Risk of osteoporotic fractures among patients with thyroid cancer: a nationwide population-based study

Lee Eun Kyung; Ku Eu Jeong; Yoo Won Sang; Hwang Yu Been; Subin Jang; Jooyoung Lee; Shinje Moon; Ahn Hwa Young; Park Young Joo

doi:10.1530/endoabs.99.EP70

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Endocrine Abstracts (2024) 99 EP70 | DOI: 10.1530/endoabs.99.EP70

ECE2024 Eposter Presentations Calcium and Bone (102 abstracts)

Risk of osteoporotic fractures among patients with thyroid cancer: a nationwide population-based study

Eun Kyung Lee ¹ , Eu Jeong Ku ² , Won Sang Yoo ³ , Yu Been Hwang ⁴ , Subin Jang ⁴ , Jooyoung Lee ⁴ , Shinje Moon ⁵ , Hwa Young Ahn ⁶ & Young Joo Park ⁷

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Author affiliations

¹National Cancer Center, Center for Thyroid Cancer, Department of Internal Medicine, Goyang; ²Seoul National University Hospital Healthcare System Gangnam Center; ³Dankook University College of Medicine; ⁴Chung-Ang University College of Statistics; ⁵Hallym University College of Medicine; ⁶Chung-Ang University College of Medicine; ⁷Seoul National University College of Medicine

Background: The association between thyroid cancer and skeletal outcomes has not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared with a matched control group.

Methods: This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006-2019). Rates of osteoporotic fractures were analysed and associations with levothyroxine dose were evaluated.

Results: Patients with thyroid cancer had a significantly lower risk of fracture compared with the control group (hazard ratio [HR] 0.81, 95% confidence interval [CI]: 0.69 to 0.94, P=0.006). The group diagnosed with thyroid cancer after the age of 50 (older cancer group) had a significantly lower risk of fractures compared with the control group (HR: 0.72, 95% CI: 0.6 to 0.85, P<0.001), especially for spine fractures (HR: 0.66, 95% CI: 0.51 to 0.85, P=0.001). The older cancer group started osteoporosis treatment earlier than the control group (65.5 ± 7.5 vs 67.3 ± 7.6 years, P<0.001). In addition, a lower dose of levothyroxine was associated with a lower risk of fracture.

Conclusions: In the actual clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than in the control group, which is interpreted as a phenomenon caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.