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Horm Metab Res 2024; 56(08): 559-565
DOI: 10.1055/a-2319-4179
Original Article: Endocrine Care

Risk of Lymphoma and Leukemia in Thyroid Cancer Patients: A Retrospective Cohort Study in Germany

Andreas Krieg 
1   Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
,
Sarah Krieg
2   Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany
,
Omar M.S. Al Natour
1   Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
,
Stephanie Brünjes
1   Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
,
Matthias Schott
3   Division for Specific Endocrinology, Medical Faculty Heinrich-Heine-University and University Hospital Duesseldorf, Duesseldorf, Germany
,
Karel Kostev
4   Epidemiology, IQVIA, Frankfurt, Germany
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Abstract

Thyroid cancer is the ninth most common cancer worldwide. While differentiated thyroid cancer (DTC) has a high survival rate, concerns arise regarding optimal treatment strategies and potential long-term risks, including second primary malignancies (SPMs), associated with therapies such as radioiodine (RAI). The aim of the present study was to investigate the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia in Germany. This retrospective cohort study used the IQVIA TM Disease Analyzer database and included adults with a first documented diagnosis of thyroid cancer between January 2005 and December 2021 as well as propensity score matched individuals without thyroid cancer in 1284 general practices. Univariate Cox regression models were performed to examine the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia. A total of 4232 thyroid cancer patients (mean age: 54.2 years; 73.6% female) and 21 160 controls (mean age: 54.2 years; 72.6% female) were available for analyses. Thyroid cancer was significantly associated with a higher lymphoma incidence (HR: 3.35, 95% CI: 2.04–5.52), especially in men (HR: 5.37) and those aged 61–70 years. Leukemia incidence was not significantly associated with thyroid cancer (HR: 1.79, 95% CI: 0.91–3.53), although associations were notable in younger age groups. Thyroid cancer is positively associated with a risk of subsequent lymphoma, highlighting the need for vigilant surveillance and tailored treatment strategies. While the association with leukemia is less pronounced, close surveillance remains critical, especially in younger patients.

Keywords

thyroid cancer - secondary primary malignancy - lymphoma - leukemia


Publikationsverlauf

Eingereicht: 16. März 2024

Angenommen nach Revision: 02. Mai 2024

Artikel online veröffentlicht:
13. Juni 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Sung H, Ferlay J, Siegel RL. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209-249
    CrossrefPubMedSuche in Google Scholar
  • 2 National Cancer Institute. Cancer statistics facts: thyroid cancer https://seer.cancer.gov/statfacts/html/thyro.html
    PubMed
  • 3 Boucai L, Zafereo M, Cabanillas ME. Thyroid cancer: a review. JAMA 2024; 331: 425-435
    CrossrefPubMedSuche in Google Scholar
  • 4 Chen DW, Lang BHH, McLeod DSA. et al. Thyroid cancer. Lancet (London, England) 2023; 401: 1531-1544
    CrossrefPubMedSuche in Google Scholar
  • 5 Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994; 97: 418-428
    CrossrefPubMedSuche in Google Scholar
  • 6 Mazzaferri EL. Long-term outcome of patients with differentiated thyroid carcinoma: effect of therapy. Endocr Pract 2000; 6: 469-476
    CrossrefPubMedSuche in Google Scholar
  • 7 Cooper DS, Doherty GM, Haugen BR. et al. Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19: 1167-1214
    CrossrefPubMedSuche in Google Scholar
  • 8 Haugen BR, Alexander EK, Bible KC. et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1-133
    CrossrefPubMedSuche in Google Scholar
  • 9 Nixon IJ, Ganly I, Patel SG. et al. The results of selective use of radioactive iodine on survival and on recurrence in the management of papillary thyroid cancer, based on Memorial Sloan-Kettering Cancer Center risk group stratification. Thyroid 2013; 23: 683-694
    CrossrefPubMedSuche in Google Scholar
  • 10 Subramanian S, Goldstein DP, Parlea L. et al. Second primary malignancy risk in thyroid cancer survivors: a systematic review and meta-analysis. Thyroid 2007; 17: 1277-1288
    CrossrefPubMedSuche in Google Scholar
  • 11 Sawka AM, Thabane L, Parlea L. et al. Second primary malignancy risk after radioactive iodine treatment for thyroid cancer: a systematic review and meta-analysis. Thyroid 2009; 19: 451-457
    CrossrefPubMedSuche in Google Scholar
  • 12 Rathmann W, Bongaerts B, Carius HJ. et al. Basic characteristics and representativeness of the German disease analyzer database. Int J Clin Pharmacol Therap 2018; 56: 459-466
    CrossrefPubMedSuche in Google Scholar
  • 13 Gremke N, Griewing S, Kostev K. et al. Association between gout and subsequent breast cancer: a retrospective cohort study including 67,598 primary care patients in Germany. Breast Cancer Res Treatment 2023; 199: 545-552
    CrossrefPubMedSuche in Google Scholar
  • 14 Krieg S, Loosen S, Krieg A. et al. Association between iron deficiency anemia and subsequent stomach and colorectal cancer diagnosis in Germany. J Cancer Res Clin Oncol 2024; 150: 53
    CrossrefPubMedSuche in Google Scholar
  • 15 Pizzato M, Li M, Vignat J. et al. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 2022; 10: 264-272
    CrossrefPubMedSuche in Google Scholar
  • 16 Vaccarella S, Franceschi S, Bray F. et al. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Eng J Med 2016; 375: 614-617
    CrossrefPubMedSuche in Google Scholar
  • 17 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015; 65: 5-29
    CrossrefPubMedSuche in Google Scholar
  • 18 Wood ME, Vogel V, Ng A. et al. Second malignant neoplasms: assessment and strategies for risk reduction. J Clin Oncol 2012; 30: 3734-3745
    CrossrefPubMedSuche in Google Scholar
  • 19 Donin N, Filson C, Drakaki A. et al. Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008. Cancer 2016; 122: 3075-3086
    CrossrefPubMedSuche in Google Scholar
  • 20 Soerjomataram I, Coebergh JW. Epidemiology of multiple primary cancers. Meth Mol Biol (Clifton, NJ) 2009; 471: 85-105
    CrossrefPubMedSuche in Google Scholar
  • 21 Brown AP, Chen J, Hitchcock YJ. et al. The risk of second primary malignancies up to three decades after the treatment of differentiated thyroid cancer. J Clin Endocrinol Metab 2008; 93: 504-515
    CrossrefPubMedSuche in Google Scholar
  • 22 Sandeep TC, Strachan MW, Reynolds RM. et al. Second primary cancers in thyroid cancer patients: a multinational record linkage study. J Clin Endocrinol Metab 2006; 91: 1819-1825
    CrossrefPubMedSuche in Google Scholar
  • 23 Rubino C, de Vathaire F, Dottorini ME. et al. Second primary malignancies in thyroid cancer patients. Br J Cancer 2003; 89: 1638-1644
    CrossrefPubMedSuche in Google Scholar
  • 24 Molenaar RJ, Sidana S, Radivoyevitch T. et al. Risk of Hematologic malignancies after radioiodine treatment of well-differentiated thyroid cancer. J Clin Oncol 2018; 36: 1831-1839
    CrossrefPubMedSuche in Google Scholar
  • 25 Seo GH, Cho YY, Chung JH. et al. Increased risk of leukemia after radioactive iodine therapy in patients with thyroid cancer: a nationwide, population-based study in Korea. Thyroid 2015; 25: 927-934
    CrossrefPubMedSuche in Google Scholar
  • 26 Hong JY, Han K, Jung JH. et al. Association of exposure to diagnostic low-dose ionizing radiation with risk of cancer among youths in South Korea. JAMA Network Open 2019; 2: e1910584
    CrossrefPubMedSuche in Google Scholar
  • 27 Cancer Genome Atlas Research Network. Integrated genomic characterization of papillary thyroid carcinoma. Cell 2014; 159: 676-690
    CrossrefPubMedSuche in Google Scholar