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Bland, Christin Elizabeth

Nursing

2011

MS

Thyroid cancer incidence has been increasing by about five percent annually over the past few decades both nationally and internationally. Regionally, this increase has been even more dramatic with Massachusetts Department of Health reporting 14.3% annual increase since 1997. The incidence ofthyroid cancer in Vermont is currently unknown. The cause of this increase has been debated in the literature and appears to be partially due to better detection. However, a significant portion of the increasing diagnoses appears to represent a true increase in incidence. It is unknown why thyroid cancer is increasing; likely there exists an unknown risk factor. Several environmental toxins have been implicated in affecting endocrine function in a range of organisms from invertebrates to humans. With this changing incidence in thyroid cancer and a changing environmental landscape, it becomes important to understand the interactions between diseases, land use, toxic exposure, etc., in order to appropriately understand and guide the health care of Vermonters.
Advanced practiced nurses are in an ideal position to conduct research to help understand these complex interactions for holistic treatment of patients and to affect public policy. Towards this end, this research project used de-identified Fletcher Allen Health Care patient records to identify thyroid cancer incidence in Vermont. Thyroid cancer is increasing annually by 4.5%, from 1991-2010, with a more dramatic increase in incidence in women (2.6% annually) than in men (1.15% annually). When adjusted for population, the northwestern counties of Vermont have a higher rate of thyroid cancer diagnoses relative to the rest of the state. These data represent an important step towards creating a mapping tool to further investigate thyroid cancer incidence and environmental factors to guide health care decisions and policy.