甲状腺癌的发生率在过去几十年中显著增加，部分原因是过度诊断。据报道，发病率的地理变化与国家发展水平有关。本研究旨在通过加入额外的社会和经济因素来促进对全球甲状腺癌负担的深入洞察，以应对跨国间的差异。我们对来自GLOBOCAN 2020数据库的126个国家的年龄标准化发病率和死亡率数据进行了多元分析，这些国家的甲状腺癌发病案例超过100例。人类发展指数（HDI）、当前卫生支出和额外的全球卫生观察指标从多个来源提取。在所研究的国家中，年龄标准化发病率与HDI高度相关（标准化系数β=0.523，95%置信区间[CI]=0.275-0.771）。提高空腹血糖的患病率与年龄标准化死亡率相关（β=0.277，95% CI=0.038-0.517）。总体而言，男性的死亡率与发病率之比高于女性。在多元分析中，HDI（β=-0.767，95% CI=-0.902至-0.633）、当前卫生支出（β=0.265，95% CI=0.137-0.394）和细颗粒物（PM2.5）浓度（β=0.192，95% CI=0.086-0.298）与死亡率与发病率之比相关。 HDI衡量的国家发展解释了甲状腺癌发病率变化的大部分差异，但在死亡率的差距中发挥较小作用。空气污染与甲状腺癌结果之间的关联需要进一步调查。© 2023.本文作者，独家许可Springer-Verlag GmbH Germany，隶属于Springer Nature。

The incidence of thyroid cancer has increased substantially over the past few decades and is partially explained by overdiagnosis. Geographical variations in incidence rates were reported to be related to national development status. This study aimed to gain deeper insights into global thyroid cancer burden by incorporating additional social and economic factors to account for cross-national disparities.We performed a multivariate analysis of age-standardized incidence and mortality data from the GLOBOCAN 2020 database for 126 countries that had more than 100 incident cases of thyroid cancer. The human development index (HDI), current health expenditure, and additional Global Health Observatory indicators were extracted from multiple sources.Age-standardized incidence was highly correlated with HDI (standardized coefficient beta = 0.523, 95% confidence interval [CI] = 0.275-0.771) among the countries studied. The prevalence of raised fasting blood glucose was associated with age-standardized mortality (beta = 0.277, 95% CI = 0.038-0.517). Generally, the mortality-to-incidence ratio was higher in males than in females. In multivariate analysis, HDI (beta = - 0.767, 95% CI = - 0.902 to - 0.633), current health expenditure (beta = 0.265, 95% CI = 0.137-0.394), and fine particulate matter (PM2.5) concentrations (beta = 0.192, 95% CI = 0.086-0.298) were associated with mortality-to-incidence ratios.National developments gauged by HDI explain the majority of the variation in incidence rates of thyroid cancer but play a smaller role in disparities in mortality rates. The association between air pollution and thyroid cancer outcomes warrants further investigation.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.