Francis-Levin Nina, Shao Edward, Ortlieb Jacob, Gay Brittany, Banerjee Mousumi, Papaleontiou Maria, Haymart Megan R
Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan.
Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
Endocr Pract. 2025 Aug;31(8):1033-1037. doi: 10.1016/j.eprac.2025.04.020. Epub 2025 Apr 30.
Close to one-quarter of thyroid cancers occur in older adults (ie, aged ≥ 65). This group also has other comorbidities and higher risk of death from other causes. Data on optimal neck ultrasound use for thyroid cancer surveillance in older adults are limited.
We identified patients aged ≥ 65 years diagnosed with thyroid cancer using data from the Centers for Medicare & Medicaid Services linked to health data from University of Michigan between 2016-2021 (median follow-up 3 years, range 0-6 years). We assessed demographic characteristics, comorbidities, frequency of neck ultrasound, and cause of death.
Of the 2007 patients diagnosed with thyroid cancer, median age was 74 years (range 65-100) and 65.1% were female. Overall, 76 (3.8%) died of thyroid cancer, and 259 (12.9%) died of other causes. There were more comorbidities in the cohort who died of other causes during the study period, eg, 179 (69.1%) in the cohort who died of other causes had heart disease compared with 868 (43.3%) of those in the entire cohort. Patients who died of other causes received a mean of 1.36 neck ultrasounds (range 0-12) and the remainder of the cohort received a mean of 2.38 neck ultrasounds (range 0-26) during the study period, P < .001.
Older adults with thyroid cancer are more likely to die of causes other than thyroid cancer. To improve high-value care in older adults with thyroid cancer and high-risk of death from other causes, there is need for individualized plans for neck ultrasound use.
近四分之一的甲状腺癌发生在老年人（即年龄≥65岁）中。该群体还存在其他合并症，且因其他原因死亡的风险更高。关于老年人甲状腺癌监测中颈部超声最佳使用的数据有限。
我们使用2016年至2021年期间医疗保险和医疗补助服务中心与密歇根大学健康数据相链接的数据，确定了年龄≥65岁且被诊断为甲状腺癌的患者（中位随访时间为3年，范围为0至6年）。我们评估了人口统计学特征、合并症、颈部超声检查频率和死亡原因。
在2007例被诊断为甲状腺癌的患者中，中位年龄为74岁（范围为65至100岁），65.1%为女性。总体而言，76例（3.8%）死于甲状腺癌，259例（12.9%）死于其他原因。在研究期间死于其他原因的队列中合并症更多，例如，死于其他原因的队列中有179例（69.1%）患有心脏病，而整个队列中有868例（43.3%）患有心脏病。在研究期间，死于其他原因的患者平均接受了1.36次颈部超声检查（范围为0至12次），队列中的其余患者平均接受了2.38次颈部超声检查（范围为0至26次），P <.001。
患有甲状腺癌的老年人更有可能死于甲状腺癌以外的原因。为了改善患有甲状腺癌且因其他原因死亡风险高的老年人的高价值护理，需要制定个性化的颈部超声使用计划。
