Rising Trends and Regional Disparities: A Review of Thyroid Cancer Statistics in India

Rising Trends and Regional Disparities: A Review of Thyroid Cancer Statistics in India | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Rising Trends and Regional Disparities: A Review of Thyroid Cancer Statistics in India Yuvraj Kaushal This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6667454/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Thyroid cancer, the most prevalent endocrine malignancy globally, has shown a significant rise in incidence in India over recent decades, particularly among women in urban regions. This review synthesizes epidemiological trends, regional variations, and possible contributing factors influencing thyroid cancer burden in the Indian context. Data from the Indian Council of Medical Research (ICMR), Population-Based Cancer Registries (PBCRs), and PubMed-indexed literature between 2000 and 2024 was analyzed. The increasing incidence, particularly of papillary thyroid carcinoma (PTC), is attributed to improved diagnostic modalities, higher awareness, urbanization, and possibly environmental exposures such as endocrine-disrupting chemicals. However, substantial disparities exist in access to healthcare between urban and rural populations, affecting timely diagnosis, treatment, and outcomes. The marked female preponderance and rising detection of low-risk microcarcinomas have raised concerns of overdiagnosis and overtreatment. Despite the prognosis, especially for differentiated thyroid cancers, uniform access to specialized care remains a challenge. The lack of national screening guidelines and comprehensive thyroid cancer registries further limits effective policy-making. Addressing these gaps through targeted public health strategies, standardized clinical protocols, and nationwide surveillance is critical to managing the rising burden of thyroid cancer in India effectively. Epidemiology Oncology Endocrinology & Metabolism Thyroid cancer India Epidemiology Papillary thyroid carcinoma Cancer registry Introduction Thyroid cancer develops from follicular or parafollicular thyroid cells to become the primary malignant endocrine tumor worldwide. Medical reports indicate that thyroid cancer cases grow at an increasing rate although the condition remains uncommon in comparison with other malignancies. [ 1 ] The global incidence of thyroid cancer stands at 1–2% but this rate becomes much higher among women and younger adults. [ 2 ] Thyroid cancer cases have been increasing among urban Indian female populations as the cancer care system in the country evolves with developing disease registries. The World Health Organization report GLOBOCAN 2020 reveals that India observes more than 34,000 new thyroid cancer cases which represent 1.1% of the total cancer cases across the country. [ 3 ] Thyroid cancer demonstrates increasing frequency in India because of three key factors that combine diagnostic progress with environmental evolution and population epidemics. The combination of enhanced ultrasound diagnostics and FNAC testing availability with public recognition of population lifestyle evolution and enhanced healthcare services has led to an increase in diagnosed cases. [ 4 ] Medical professionals must address a fundamental concern regarding the increasing incidence numbers because these numbers might stem from excessive identification of benign papillary thyroid carcinomas instead of reflecting true disease progression rates. [ 5 ] The epidemiological patterns of thyroid cancer in India demonstrate that females predominate among patients and that cancer usually appears between ages 30 and 50 when people are economically active. [ 4 ] The National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR) positions thyroid cancer as one of the leading female cancers at public institutions in cities like Delhi Chennai and Bengaluru. [ 6 ] Research indicates higher incidence rates exist in the southern and northeastern states beyond northern and western India. Several healthcare system factors along with iodine consumption rates inheritance patterns registry operations and accessibility appear to contribute to these discrepancies. [ 7 ] The Indian population experiences primarily papillary thyroid carcinomas (PTC) among thyroid cancer cases with follicular thyroid carcinomas (FTC) and medullary thyroid carcinomas (MTC) as secondary diagnoses and anaplastic thyroid carcinomas (ATC) as a rare occurrence. [ 8 ] DTCs composed of PTC and FTC usually demonstrate excellent outcomes when diagnosed. The healthcare results deteriorate when people receive late-stage diagnoses or lack access to specialized medical services, especially in underdeveloped rural areas and under-resourced locations. [ 9 ] Thyroid nodules frequently encounter unexpected outcomes during medical tests used for different conditions in urban centers where imaging technology usage grows substantially. The discovery of thyroid nodules by chance during other medical tests creates the medical condition known as incidentaloma that leads to both overdiagnosis and unnecessary treatment posing supplemental and fınancıal burdens with no effect on survival rates. [ 10 ] The increasing trend of non-communicable diseases requires the Indian thyroid cancer trajectory to become the focus of nationwide research and policy interventions. The good survival rates for thyroid cancer during early disease stages exist alongside significant psychosocial impacts together with treatment complications which demand a thorough cost-effectiveness review. Researchers are investigating how iodine availability interacts with autoimmune thyroiditis incidence combined with elements such as radiation and endocrine disruptors for their potential impact on thyroid cancer development. [ 11 , 12 ] This review article seeks to analyze the most recent trends in thyroid cancer incidence and mortality in India, based on published literature and national data. It aims to provide a consolidated perspective on the patterns, determinants, and potential public health implications of the disease in the Indian context. Materials and Methods The research employed data from two main sources including PubMed peer-reviewed studies as well as official statistics collected under programs of the Indian Council of Medical Research (ICMR) National Cancer Registry Programme (NCRP) and Population-Based Cancer Registries (PBCRs). Research using the keywords “thyroid cancer India” and both “thyroid carcinoma epidemiology” and “thyroid cancer incidence India” yielded comprehensive results from PubMed databases. Publications in the English language starting from 2000 up to 2024 were included. National data stem from NCRP publications that include both “Three-Year Report of PBCRs (2012–2014)” and “Cancer Statistics, India 2020.” These reports supply age-standardized incidence rates with trends by sex and age in addition to regional variations regarding cancer burden throughout India. Official cancer registry reports along with original studies using established statistical methods made it to the inclusion list while the reviewers blocked case reports as well as opinion pieces and studies without regional applicability. Each study within this assessment provided data about incidence rates together with mortality statistics and temporal patterns and age and sex-based distributions. The analysis included available data points on diagnostic patterns and the intake of iodine supplement as well as the possibility of misdiagnoses. Population-based reports served as the main emphasis to establish research reliability and reduce referral bias. This review did not need ethical approval because all data from public resources contained no individual patient information. Discussion The incidence of Thyroid cancer has grown significantly in India since the late 1990s even though experts viewed this disease as extremely rare at the start of the century. Research shows PTC thyroid carcinoma makes up most of the diagnoses similar to global patterns while representing more than 85 percent of all Indian thyroid cancers. [ 8 ] The 2020 National Cancer Registry Program (NCDIR) of the ICMR shows Thiruvananthapuram has an Age-Adjusted Rate (AAR) of 10.9 and Bengaluru has 8.4 while Chennai has 7.3 which places thyroid cancer among the leading tumor types affecting women at rates between 6.4 and 10.9 per 100,000 females. Barshi (AAR: 1.6) and Dibrugarh (AAR: 1.2) stand as examples of rural areas where thyroid cancer rates remain low compared to urban populations. These figures demonstrate both diagnostic and reporting differences in the regions. [ 13 , 14 ] This differs strongly from smaller incidence rates present in rural sections thus highlighting dual detection and reporting discrepancies. [ 9 ] NCRP data shows how urban centers in Delhi and Chennai demonstrate elevated disease incidence levels compared to rural districts according to the reported data. The improved health services and detection methods coupled with higher urban patient engagement explain this variation in statistics between urban and rural areas. [ 14 ] The worldwide pattern shows that thyroid cancer tends to affect women more than men at a rate of 3–4 females for every male according to Indian statistics. The urban population shows a remarkable gender disparity in thyroid cancer incidence rates because women develop this disease nearly four times more often than men based on NCDIR data. Female thyroid cancer incidence reached levels of 10.9 per 100,000 in some cities but male incidence remained below 3.5 according to medical data. [ 13 , 14 ] The noted gap in incidence rates highlights this distinction. Health checkups performed by women for cosmetic reasons lead to incidental findings about neck swellings and nodules in sociocultural settings. Men tend to reveal thyroid cancer at later stages which potentially leads to worse treatment results. [ 4 , 15 ] Researchers must focus on various environmental substances as well as food components that affect thyroid conditions. Recent research indicates that the histopathological distribution of follicular carcinoma has evolved to papillary carcinoma in areas that implemented Universal Salt Iodization during the post-USI era just like other iodine-replete regions according to findings in the literature. [ 16 ] Several remote districts within India remain iodine deficient because officials have not efficiently implemented iodized salt distribution throughout areas such as Madhya Pradesh and Odisha and parts of the northeast regions despite ineffective iodized salt policies. National surveys indicated that 74% of rural households in Odisha received adequate iodized salt. [ 13 , 14 ] Additionally the combination of urban growth with dietary shifts and endocrine-disrupting chemicals exposure which includes industrial solvents and bisphenol A has been related to thyroid cancer formation. Research patterns have established a foundation for a more profound analysis of direct contributors although definitive proof remains elusive. [ 4 , 8 , 14 , 17 , 18 ] Although the number of thyroid cancer cases increases, mortality rates from this condition remain minimal. These statistics suggest localized papillary carcinoma has a survival rate above 95% within five years thus becoming one of the most treatable malignancies. [ 19 ] The results of medical procedures continue to vary between patients because healthcare facilities providing specialized care have different access levels. The standard clinical approach to thyroid cancer management in metropolitan areas consists of combined specialized healthcare teams practicing thyroidectomy procedures along with radioiodine therapy and TSH suppression along with lifelong patient monitoring. NCRP studies demonstrate that districts without one tertiary care center serving a 5 lakh population exhibit higher mortality rates from thyroid cancer which showcases this accessibility gap. [ 13 , 14 ] At the same time patients living in rural areas or disadvantaged regions encounter delayed medical diagnosis alongside less experienced surgeons and limited access to nuclear medicine equipment and suboptimal continue The urban-rural difference causes more patients to present with advanced or metastatic disease at healthcare facilities outside main cities. [ 9 , 13 , 20 ] The discovery of small thyroid cancers frequently known as microcarcinomas (measuring less than one centimeter) has become common because of incidental findings during imaging tests while generating worries about their unnecessary treatment. The majority of global medical investigations suggest monitoring low-risk thyroid cases without immediate surgery to diminish the lifetime consequences of thyroid hormone therapy and the complications of thyroid gland removal. [ 21 ] Both patients and clinicians in India tend to pursue definitive surgical interventions for subcentimeter nodules because of prevailing cultural and psychological factors yet the situation requires awareness programs to develop appropriate guidelines for Indian healthcare. The social economic conditions dramatically influence how Indians detect thyroid cancer along with their therapeutic choices. The NCRP 2020 report showed urban populations exceeding 80% literacy rates alongside per capita monthly expenditures greater than Rs. 2500 achieve nearly double the diagnostic rates than areas spending less than Rs. 2500. [ 13 , 14 ] This economic disparity results in delayed early diagnosis among the general public because residents are unaware of thyroid health and its symptoms. The implementation of public health initiatives concerning thyroid disease education in high-incidence areas will support disease management over an extended period. [ 14 ] India must address several obstacles when it comes to research and registry-based data collection. The ICMR-NCDIR has expanded its data collection but cancer registry programs consist only of 36 population-based cancer registries and their presence is restricted to select urban and semi-urban areas and thyroid cancer records remain scarce. [ 14 ] A national database system that emphasizes thyroid cancer histopathology examination alongside treatment methods and extended results must be created to develop clinical guidelines and policy recommendations. The inclusion of thyroid cancer screening and management protocols within Ayushman Bharat national health programs will serve to enhance the early diagnosis process and improve healthcare quality throughout different socioeconomic groups. [ 22 ] An approaching solution to control India's growing thyroid cancer problem requires the combined expertise of endocrinologists, oncologists, pathologists, and surgeons with public health specialists. The upward trend in thyroid cancer incidence requires healthcare professionals to concentrate on patient-specific risk assessment and individualized therapeutic approaches and procedures of minimum necessity. Research that examines environmental and genetic risk factors unique to the Indian population should gain priority status to discover etiological factors that are specific to this region. Conclusion India shows a growing pattern of thyroid cancer occurrence which affects women specifically because three urban areas including Thiruvananthapuram, Bengaluru, and Chennai document increasing incidence rates. The growing detection rates reflect improved diagnostic techniques led by ultrasonography and fine-needle aspiration cytology during which time additional suspected low-risk papillary microcarcinomas might also be inaccurately diagnosed. The increasing number of thyroid cancer cases in India still presents patients with favorable treatment outcomes since papillary cases comprise most of the diagnosed patients. Concerns about uniform standards in diagnosis, as well as treatment and follow-up, exist because urban populations enjoy better access to healthcare than rural populations. Remote areas experience difficulties regarding treatment outcomes because they lack both sophisticated surgical services, nuclear medicine and radioactive iodine therapy. The increasing public health burden requires India to develop an extensive thyroid cancer registry as well as standardized treatment protocols and enhanced healthcare procedures. Seeking additional awareness about proper diagnostic approaches combined with relevant physician training regarding active surveillance of low-risk cases will help minimize unnecessary treatment. A successful approach to treating thyroid cancer in India relies on combining evidence-based practices with health equity considerations integrated through epidemiological research to reduce its future impact. Declarations Ethics Statement: No ethical approval was required for this review Informed Consent: Not Applicable Acknowledgement: Not Applicable Funding: No funding received. Conflict of Interest Statement: The authors declare no conflict of interest. Availability of data and materials: Not Applicable Authors’ contributions: CRediT authorship contribution statement Yuvraj Kaushal: Data curation, Conceptualization, Project Administration, Writing - original draft preparation, Writing: Review and editing References Kitahara CM, Sosa JA (2020) Understanding the ever-changing incidence of thyroid cancer. Nat Rev Endocrinol 16(11):617–618. 10.1038/s41574-020-00414-9 Pizzato M, Li M, Vignat J, Laversanne M, Singh D, La Vecchia C, Vaccarella S (2022) The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 10(4):264–272. 10.1016/S2213-8587(22)00035-3 Miranda-Filho A, Lortet-Tieulent J, Bray F et al (2022) The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol. ;10(3):168–178. 10.1016/S2213-8587(22)00035-3 . PMID: 35271818 Panato C, Vaccarella S, Dal Maso L, Basu P, Franceschi S, Serraino D, Wang K, Lei F, Chen Q, Huang B, Mathew A (2020) Thyroid cancer incidence in India between 2006 and 2014 and impact of overdiagnosis. J Clin Endocrinol Metab 105(8):2507–2514. 10.1210/clinem/dgaa192 Increasing incidence of thyroid cancer A surge in cases or overdiagnosis? N Engl J Med. Available at: https://www.nejm.org/doi/ 10.1056/NEJMp1604412 Veedu JS et al (2018) Trends in thyroid cancer incidence in India. JCO 36:e18095–e18095. 10.1200/JCO.2018.36.15_suppl.e18095 Mathew IE, Mathew A (2017) Rising thyroid cancer incidence in Southern India: An epidemic of overdiagnosis? J Endocr Soc 1(5):480–487. 10.1210/js.2017-00097 Bhandari H, Sharma A, Nilapwar RD, Vyas PG, Pawar AS (2024) Histopathological spectrum of thyroid neoplasm- A retrospective study done at tertiary cancer care hospital. Int J Sci Healthc Res 9(1):169–174. 10.52403/ijshr.20240121 McDow AD, Zahnd WE, Angelos P, Mellinger JD, Ganai S (2020) Impact of rurality on national trends in thyroid cancer incidence and long-term survival. J Rural Health 36(3):326–333. 10.1111/jrh.12374 Acosta GJ, Ospina NS, Brito JP (2023) Overuse of thyroid ultrasound. Curr Opin Endocrinol Diabetes Obes 30(5):225–230. 10.1097/MED.0000000000000814 George PS, Mathew A, Sruthi S, Kurup SA, Kattoor J, Vinod TR (2023) Spatiotemporal pattern of thyroid cancer incidence in South Kerala: A population-based study. Indian J Public Health 67(2):240–246. 10.4103/ijph.ijph_1419_22 Fiore M, Oliveri Conti G, Caltabiano R, Buffone A, Zuccarello P, Cormaci L, Cannizzaro MA, Ferrante M (2019) Role of emerging environmental risk factors in thyroid cancer: A brief review. Int J Environ Res Public Health 16(7):1185. 10.3390/ijerph16071185 https:// ncdirindia.org/All_Reports/Report_2020/resources/Chapter5ComparisonofcancerincidenceandpatternsofallPopulationBasedCancerRegistries.pdf Mathur P et al (2020) Cancer statistics, 2020: Report from National Cancer Registry Programme, India. JCO Glob Oncol 6:1063–1075. 10.1200/GO.20.00122 Rahbari R, Zhang L, Kebebew E (2010) Thyroid cancer gender disparity. Future Oncol 6(11):1771–1779. 10.2217/fon.10.127 PMID: 21142662; PMCID: PMC3077966 Zimmermann MB, Galetti V (2015) Iodine intake as a risk factor for thyroid cancer: a comprehensive review of animal and human studies. Thyroid Res 8:8. 10.1186/s13044-015-0020-8 PMID: 26146517; PMCID: PMC4490680 Unnikrishnan AG, Menon UV (2011) Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab 15(Suppl 2):S78–81. 10.4103/2230-8210.83329 PMID: 21966658; PMCID: PMC3169866 Rao DK, Jindal A, Dabas A, Sait H, Yadav S, Kapoor S (2024) Effect of maternal iodine excess during pregnancy on neonatal thyroid function and neurodevelopmental status at 12 weeks. J ASEAN Fed Endocr Soc 39(2):27–32. 10.15605/jafes.039.02.12 Epub 2024 Aug 27. PMID: 39620182; PMCID: PMC11604369 Deshmukh A, Gangiti K, Pantvaidya G, Nair D, Basu S, Chaukar D, Pai P, Nair S, Hawaldar R, Dusane R, Chaturvedi P, D'Cruz A (2018 Jan-Mar) Surgical outcomes of thyroid cancer patients in a tertiary cancer center in India. Indian J Cancer 55(1):23–32. 10.4103/ijc.IJC_528_17 Regmi S, Farazi PA, Lyden E, Kotwal A, Ganti AK, Goldner W (2020) Active surveillance of low-risk papillary thyroid cancer: A meta-analysis. Surgery 167(1):46–55. 10.1016/j.surg.2019.03.040 Epub 2019 Sep 13. PMID: 31526581 Saravana-Bhavan B, Bajwa A, Paterson J, McMullen T (2020) Active surveillance of low-risk papillary thyroid cancer: A meta-analysis. Surgery 167(1):46–55. 10.1016/j.surg.2019.03.040 Epub 2019 Sep 13. PMID: 31526581 https://abdm.gov.in/ Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6667454","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":456755208,"identity":"25507129-58e4-45f5-ad6f-4a93944775f1","order_by":0,"name":"Yuvraj Kaushal","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYNACngQQwcDwwMBGDsQ/8IBoLQkFacZgLQmErYFp+XA4sQHGxwUMbuSYffghkyZvcP7swQ8JBszp88MOPwTaYien24BTi/HMHp4cww038pIlEgzYcjfeTjMAakk2NjuAS0taMgMPTwXjhhs8BkAtPLkbZyeAtBxI3IZHC+Mfngr7DefPGP9IMJBIN5yd/oGAluTDzDw8OYkbDuSYAW0xSJCXzsFvi+SZx4eZZXjSkmcCw8EiwSDBcIN0TsGBBAPcfuE7ntjM+LYn2bYP6LAbH/78l5efnb75w4cKOzlcWhRA4ow9yE4FqzTArhwE5BtA5A8MkVEwCkbBKBgFCAAAsIZm3u5BjoAAAAAASUVORK5CYII=","orcid":"https://orcid.org/0009-0000-0314-3742","institution":"Government Medical College, Patiala","correspondingAuthor":true,"prefix":"","firstName":"Yuvraj","middleName":"","lastName":"Kaushal","suffix":""}],"badges":[],"createdAt":"2025-05-14 22:42:01","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6667454/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6667454/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82857537,"identity":"bf7978dc-3f32-47fb-b868-fe78813f1f86","added_by":"auto","created_at":"2025-05-16 05:43:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":311503,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6667454/v1/d5fca507-1324-4e72-b6e8-79a81f111038.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eRising Trends and Regional Disparities: A Review of Thyroid Cancer Statistics in India\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThyroid cancer develops from follicular or parafollicular thyroid cells to become the primary malignant endocrine tumor worldwide. Medical reports indicate that thyroid cancer cases grow at an increasing rate although the condition remains uncommon in comparison with other malignancies.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e The global incidence of thyroid cancer stands at 1\u0026ndash;2% but this rate becomes much higher among women and younger adults.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e Thyroid cancer cases have been increasing among urban Indian female populations as the cancer care system in the country evolves with developing disease registries. The World Health Organization report GLOBOCAN 2020 reveals that India observes more than 34,000 new thyroid cancer cases which represent 1.1% of the total cancer cases across the country.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThyroid cancer demonstrates increasing frequency in India because of three key factors that combine diagnostic progress with environmental evolution and population epidemics. The combination of enhanced ultrasound diagnostics and FNAC testing availability with public recognition of population lifestyle evolution and enhanced healthcare services has led to an increase in diagnosed cases.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e Medical professionals must address a fundamental concern regarding the increasing incidence numbers because these numbers might stem from excessive identification of benign papillary thyroid carcinomas instead of reflecting true disease progression rates.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e The epidemiological patterns of thyroid cancer in India demonstrate that females predominate among patients and that cancer usually appears between ages 30 and 50 when people are economically active.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e The National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR) positions thyroid cancer as one of the leading female cancers at public institutions in cities like Delhi Chennai and Bengaluru.\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e Research indicates higher incidence rates exist in the southern and northeastern states beyond northern and western India. Several healthcare system factors along with iodine consumption rates inheritance patterns registry operations and accessibility appear to contribute to these discrepancies.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe Indian population experiences primarily papillary thyroid carcinomas (PTC) among thyroid cancer cases with follicular thyroid carcinomas (FTC) and medullary thyroid carcinomas (MTC) as secondary diagnoses and anaplastic thyroid carcinomas (ATC) as a rare occurrence.\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e DTCs composed of PTC and FTC usually demonstrate excellent outcomes when diagnosed. The healthcare results deteriorate when people receive late-stage diagnoses or lack access to specialized medical services, especially in underdeveloped rural areas and under-resourced locations.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e Thyroid nodules frequently encounter unexpected outcomes during medical tests used for different conditions in urban centers where imaging technology usage grows substantially. The discovery of thyroid nodules by chance during other medical tests creates the medical condition known as incidentaloma that leads to both overdiagnosis and unnecessary treatment posing supplemental and fınancıal burdens with no effect on survival rates.\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e The increasing trend of non-communicable diseases requires the Indian thyroid cancer trajectory to become the focus of nationwide research and policy interventions. The good survival rates for thyroid cancer during early disease stages exist alongside significant psychosocial impacts together with treatment complications which demand a thorough cost-effectiveness review. Researchers are investigating how iodine availability interacts with autoimmune thyroiditis incidence combined with elements such as radiation and endocrine disruptors for their potential impact on thyroid cancer development.\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThis review article seeks to analyze the most recent trends in thyroid cancer incidence and mortality in India, based on published literature and national data. It aims to provide a consolidated perspective on the patterns, determinants, and potential public health implications of the disease in the Indian context.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThe research employed data from two main sources including PubMed peer-reviewed studies as well as official statistics collected under programs of the Indian Council of Medical Research (ICMR) National Cancer Registry Programme (NCRP) and Population-Based Cancer Registries (PBCRs). Research using the keywords \u0026ldquo;thyroid cancer India\u0026rdquo; and both \u0026ldquo;thyroid carcinoma epidemiology\u0026rdquo; and \u0026ldquo;thyroid cancer incidence India\u0026rdquo; yielded comprehensive results from PubMed databases. Publications in the English language starting from 2000 up to 2024 were included. National data stem from NCRP publications that include both \u0026ldquo;Three-Year Report of PBCRs (2012\u0026ndash;2014)\u0026rdquo; and \u0026ldquo;Cancer Statistics, India 2020.\u0026rdquo; These reports supply age-standardized incidence rates with trends by sex and age in addition to regional variations regarding cancer burden throughout India. Official cancer registry reports along with original studies using established statistical methods made it to the inclusion list while the reviewers blocked case reports as well as opinion pieces and studies without regional applicability.\u003c/p\u003e \u003cp\u003eEach study within this assessment provided data about incidence rates together with mortality statistics and temporal patterns and age and sex-based distributions. The analysis included available data points on diagnostic patterns and the intake of iodine supplement as well as the possibility of misdiagnoses. Population-based reports served as the main emphasis to establish research reliability and reduce referral bias. This review did not need ethical approval because all data from public resources contained no individual patient information.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe incidence of Thyroid cancer has grown significantly in India since the late 1990s even though experts viewed this disease as extremely rare at the start of the century. Research shows PTC thyroid carcinoma makes up most of the diagnoses similar to global patterns while representing more than 85 percent of all Indian thyroid cancers.\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e The 2020 National Cancer Registry Program (NCDIR) of the ICMR shows Thiruvananthapuram has an Age-Adjusted Rate (AAR) of 10.9 and Bengaluru has 8.4 while Chennai has 7.3 which places thyroid cancer among the leading tumor types affecting women at rates between 6.4 and 10.9 per 100,000 females. Barshi (AAR: 1.6) and Dibrugarh (AAR: 1.2) stand as examples of rural areas where thyroid cancer rates remain low compared to urban populations. These figures demonstrate both diagnostic and reporting differences in the regions.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e This differs strongly from smaller incidence rates present in rural sections thus highlighting dual detection and reporting discrepancies.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e NCRP data shows how urban centers in Delhi and Chennai demonstrate elevated disease incidence levels compared to rural districts according to the reported data. The improved health services and detection methods coupled with higher urban patient engagement explain this variation in statistics between urban and rural areas.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe worldwide pattern shows that thyroid cancer tends to affect women more than men at a rate of 3\u0026ndash;4 females for every male according to Indian statistics. The urban population shows a remarkable gender disparity in thyroid cancer incidence rates because women develop this disease nearly four times more often than men based on NCDIR data. Female thyroid cancer incidence reached levels of 10.9 per 100,000 in some cities but male incidence remained below 3.5 according to medical data.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e The noted gap in incidence rates highlights this distinction. Health checkups performed by women for cosmetic reasons lead to incidental findings about neck swellings and nodules in sociocultural settings. Men tend to reveal thyroid cancer at later stages which potentially leads to worse treatment results.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eResearchers must focus on various environmental substances as well as food components that affect thyroid conditions. Recent research indicates that the histopathological distribution of follicular carcinoma has evolved to papillary carcinoma in areas that implemented Universal Salt Iodization during the post-USI era just like other iodine-replete regions according to findings in the literature.\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e Several remote districts within India remain iodine deficient because officials have not efficiently implemented iodized salt distribution throughout areas such as Madhya Pradesh and Odisha and parts of the northeast regions despite ineffective iodized salt policies. National surveys indicated that 74% of rural households in Odisha received adequate iodized salt.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e Additionally the combination of urban growth with dietary shifts and endocrine-disrupting chemicals exposure which includes industrial solvents and bisphenol A has been related to thyroid cancer formation. Research patterns have established a foundation for a more profound analysis of direct contributors although definitive proof remains elusive.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAlthough the number of thyroid cancer cases increases, mortality rates from this condition remain minimal. These statistics suggest localized papillary carcinoma has a survival rate above 95% within five years thus becoming one of the most treatable malignancies.\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e The results of medical procedures continue to vary between patients because healthcare facilities providing specialized care have different access levels. The standard clinical approach to thyroid cancer management in metropolitan areas consists of combined specialized healthcare teams practicing thyroidectomy procedures along with radioiodine therapy and TSH suppression along with lifelong patient monitoring. NCRP studies demonstrate that districts without one tertiary care center serving a 5 lakh population exhibit higher mortality rates from thyroid cancer which showcases this accessibility gap.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e At the same time patients living in rural areas or disadvantaged regions encounter delayed medical diagnosis alongside less experienced surgeons and limited access to nuclear medicine equipment and suboptimal continue The urban-rural difference causes more patients to present with advanced or metastatic disease at healthcare facilities outside main cities.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe discovery of small thyroid cancers frequently known as microcarcinomas (measuring less than one centimeter) has become common because of incidental findings during imaging tests while generating worries about their unnecessary treatment. The majority of global medical investigations suggest monitoring low-risk thyroid cases without immediate surgery to diminish the lifetime consequences of thyroid hormone therapy and the complications of thyroid gland removal.\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e Both patients and clinicians in India tend to pursue definitive surgical interventions for subcentimeter nodules because of prevailing cultural and psychological factors yet the situation requires awareness programs to develop appropriate guidelines for Indian healthcare.\u003c/p\u003e \u003cp\u003eThe social economic conditions dramatically influence how Indians detect thyroid cancer along with their therapeutic choices. The NCRP 2020 report showed urban populations exceeding 80% literacy rates alongside per capita monthly expenditures greater than Rs. 2500 achieve nearly double the diagnostic rates than areas spending less than Rs. 2500.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e This economic disparity results in delayed early diagnosis among the general public because residents are unaware of thyroid health and its symptoms. The implementation of public health initiatives concerning thyroid disease education in high-incidence areas will support disease management over an extended period.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIndia must address several obstacles when it comes to research and registry-based data collection. The ICMR-NCDIR has expanded its data collection but cancer registry programs consist only of 36 population-based cancer registries and their presence is restricted to select urban and semi-urban areas and thyroid cancer records remain scarce.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e A national database system that emphasizes thyroid cancer histopathology examination alongside treatment methods and extended results must be created to develop clinical guidelines and policy recommendations. The inclusion of thyroid cancer screening and management protocols within Ayushman Bharat national health programs will serve to enhance the early diagnosis process and improve healthcare quality throughout different socioeconomic groups.\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAn approaching solution to control India's growing thyroid cancer problem requires the combined expertise of endocrinologists, oncologists, pathologists, and surgeons with public health specialists. The upward trend in thyroid cancer incidence requires healthcare professionals to concentrate on patient-specific risk assessment and individualized therapeutic approaches and procedures of minimum necessity. Research that examines environmental and genetic risk factors unique to the Indian population should gain priority status to discover etiological factors that are specific to this region.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIndia shows a growing pattern of thyroid cancer occurrence which affects women specifically because three urban areas including Thiruvananthapuram, Bengaluru, and Chennai document increasing incidence rates. The growing detection rates reflect improved diagnostic techniques led by ultrasonography and fine-needle aspiration cytology during which time additional suspected low-risk papillary microcarcinomas might also be inaccurately diagnosed. The increasing number of thyroid cancer cases in India still presents patients with favorable treatment outcomes since papillary cases comprise most of the diagnosed patients. Concerns about uniform standards in diagnosis, as well as treatment and follow-up, exist because urban populations enjoy better access to healthcare than rural populations. Remote areas experience difficulties regarding treatment outcomes because they lack both sophisticated surgical services, nuclear medicine and radioactive iodine therapy.\u003c/p\u003e \u003cp\u003eThe increasing public health burden requires India to develop an extensive thyroid cancer registry as well as standardized treatment protocols and enhanced healthcare procedures. Seeking additional awareness about proper diagnostic approaches combined with relevant physician training regarding active surveillance of low-risk cases will help minimize unnecessary treatment. A successful approach to treating thyroid cancer in India relies on combining evidence-based practices with health equity considerations integrated through epidemiological research to reduce its future impact.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Statement:\u0026nbsp;\u003c/strong\u003eNo ethical approval was required for this review\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent:\u0026nbsp;\u003c/strong\u003eNot Applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u0026nbsp;\u003c/strong\u003eNot Applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNo funding received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement:\u0026nbsp;\u003c/strong\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eNot Applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u0026nbsp;\u003c/strong\u003eCRediT authorship contribution statement\u003c/p\u003e\n\u003cp\u003eYuvraj Kaushal: \u0026nbsp;Data curation, Conceptualization, \u0026nbsp;Project Administration, Writing - original draft preparation, Writing: Review and editing \u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKitahara CM, Sosa JA (2020) Understanding the ever-changing incidence of thyroid cancer. 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PMID: 39620182; PMCID: PMC11604369\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDeshmukh A, Gangiti K, Pantvaidya G, Nair D, Basu S, Chaukar D, Pai P, Nair S, Hawaldar R, Dusane R, Chaturvedi P, D'Cruz A (2018 Jan-Mar) Surgical outcomes of thyroid cancer patients in a tertiary cancer center in India. Indian J Cancer 55(1):23\u0026ndash;32. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/ijc.IJC_528_17\u003c/span\u003e\u003cspan address=\"10.4103/ijc.IJC_528_17\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRegmi S, Farazi PA, Lyden E, Kotwal A, Ganti AK, Goldner W (2020) Active surveillance of low-risk papillary thyroid cancer: A meta-analysis. 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PMID: 31526581\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://abdm.gov.in/\u003c/span\u003e\u003cspan address=\"https://abdm.gov.in/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Government Medical College, Patiala","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Thyroid cancer, India, Epidemiology, Papillary thyroid carcinoma, Cancer registry","lastPublishedDoi":"10.21203/rs.3.rs-6667454/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6667454/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThyroid cancer, the most prevalent endocrine malignancy globally, has shown a significant rise in incidence in India over recent decades, particularly among women in urban regions. This review synthesizes epidemiological trends, regional variations, and possible contributing factors influencing thyroid cancer burden in the Indian context. Data from the Indian Council of Medical Research (ICMR), Population-Based Cancer Registries (PBCRs), and PubMed-indexed literature between 2000 and 2024 was analyzed. The increasing incidence, particularly of papillary thyroid carcinoma (PTC), is attributed to improved diagnostic modalities, higher awareness, urbanization, and possibly environmental exposures such as endocrine-disrupting chemicals. However, substantial disparities exist in access to healthcare between urban and rural populations, affecting timely diagnosis, treatment, and outcomes. The marked female preponderance and rising detection of low-risk microcarcinomas have raised concerns of overdiagnosis and overtreatment. Despite the prognosis, especially for differentiated thyroid cancers, uniform access to specialized care remains a challenge. The lack of national screening guidelines and comprehensive thyroid cancer registries further limits effective policy-making. Addressing these gaps through targeted public health strategies, standardized clinical protocols, and nationwide surveillance is critical to managing the rising burden of thyroid cancer in India effectively.\u003c/p\u003e","manuscriptTitle":"Rising Trends and Regional Disparities: A Review of Thyroid Cancer Statistics in India","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-16 05:35:07","doi":"10.21203/rs.3.rs-6667454/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3f16aac0-d838-4611-ac69-d72ed7f9727e","owner":[],"postedDate":"May 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":48613317,"name":"Epidemiology"},{"id":48613318,"name":"Oncology"},{"id":48613319,"name":"Endocrinology \u0026 Metabolism"}],"tags":[],"updatedAt":"2025-05-16T05:35:07+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-16 05:35:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6667454","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6667454","identity":"rs-6667454","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}