TY - JOUR
T1 - Cancer risk in patients with Graves' disease
T2 - A nationwide cohort study
AU - Chen, Yen Kung
AU - Lin, Cheng Li
AU - Chang, Yen Jung
AU - Cheng, Fiona Tsui Fen
AU - Peng, Chiao Ling
AU - Sung, Fung Chang
AU - Cheng, Ya Hsin
AU - Kao, Chia Hung
PY - 2013/7/1
Y1 - 2013/7/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84881442008&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84881442008&partnerID=8YFLogxK
U2 - 10.1089/thy.2012.0568
DO - 10.1089/thy.2012.0568
M3 - Article
C2 - 23421548
AN - SCOPUS:84881442008
SN - 1050-7256
VL - 23
SP - 879
EP - 884
JO - Thyroid
JF - Thyroid
IS - 7
ER -
