Metso Saara, Auvinen Anssi, Huhtala Heini, Salmi Jorma, Oksala Heikki, Jaatinen Pia
Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
Cancer. 2007 May 15;109(10):1972-9. doi: 10.1002/cncr.22635.
Concerns remain about risk of cancer after radioactive iodine (RAI) treatment for hyperthyroidism, especially in organs that concentrate iodine. The objective was to assess the long-term cancer risk from RAI treatment for hyperthyroidism.
A total of 2793 hyperthyroid patients treated with RAI at Tampere University Hospital between 1965 and 2002, and 2793 age- and sex-matched reference subjects were followed for an average of 10 years through the Finnish Cancer Registry.
Cancer incidence among hyperthyroid patients treated with RAI was higher than in the population-based control group (118.9 vs 94.9 per 10,000 person-years, rate ratio [RR], 1.25; 95% confidence interval [CI]: 1.08-1.46). Furthermore, incidence of stomach (RR, 1.75, 95% CI: 1.00-3.14), kidney (RR, 2.32; 95% CI: 1.06-5.09), and breast (RR, 1.53; 95% CI: 1.07-2.19) cancer was increased among RAI-treated patients. The relative risk of cancer increased with higher RAI dose administered. The increase in cancer incidence was statistically significant in patients treated at the age of 50-59 (RR, 1.44; 95% CI: 1.05-1.97) or older than 70 years (RR, 1.39; 95% CI: 1.05-1.82). There was a 5-year latent period after the RAI treatment before the cancer incidence began to differ between the RAI-treated hyperthyroid patients and the control group.
Cancer incidence, especially cancer of the stomach, kidney, and breast, was higher in patients treated with RAI for hyperthyroidism.
对于放射性碘(RAI)治疗甲亢后癌症风险仍存在担忧,尤其是在摄取碘的器官中。目的是评估RAI治疗甲亢的长期癌症风险。
1965年至2002年间在坦佩雷大学医院接受RAI治疗的2793例甲亢患者,以及2793例年龄和性别匹配的对照受试者通过芬兰癌症登记处平均随访10年。
接受RAI治疗的甲亢患者的癌症发病率高于基于人群的对照组(每10000人年118.9例对94.9例,率比[RR]为1.25;95%置信区间[CI]:1.08 - 1.46)。此外,接受RAI治疗的患者中胃癌(RR为1.75,95%CI:1.00 - 3.14)、肾癌(RR为2.32;95%CI:1.06 - 5.09)和乳腺癌(RR为1.53;95%CI:1.07 - 2.19)的发病率增加。给予的RAI剂量越高,癌症的相对风险增加。在50 - 59岁(RR为1.44;95%CI:1.05 - 1.97)或70岁以上(RR为1.39;95%CI:1.05 - 1.82)接受治疗的患者中,癌症发病率的增加具有统计学意义。RAI治疗后有5年的潜伏期,之后接受RAI治疗的甲亢患者与对照组之间的癌症发病率开始出现差异。
接受RAI治疗甲亢的患者癌症发病率较高,尤其是胃癌、肾癌和乳腺癌。