ETA2023 Poster Presentations Graves’ Disease (9 abstracts)
Association between radioactive iodine treatment and cancer risk in graves’ disease: a nationwide cohort study
Kyeong Jin Kim 1 , Yeji Lee 1 , Da Won Park 2 , Kyoung Jin Kim 1 , Min Seon Park 3 , Joo Hyung Kim 1 , Hee Young Kim 1 , Nam Hoon Kim 3 , Jimi Choi 3 , Hun Yub Kim 2 , Seung-kuk Baek 4 , Kwang Yoon Jung 4 & Sin Gon Kim 3
1Korea University College of Medicine, Internal Medicine, Seoul, Korea, Rep. of South; 2Korea University Colleg of Medicine, Department of Surgery, Seoul, Korea, Rep. of South; 3Korea University Colleg of Medicine, Internal Medicine, Seoul, Korea, Rep. of South; 4Korea University Colleg of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, Korea, Rep. of South
Objectives: Radioactive iodine (RAI) therapy has potential therapeutic effects in treating Graves’ disease (GD). However, whether RAI therapy for GD can increase cancer risk remains a controversial issue in medicine and public health.
Methods: Using the Korean National Health Insurance Service-National Health Information Database (NHIS-NHID, 2002–2020), we investigated hazard ratios (HRs) of overall and site-specific cancer associated with RAI in GD. Subsequent cancer was only defined as a primary malignancy treated at least 1 year after RAI therapy.
Results: A total of 10,737 GD patients who received RAI therapy (7,193 women, 67.0%; mean age, 43.7 ± 13.4 years) were matched to 53,003 GD patients without RAI therapy (35,471 women, 66.9%; mean age 43.8 ± 13.2 years) in a 1:4~5 ratio by age, sex, and health check-up data. The median follow-up duration was 8.7 years (interquartile range [IQR]: 5.2–12.1), and the median cumulative RAI dose was 15.0 mCi (IQR 10.0–17.1) in the RAI therapy group. During 2004-2020, the overall subsequent cancer rates were 5.66 and 5.84 per 1,000 person-years in the RAI and non-RAI groups, respectively, with an unadjusted HR of 0.97 (95% CI, 0.88–1.06); this remained at 0.92 (95% CI, 0.81–1.04) after adjustment for multiple clinical confounding factors. For leukemia, incidence rates were 0.12 and 0.05 per 1,000 person-years in the RAI and non-RAI groups, respectively, with an unadjusted HR of 2.39 (95% CI, 0.17–4.91): however, HR was insignificant of 2.03 (95% CI, 0.73–5.60) after adjustment for confounding factors.
Conclusions: This study identified that the overall cancer risk in GD patients with RAI therapy compared to those without was not significant in Korea. Further long-term studies are needed on the risks and advantages of RAI therapy in patients with GD.
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Endocrine Abstracts
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