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Benign Thyroid Diseases and Risk of Thyroid Cancer: A Nationwide Cohort Study

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Benign Thyroid Diseases and Risk of Thyroid Cancer : A Nationwide Cohort Study. / Kitahara, Cari M; Komendiné Farkas, Dóra; Jørgensen, Jens Otto L; Cronin-Fenton, Deirdre; Sørensen, Henrik Toft.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 103, No. 6, 01.06.2018, p. 2216-2224.

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Kitahara, Cari M et al. "Benign Thyroid Diseases and Risk of Thyroid Cancer: A Nationwide Cohort Study". Journal of Clinical Endocrinology and Metabolism. 2018, 103(6). 2216-2224. https://doi.org/10.1210/jc.2017-02599

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@article{336ca1cc199e4b33aef4420826a5cf35,
title = "Benign Thyroid Diseases and Risk of Thyroid Cancer: A Nationwide Cohort Study",
abstract = "Context: Thyroid nodules, adenomas, and goiter have consistently been associated with thyroid cancer risk. Few studies have assessed whether thyroid dysfunction and thyroid autoimmunity influence this risk.Objective: To examine thyroid cancer risk after diagnoses of a wide range of benign thyroid conditions.Design: Hospital and cancer registry linkage cohort study for the years 1978 to 2013.Setting: Nationwide (Denmark).Participants: Patients diagnosed with hyperthyroidism (n = 85,169), hypothyroidism (n = 63,143), thyroiditis (n = 12,532), nontoxic nodular goiter (n = 65,782), simple goiter (n = 11,582), other/unspecified goiter (n = 21,953), or adenoma (n = 6,481) among 8,258,807 residents of Denmark during the study period.Main Outcome Measures: We computed standardized incidence ratios (SIRs) for differentiated thyroid cancer, excluding the first 12 months of follow-up after benign thyroid disease diagnosis.Results: SIRs were significantly elevated for all benign thyroid diseases apart from hypothyroidism. SIRs were higher for men than women and in the earlier follow-up periods. Elevated SIRs were observed for localized and regional/distant thyroid cancer. After excluding the first 10 years of follow-up, hyperthyroidism [n = 27 thyroid cancer cases; SIR = 2.00; 95{\%} confidence interval (CI): 1.32 to 2.92], nontoxic nodular goiter (n = 83; SIR = 4.91; 95{\%} CI: 3.91 to 6.09), simple goiter (n = 8; SIR = 4.33; 95{\%} CI: 1.87 to 8.53), other/unspecified goiter (n = 20; SIR = 3.94; 95{\%} CI: 2.40 to 6.08), and adenoma (n = 9; SIR = 6.02; 95{\%} CI: 2.76 to 11.5) remained positively associated with thyroid cancer risk.Conclusions: We found an unexpected increased risk of differentiated thyroid cancer, including regional/distant disease, following diagnosis of hyperthyroidism and thyroiditis that could not be solely attributed to increased medical surveillance. Hypothyroidism was less clearly associated with thyroid cancer risk.",
keywords = "Adult, Aged, Cohort Studies, Denmark/epidemiology, Female, Humans, Hyperthyroidism/complications, Hypothyroidism/complications, Incidence, Male, Middle Aged, Registries, Risk, Sex Factors, Thyroid Neoplasms/epidemiology, Thyroiditis/complications",
author = "Kitahara, {Cari M} and {Komendin{\'e} Farkas}, D{\'o}ra and J{\o}rgensen, {Jens Otto L} and Deirdre Cronin-Fenton and S{\o}rensen, {Henrik Toft}",
year = "2018",
month = "6",
day = "1",
doi = "10.1210/jc.2017-02599",
language = "English",
volume = "103",
pages = "2216--2224",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "Oxford University Press",
number = "6",

}

RIS

TY - JOUR

T1 - Benign Thyroid Diseases and Risk of Thyroid Cancer

T2 - A Nationwide Cohort Study

AU - Kitahara, Cari M

AU - Komendiné Farkas, Dóra

AU - Jørgensen, Jens Otto L

AU - Cronin-Fenton, Deirdre

AU - Sørensen, Henrik Toft

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Context: Thyroid nodules, adenomas, and goiter have consistently been associated with thyroid cancer risk. Few studies have assessed whether thyroid dysfunction and thyroid autoimmunity influence this risk.Objective: To examine thyroid cancer risk after diagnoses of a wide range of benign thyroid conditions.Design: Hospital and cancer registry linkage cohort study for the years 1978 to 2013.Setting: Nationwide (Denmark).Participants: Patients diagnosed with hyperthyroidism (n = 85,169), hypothyroidism (n = 63,143), thyroiditis (n = 12,532), nontoxic nodular goiter (n = 65,782), simple goiter (n = 11,582), other/unspecified goiter (n = 21,953), or adenoma (n = 6,481) among 8,258,807 residents of Denmark during the study period.Main Outcome Measures: We computed standardized incidence ratios (SIRs) for differentiated thyroid cancer, excluding the first 12 months of follow-up after benign thyroid disease diagnosis.Results: SIRs were significantly elevated for all benign thyroid diseases apart from hypothyroidism. SIRs were higher for men than women and in the earlier follow-up periods. Elevated SIRs were observed for localized and regional/distant thyroid cancer. After excluding the first 10 years of follow-up, hyperthyroidism [n = 27 thyroid cancer cases; SIR = 2.00; 95% confidence interval (CI): 1.32 to 2.92], nontoxic nodular goiter (n = 83; SIR = 4.91; 95% CI: 3.91 to 6.09), simple goiter (n = 8; SIR = 4.33; 95% CI: 1.87 to 8.53), other/unspecified goiter (n = 20; SIR = 3.94; 95% CI: 2.40 to 6.08), and adenoma (n = 9; SIR = 6.02; 95% CI: 2.76 to 11.5) remained positively associated with thyroid cancer risk.Conclusions: We found an unexpected increased risk of differentiated thyroid cancer, including regional/distant disease, following diagnosis of hyperthyroidism and thyroiditis that could not be solely attributed to increased medical surveillance. Hypothyroidism was less clearly associated with thyroid cancer risk.

AB - Context: Thyroid nodules, adenomas, and goiter have consistently been associated with thyroid cancer risk. Few studies have assessed whether thyroid dysfunction and thyroid autoimmunity influence this risk.Objective: To examine thyroid cancer risk after diagnoses of a wide range of benign thyroid conditions.Design: Hospital and cancer registry linkage cohort study for the years 1978 to 2013.Setting: Nationwide (Denmark).Participants: Patients diagnosed with hyperthyroidism (n = 85,169), hypothyroidism (n = 63,143), thyroiditis (n = 12,532), nontoxic nodular goiter (n = 65,782), simple goiter (n = 11,582), other/unspecified goiter (n = 21,953), or adenoma (n = 6,481) among 8,258,807 residents of Denmark during the study period.Main Outcome Measures: We computed standardized incidence ratios (SIRs) for differentiated thyroid cancer, excluding the first 12 months of follow-up after benign thyroid disease diagnosis.Results: SIRs were significantly elevated for all benign thyroid diseases apart from hypothyroidism. SIRs were higher for men than women and in the earlier follow-up periods. Elevated SIRs were observed for localized and regional/distant thyroid cancer. After excluding the first 10 years of follow-up, hyperthyroidism [n = 27 thyroid cancer cases; SIR = 2.00; 95% confidence interval (CI): 1.32 to 2.92], nontoxic nodular goiter (n = 83; SIR = 4.91; 95% CI: 3.91 to 6.09), simple goiter (n = 8; SIR = 4.33; 95% CI: 1.87 to 8.53), other/unspecified goiter (n = 20; SIR = 3.94; 95% CI: 2.40 to 6.08), and adenoma (n = 9; SIR = 6.02; 95% CI: 2.76 to 11.5) remained positively associated with thyroid cancer risk.Conclusions: We found an unexpected increased risk of differentiated thyroid cancer, including regional/distant disease, following diagnosis of hyperthyroidism and thyroiditis that could not be solely attributed to increased medical surveillance. Hypothyroidism was less clearly associated with thyroid cancer risk.

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Female

KW - Humans

KW - Hyperthyroidism/complications

KW - Hypothyroidism/complications

KW - Incidence

KW - Male

KW - Middle Aged

KW - Registries

KW - Risk

KW - Sex Factors

KW - Thyroid Neoplasms/epidemiology

KW - Thyroiditis/complications

U2 - 10.1210/jc.2017-02599

DO - 10.1210/jc.2017-02599

M3 - Journal article

VL - 103

SP - 2216

EP - 2224

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 6

ER -