Kim Min-Su, Lee Sang Jun, Lee Myeong Hoon, Choi Jay Hyug, Han Hyun Wook, Song Young Shin
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea.
Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea.
Diagnostics (Basel). 2023 Sep 11;13(18):2903. doi: 10.3390/diagnostics13182903.
Despite obtaining a good prognosis and long life expectancy, survivors of thyroid cancer can nevertheless develop subsequent primary cancer (SPC). We investigated the risk and types of SPC in patients with thyroid cancer and compared them with subjects without thyroid cancer history (controls). We conducted a nationwide, population-based, retrospective cohort study based on the Korean National Health Insurance Database. A total of 432,654 patients diagnosed with thyroid cancer between 2004 and 2019 were 1:1 matched with controls for age, sex, income, and region of residence. The hazard ratios (HR) and 95% confidence intervals (CI) of SPC were estimated using Cox proportional hazard models. In total, 78,584 (18.2%) patients with thyroid cancer and 49,979 (11.6%) controls were diagnosed with SPCs over a mean follow-up of 6.9 years. Patients with thyroid cancer had a higher risk of SPC at any site (adjusted HR, 1.62; 95% CI, 1.60-1.64) than the controls. The risk of SPCs was particularly high for patients diagnosed with thyroid cancer at a younger age (<40 years) and within 5 years. Medical caregivers should consider the long-term follow-up of patients with thyroid cancer and discuss the risk of SPC, especially if they complain of cancer-related symptoms.
尽管甲状腺癌幸存者预后良好且预期寿命长，但仍可能发生后续原发性癌症（SPC）。我们调查了甲状腺癌患者发生SPC的风险和类型，并将其与无甲状腺癌病史的受试者（对照组）进行比较。我们基于韩国国民健康保险数据库进行了一项全国性的、基于人群的回顾性队列研究。2004年至2019年间共432,654例诊断为甲状腺癌的患者按年龄、性别、收入和居住地区与对照组进行1:1匹配。使用Cox比例风险模型估计SPC的风险比（HR）和95%置信区间（CI）。在平均6.9年的随访中，共有78,584例（18.2%）甲状腺癌患者和49,979例（11.6%）对照组患者被诊断为SPC。甲状腺癌患者在任何部位发生SPC的风险均高于对照组（校正HR，1.62；95%CI，1.60 - 1.64）。对于年龄较轻（<40岁）且在5年内诊断为甲状腺癌的患者，SPC的风险尤其高。医疗护理人员应考虑对甲状腺癌患者进行长期随访，并讨论SPC的风险，特别是当他们出现癌症相关症状时。
