Department of Endocrinology, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.
Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
PLoS One. 2022 Oct 5;17(10):e0275568. doi: 10.1371/journal.pone.0275568. eCollection 2022.
The objective of this study was to determine the association between hypothyroidism and overall and site-specific cancer in Spanish population.
A cross-sectional study was performed using the population-based database BDCAP (Base de Datos Clínicos de Atención Primaria, primary care clinical database) to analyze the relative risk of cancer in Spanish population with hypothyroidism.
In a total of 2,414,165 patients diagnosed with hypothyroidism in BDCAP in 2019, the relative risk (OR) of cancer, compared to the non-hypothyroid population, was 1.73 (1.72-1.74) (P<0.0001). The higher risk was observed in both men (OR 2.15 [2.13-2.17]; P<0.0001) and women (OR 1.67 [1.636-1.68]; P<0.0001). However, hypothyroid persons aged 65 years or older had a reduced risk of cancer (OR 0.98 [0.97-0.98]; P<0.0001). In addition, hypothyroid patients aged 65 or over showed a decreased risk of cancers of the bladder, colorectal, gastric, pancreatic and prostate. Socioeconomic characteristics such as income level, municipality size, country of birth and employment situation had limited influence on the association between hypothyroidism and cancer. However, hypothyroid patients receiving replacement therapy exhibited higher cancer risk compared with patients without treatment (OR 1.30 [1.28-1.31]; P<0.0001).
Spanish hypothyroid patients of both genders have a risk of overall cancer higher than that found in non-hypothyroid population. However, people over 65 years have a reduced risk of various malignancies. This peculiarity of hypothyroidism should be considered by the health authorities.
本研究旨在确定西班牙人群中甲状腺功能减退症与总体和特定部位癌症之间的关联。
本研究采用基于人群的 BDCAP（初级保健临床数据库）数据库进行横断面研究，以分析西班牙甲状腺功能减退症人群中癌症的相对风险。
在 2019 年 BDCAP 中诊断为甲状腺功能减退症的 2414165 例患者中，与非甲状腺功能减退症人群相比，癌症的相对风险（OR）为 1.73（1.72-1.74）（P<0.0001）。男性（OR 2.15[2.13-2.17]；P<0.0001）和女性（OR 1.67[1.636-1.68]；P<0.0001）的风险均升高。然而，年龄在 65 岁或以上的甲状腺功能减退症患者患癌症的风险降低（OR 0.98[0.97-0.98]；P<0.0001）。此外，年龄在 65 岁或以上的甲状腺功能减退症患者膀胱癌、结直肠癌、胃癌、胰腺癌和前列腺癌的风险降低。社会经济特征，如收入水平、城市规模、出生国和就业状况，对甲状腺功能减退症与癌症之间的关联影响有限。然而，与未接受治疗的患者相比，接受替代治疗的甲状腺功能减退症患者的癌症风险更高（OR 1.30[1.28-1.31]；P<0.0001）。
西班牙甲状腺功能减退症患者的总体癌症风险高于非甲状腺功能减退症人群。然而，年龄在 65 岁以上的人群各种恶性肿瘤的风险降低。卫生当局应考虑甲状腺功能减退症的这种特殊性。
