The global incidence of thyroid cancer (TC) has increased significantly in recent decades. Traditionally, this trend has been attributed to overdiagnosis resulting from the widespread use of imaging and improved diagnostic techniques, but increasing evidence suggests that current epidemiological patterns may not be fully explained by diagnostic factors alone. Most importantly, increasing rates of larger and more advanced tumors have been reported in several populations. This narrative review discusses the evidence on possible drivers of rising TC incidence: obesity and metabolic dysfunction, environmental exposures such as air pollution, and endocrine-disrupting chemicals (EDCs) and ionizing radiation, as well as molecular and genetic mechanisms involved in thyroid carcinogenesis. The role of advances in diagnostics and their contribution to overdiagnosis are also discussed. Current available data support a multifactorial model with better detection coupled with changes in environmental, metabolic and biological risk factors. A better understanding of the relative contribution and interaction of these determinants may help refine diagnostic strategies, reduce unnecessary interventions, and improve the prevention and management of TC.

Mushroom-related intoxications pose a distinctive challenge for forensic medicine because early manifestations are non-specific, latency may be prolonged, and co-exposures can obscure the mechanism of death. This narrative review summarizes key toxic and psychoactive fungi and their principal compounds, spanning organ-toxic syndromes (amatoxins, orellanine) and functional neuropsychiatric intoxications—acute, predominantly functional effects causing impairment rather than organ failure (psilocybin/psilocin, ibotenic acid/muscimol). We propose an integrated diagnostic workflow combining exposure history, biochemical markers of organ injury, mycological assessment, and confirmatory toxicology. Particular emphasis is placed on postmortem interpretation: toxin instability and biotransformation, conjugation, matrix effects, postmortem redistribution (central vs. femoral blood), and postmortem fungal colonization that may alter analyte profiles or generate misleading metabolites. Because robust lethality thresholds are unavailable for most mushroom toxins, conclusions should rely on a multi-source synthesis of scene information, autopsy/histopathology, and time-dependent matrix selection (urine, gastric contents/vomitus, bile, and selected tissues; kidney for late orellanine confirmation). We review current screening and confirmatory methods—ELISA; LC-MS/MS, LC-HRMS/MS, GC-MS—and highlight pre-analytical requirements (rapid sampling, cold storage) to reduce false negatives. Finally, we discuss emerging directions such as point-of-care tests, portable mass spectrometry, and DNA barcoding for species identification.