Cancer risk in patients with Graves' disease: A nationwide cohort study

Yen Kung Chen, Cheng Li Lin, Yen Jung Chang, Fiona Tsui Fen Cheng, Chiao Ling Peng, Fung Chang Sung, Ya Hsin Cheng, Chia Hung Kao

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Abstract

Background: The possibility of an association of Graves' disease (GD) with subsequent cancers has been previously reported. Methods: Our study used the Taiwanese National Health Insurance Research Database (NHIRD), which identified 5025 newly diagnosed GD patients from 1997 to 2010, and 20,100 frequency matched non-GD patients. The risk of developing cancer for GD patients was measured using the Cox proportional hazard model. Results: The incidence of developing cancer in the GD cohort was 4.92 per 1000 person-years and was 1.37-fold higher than in the comparison cohort (p<0.001). Compared with patients aged 20-34 years, older age groups demonstrated a higher risk of developing cancer (35-49 years: hazard ratio (HR)=4.15; 50-64 years: HR=7.39;≥65 years: HR=13.4). After adjusting for sex, age, and comorbidities, the HR for developing breast cancer and thyroid cancer was 1.58- and 10.4-fold higher for patients with GD. Furthermore, the incidence rates (IRR) were the highest in the first three years: 2.06 [confidence interval (CI)=1.87-2.27] and 15.6 [CI=13.9-17.5] in breast cancer and thyroid cancer with GD respectively. Specifically, a 16-fold hazard of developing thyroid cancer was present in the first three years in the GD cohort compared to the non-GD cohort [CI=7.95-32.1]. Conclusions: GD patients have a higher risk of cancer, particularly thyroid and breast cancer sequent within six and three years respectively. Strategies for preventing thyroid and breast cancer are proposed.

Original languageEnglish
Pages (from-to)879-884
Number of pages6
JournalThyroid
Volume23
Issue number7
DOIs
Publication statusPublished - 2013 Jul 1
Externally publishedYes

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Chen, Y. K., Lin, C. L., Chang, Y. J., Cheng, F. T. F., Peng, C. L., Sung, F. C., Cheng, Y. H., & Kao, C. H. (2013). Cancer risk in patients with Graves' disease: A nationwide cohort study. Thyroid, 23(7), 879-884. https://doi.org/10.1089/thy.2012.0568