal.pone.0343394","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:25:18Z","timestamp":1774027518000},"page":"e0343394","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global burden and temporal trend of thyroid cancer associated with high BMI from 1990 to 2021"],"prefix":"10.1371","volume":"21","author":[{"given":"Dan","family":"Pan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Xiu","family":"Diao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Xiang","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zi-Hang","family":"Ai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing-Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9814-1712","authenticated-orcid":true,"given":"Zan-Bin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"pone.0343394.ref001","doi-asserted-by":"crossref","first-page":"1500926","DOI":"10.3389\/fendo.2024.1500926","article-title":"Burden of thyroid cancer in China and worldwide from 1990 to 2021: observation, comparison, and forecast from the Global Burden of Disease Study 2021","volume":"15","author":"Z Meng","year":"2024","journal-title":"Front Endocrinol"},{"key":"pone.0343394.ref002","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s13193-021-01429-y","article-title":"Thyroid cancer: global burden and trends","volume":"13","author":"JB Shank","year":"2022","journal-title":"Indian J Surg Oncol"},{"key":"pone.0343394.ref003","doi-asserted-by":"crossref","first-page":"04090","DOI":"10.7189\/jogh.14.04090","article-title":"Assessing and projecting the global burden of thyroid cancer, 1990-2030: Analysis of the Global Burden of Disease Study","volume":"14","author":"Q Zhao","year":"2024","journal-title":"J Glob Health"},{"issue":"9","key":"pone.0343394.ref004","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.3390\/healthcare10091621","article-title":"Tackling thyroid cancer in Europe-the challenges and opportunities","volume":"10","author":"D Horgan","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"pone.0343394.ref005","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults","volume":"403","author":"NCD Risk Factor Collaboration (NCD-RisC)","year":"2024","journal-title":"Lancet"},{"issue":"1","key":"pone.0343394.ref006","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41574-019-0263-x","article-title":"Geographic influences in the global rise of thyroid cancer","volume":"16","author":"J Kim","year":"2020","journal-title":"Nat Rev Endocrinol"},{"issue":"12","key":"pone.0343394.ref007","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/obr.12321","article-title":"Adiposity and risk of thyroid cancer: a systematic review and meta-analysis","volume":"16","author":"D Schmid","year":"2015","journal-title":"Obes Rev"},{"key":"pone.0343394.ref008","doi-asserted-by":"crossref","first-page":"283","DOI":"10.12659\/MSM.892035","article-title":"Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies","volume":"21","author":"J Ma","year":"2015","journal-title":"Med Sci Monit"},{"issue":"2","key":"pone.0343394.ref009","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1080\/01635581.2024.2419488","article-title":"Associations between obesity and risk of thyroid cancer: a meta-analysis of cohort studies","volume":"77","author":"UK Hisan","year":"2025","journal-title":"Nutr Cancer"},{"issue":"3","key":"pone.0343394.ref010","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1089\/thy.2021.0445","article-title":"Body mass index and thyroid cancer risk: a pooled analysis of half a million men and women in the Asia Cohort Consortium","volume":"32","author":"A Shin","year":"2022","journal-title":"Thyroid"},{"issue":"3","key":"pone.0343394.ref011","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1158\/1055-9965.EPI-10-1220","article-title":"Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies","volume":"20","author":"CM Kitahara","year":"2011","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"3","key":"pone.0343394.ref012","doi-asserted-by":"crossref","DOI":"10.1530\/ERC-24-0297","article-title":"Global trends in thyroid cancer 1990-2021: an analysis based on the GBD 2021","volume":"32","author":"T Deng","year":"2025","journal-title":"Endocr Relat Cancer"},{"key":"pone.0343394.ref013","doi-asserted-by":"crossref","first-page":"692879","DOI":"10.3389\/fendo.2021.692879","article-title":"Association between aggressive clinicopathologic features of papillary thyroid carcinoma and body mass index: a systematic review and meta-analysis","volume":"12","author":"A Economides","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"pone.0343394.ref014","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.3390\/ijerph19031116","article-title":"Obesity and thyroid cancer risk: an update","volume":"19","author":"F Franchini","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"pone.0343394.ref015","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s12672-017-0320-7","article-title":"Mechanisms linking obesity and thyroid cancer development and progression in mouse models","volume":"9","author":"WG Kim","year":"2018","journal-title":"Horm Cancer"},{"key":"pone.0343394.ref016","doi-asserted-by":"crossref","DOI":"10.1210\/clinem\/dgaa376","article-title":"Obesity, thyroid nodularity, and thyroid cancer: epiphenomenon or cause","volume":"105","author":"D Bradley","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"pone.0343394.ref017","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1186\/s12889-025-21960-9","article-title":"Global trend and disparity in the burden of thyroid cancer attributable to high body-mass index from 1990 to 2021 and projection to 2049: a systematic analysis based on the Global Burden of Disease Study 2021","volume":"25","author":"Y-X Chen","year":"2025","journal-title":"BMC Public Health"},{"key":"pone.0343394.ref018","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","article-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"GBD 2021 Causes of Death Collaborators","year":"2024","journal-title":"Lancet"},{"issue":"29","key":"pone.0343394.ref019","doi-asserted-by":"crossref","first-page":"3670","DOI":"10.1002\/sim.3733","article-title":"Estimating average annual per cent change in trend analysis","volume":"28","author":"LX Clegg","year":"2009","journal-title":"Stat Med"},{"issue":"11","key":"pone.0343394.ref020","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/S2352-4642(22)00219-X","article-title":"Global, regional, and national burdens of HIV and other sexually transmitted infections in adolescents and young adults aged 10-24 years from 1990 to 2019: a trend analysis based on the Global Burden of Disease Study 2019","volume":"6","author":"J Zhang","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"issue":"1","key":"pone.0343394.ref021","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s12889-023-17573-9","article-title":"Persistence of severe global inequalities in the burden of Hypertension Heart Disease from 1990 to 2019: findings from the global burden of disease study 2019","volume":"24","author":"M Lu","year":"2024","journal-title":"BMC Public Health"},{"issue":"2","key":"pone.0343394.ref022","doi-asserted-by":"crossref","first-page":"95","DOI":"10.11106\/ijt.2020.13.2.95","article-title":"Increasing incidence of thyroid carcinoma: risk factors and seeking approaches for primary prevention","volume":"13","author":"V Drozd","year":"2020","journal-title":"Int J Thyroidol"},{"key":"pone.0343394.ref023","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/jnci\/djz202","article-title":"Impact of overweight and obesity on US papillary thyroid cancer incidence trends (1995-2015)","volume":"112","author":"CM Kitahara","year":"2020","journal-title":"J Natl Cancer Inst"},{"issue":"9","key":"pone.0343394.ref024","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.3390\/biomedicines12091962","article-title":"The role of body mass index (BMI) in differentiated thyroid cancer: a potential prognostic factor?","volume":"12","author":"C Mele","year":"2024","journal-title":"Biomedicines"},{"issue":"9","key":"pone.0343394.ref025","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1586\/14737140.8.9.1425","article-title":"Nuclear medicine in the management of thyroid disease","volume":"8","author":"J Buscombe","year":"2008","journal-title":"Expert Rev Anticancer Ther"},{"issue":"5","key":"pone.0343394.ref026","doi-asserted-by":"crossref","DOI":"10.1530\/ERC-14-0070","article-title":"Obesity and thyroid cancer","volume":"21","author":"MA Marcello","year":"2014","journal-title":"Endocr Relat Cancer"},{"issue":"5","key":"pone.0343394.ref027","article-title":"Molecular approaches to thyroid cancer diagnosis","volume":"21","author":"SJ Hsiao","year":"2014","journal-title":"Endocr Relat Cancer"},{"key":"pone.0343394.ref028","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/epirev\/mxm007","article-title":"The obesity epidemic in the United States--gender, age, socioeconomic, racial\/ethnic, and geographic characteristics: a systematic review and meta-regression analysis","volume":"29","author":"Y Wang","year":"2007","journal-title":"Epidemiol Rev"},{"key":"pone.0343394.ref029","doi-asserted-by":"crossref","first-page":"20420188211000251","DOI":"10.1177\/20420188211000251","article-title":"Advancements in the treatment of differentiated thyroid cancer","volume":"12","author":"LA Stewart","year":"2021","journal-title":"Ther Adv Endocrinol Metab"},{"issue":"3","key":"pone.0343394.ref030","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1089\/thy.2022.0618","article-title":"Obesity, physical activity, and thyroid cancer risk: disentangling true associations from detection bias","volume":"33","author":"CM Kitahara","year":"2023","journal-title":"Thyroid"},{"key":"pone.0343394.ref031","doi-asserted-by":"crossref","first-page":"7","DOI":"10.21037\/aot-24-24","article-title":"Obesity and thyroid cancer in Europe\u2014is there a gender disparity developing?","volume":"9","author":"L Borg","year":"2024","journal-title":"Ann Thyroid"},{"key":"pone.0343394.ref032","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3389\/fendo.2017.00111","article-title":"Female reproductive factors and differentiated thyroid cancer","volume":"8","author":"M Moleti","year":"2017","journal-title":"Front Endocrinol"},{"issue":"2","key":"pone.0343394.ref033","doi-asserted-by":"crossref","first-page":"862","DOI":"10.3390\/ijms26020862","article-title":"Exploring how adipose tissue, obesity, and gender influence the immune response to vaccines: a comprehensive narrative review","volume":"26","author":"JB De Sanctis","year":"2025","journal-title":"Int J Mol Sci"},{"issue":"5","key":"pone.0343394.ref034","article-title":"Adiponectin inhibits the progression of obesity-associated papillary thyroid carcinoma through autophagy","volume":"165","author":"C Li","year":"2024","journal-title":"Endocrinology"},{"issue":"4","key":"pone.0343394.ref035","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1001\/jamacardio.2018.0022","article-title":"Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity","volume":"3","author":"SS Khan","year":"2018","journal-title":"JAMA Cardiol"},{"key":"pone.0343394.ref036","doi-asserted-by":"crossref","first-page":"04131","DOI":"10.7189\/jogh.14.04131","article-title":"Thyroid cancer trends in China and its comparative analysis with G20 countries: Projections for 2020-2040","volume":"14","author":"Y Gong","year":"2024","journal-title":"J Glob Health"},{"key":"pone.0343394.ref037","doi-asserted-by":"crossref","first-page":"04084","DOI":"10.7189\/jogh.14.04084","article-title":"Trends and projections of the global burden of thyroid cancer from 1990 to 2030","volume":"14","author":"S Hu","year":"2024","journal-title":"J Glob Health"},{"key":"pone.0343394.ref038","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1001\/jamaoncol.2021.6987","article-title":"Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"8","author":"Global Burden of Disease 2019 Cancer Collaboration","year":"2022","journal-title":"JAMA Oncol"},{"issue":"9","key":"pone.0343394.ref039","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1038\/ijo.2008.102","article-title":"Global burden of obesity in 2005 and projections to 2030","volume":"32","author":"T Kelly","year":"2008","journal-title":"Int J Obes (Lond)"},{"key":"pone.0343394.ref040","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1089\/thy.2012.0532","article-title":"Thyroid cancer incidence patterns in Sao Paulo, Brazil, and the U.S. SEER program, 1997-2008","volume":"23","author":"LH Veiga","year":"2013","journal-title":"Thyroid"},{"issue":"8","key":"pone.0343394.ref041","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1089\/1050725041692909","article-title":"Iodine nutrition improves in Latin America","volume":"14","author":"EA Pretell","year":"2004","journal-title":"Thyroid"},{"key":"pone.0343394.ref042","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1186\/1471-2458-12-474","article-title":"Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: results from the World Health Survey","volume":"12","author":"AR Hosseinpoor","year":"2012","journal-title":"BMC Public Health"},{"key":"pone.0343394.ref043","volume-title":"Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report","year":"2008"},{"issue":"9945","key":"pone.0343394.ref044","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"M Ng","year":"2014","journal-title":"Lancet"},{"key":"pone.0343394.ref045","volume-title":"Closing the cancer divide: a blueprint to expand access in low and middle income countries","author":"F Knaul","year":"2011"},{"issue":"1","key":"pone.0343394.ref046","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1753-4887.2011.00456.x","article-title":"Global nutrition transition and the pandemic of obesity in developing countries","volume":"70","author":"BM Popkin","year":"2012","journal-title":"Nutr Rev"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0343394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:25:26Z","timestamp":1774027526000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0343394"}},"subtitle":[],"editor":[{"given":"Girijesh Kumar","family":"Patel","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0343394","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]}}}