Second primary malignancies following thyroid cancer

A population-based study in Taiwan

Chang Hsien Lu, Kuan Der Lee, Ping Tsung Chen, Chih Cheng Chen, Feng Che Kuan, Cih En Huang, Miao Fen Chen, Min Chi Chen

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: Most studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors. Design: A population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006. Methods: We quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19068 individuals (4205 males and 14 863 females) with primary thyroid cancer. Results: A total of 644 cases (3.38%) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23-1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR = 5.29, 1.68, and 0.68 for ≦5, 5-10, and > 10 respectively) and in the younger patients (SIR = 1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs. Conclusion: Thyroid cancer is associated with a 33% risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.

Original languageEnglish
Pages (from-to)577-585
Number of pages9
JournalEuropean Journal of Endocrinology
Volume169
Issue number5
DOIs
Publication statusPublished - Nov 2013
Externally publishedYes

Fingerprint

Second Primary Neoplasms
Taiwan
Thyroid Neoplasms
Population
Incidence
Survival
Genetic Predisposition to Disease
Salivary Glands
Urinary Bladder Neoplasms
Brain Neoplasms
Thymus Gland
Survivors
Registries
Epidemiologic Studies
Lymphoma
Leukemia
Databases
Breast Neoplasms
Lung

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Second primary malignancies following thyroid cancer : A population-based study in Taiwan. / Lu, Chang Hsien; Lee, Kuan Der; Chen, Ping Tsung; Chen, Chih Cheng; Kuan, Feng Che; Huang, Cih En; Chen, Miao Fen; Chen, Min Chi.

In: European Journal of Endocrinology, Vol. 169, No. 5, 11.2013, p. 577-585.

Research output: Contribution to journalArticle

Lu, CH, Lee, KD, Chen, PT, Chen, CC, Kuan, FC, Huang, CE, Chen, MF & Chen, MC 2013, 'Second primary malignancies following thyroid cancer: A population-based study in Taiwan', European Journal of Endocrinology, vol. 169, no. 5, pp. 577-585. https://doi.org/10.1530/EJE-13-0309
Lu, Chang Hsien ; Lee, Kuan Der ; Chen, Ping Tsung ; Chen, Chih Cheng ; Kuan, Feng Che ; Huang, Cih En ; Chen, Miao Fen ; Chen, Min Chi. / Second primary malignancies following thyroid cancer : A population-based study in Taiwan. In: European Journal of Endocrinology. 2013 ; Vol. 169, No. 5. pp. 577-585.
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abstract = "Objective: Most studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors. Design: A population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006. Methods: We quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19068 individuals (4205 males and 14 863 females) with primary thyroid cancer. Results: A total of 644 cases (3.38{\%}) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95{\%} CI 1.23-1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR = 5.29, 1.68, and 0.68 for ≦5, 5-10, and > 10 respectively) and in the younger patients (SIR = 1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs. Conclusion: Thyroid cancer is associated with a 33{\%} risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.",
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T2 - A population-based study in Taiwan

AU - Lu, Chang Hsien

AU - Lee, Kuan Der

AU - Chen, Ping Tsung

AU - Chen, Chih Cheng

AU - Kuan, Feng Che

AU - Huang, Cih En

AU - Chen, Miao Fen

AU - Chen, Min Chi

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N2 - Objective: Most studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors. Design: A population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006. Methods: We quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19068 individuals (4205 males and 14 863 females) with primary thyroid cancer. Results: A total of 644 cases (3.38%) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23-1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR = 5.29, 1.68, and 0.68 for ≦5, 5-10, and > 10 respectively) and in the younger patients (SIR = 1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs. Conclusion: Thyroid cancer is associated with a 33% risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.

AB - Objective: Most studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors. Design: A population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006. Methods: We quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19068 individuals (4205 males and 14 863 females) with primary thyroid cancer. Results: A total of 644 cases (3.38%) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23-1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR = 5.29, 1.68, and 0.68 for ≦5, 5-10, and > 10 respectively) and in the younger patients (SIR = 1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs. Conclusion: Thyroid cancer is associated with a 33% risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.

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