In the JournalsPerspective

Aging-related disease risks high among thyroid cancer survivors

MIa Hashibe
Mia Hashibe

Adults diagnosed with thyroid cancer have increased risks for circulatory conditions, diabetes, disorders of lipid metabolism, eye disorders and heart disease compared with adults who were never diagnosed with thyroid cancer, study data show.

“Thyroid cancer patients diagnosed at young ages (< 40 years) are at increased risk for various aging-related diseases such as diabetes, heart disease and osteoporosis,” Mia Hashibe, PhD, associate professor in the department of family and preventive medicine at the University of Utah, told Endocrine Today. “Some of the risks appeared to be higher than for thyroid cancer patients diagnosed at older ages. Thyroid cancer treatment, as well as obesity, increases the risk of these diseases among thyroid cancer patients.”

Hashibe and colleagues evaluated data from the Utah Population Database on 3,706 adult thyroid cancer survivors diagnosed between 1997 and 2012 (37% < 40 years at diagnosis) and 15,587 matched adults without cancer to determine the risks for diseases related to aging. Follow-up was conducted from date of thyroid cancer diagnosis to diagnosis of another disease or death.

Thyroid cancer survivors had higher mortality rates and greater BMI compared with controls (P < .0001 for both). Participants diagnosed with thyroid cancer before age 40 years were more likely to be women and to have been diagnosed before 2000 (P < .0001 for both) compared with those diagnosed after age 40 years.

The risks for circulatory conditions were greater among participants diagnosed with thyroid cancer before age 40 years compared with controls. One to 5 years after thyroid cancer diagnosis, those diagnosed before age 40 years had a significantly increased risk for hypertension compared with those who were older at diagnosis. The risk for heart disease was increased among all cancer survivors compared with controls. The risks for nutritional deficiencies were higher in the younger thyroid cancer survivor group compared with those diagnosed later. Risks for diabetes, disorders of lipid metabolism, eye disorders, ear conditions, diseases of the musculoskeletal system and connective tissue were increased among all cancer survivors.

Participants who were older at cancer diagnosis, men and those with obesity at baseline had increased risks for multiple circulatory health conditions compared with their counterparts.

“As cancer patients finish their treatment, we hope that these research results help to make them aware of what other diseases they may be at increased risk for so that they can make healthy lifestyle choices and live long healthy lives,” Hashibe said. “It would be up to clinical organizations such as the National Comprehensive Cancer Network to incorporate evidence from our study and other studies to develop specific monitoring and management guidelines. Our study suggests that screening for the aging-related diseases, such as diabetes, heart disease and osteoporosis, could be beneficial for thyroid cancer survivors.” – by Amber Cox

For more information:

Mia Hashibe, PhD, can be reached at mia.hashibe@utah.edu.

Disclosures: The authors report no relevant financial disclosures.

MIa Hashibe
Mia Hashibe

Adults diagnosed with thyroid cancer have increased risks for circulatory conditions, diabetes, disorders of lipid metabolism, eye disorders and heart disease compared with adults who were never diagnosed with thyroid cancer, study data show.

“Thyroid cancer patients diagnosed at young ages (< 40 years) are at increased risk for various aging-related diseases such as diabetes, heart disease and osteoporosis,” Mia Hashibe, PhD, associate professor in the department of family and preventive medicine at the University of Utah, told Endocrine Today. “Some of the risks appeared to be higher than for thyroid cancer patients diagnosed at older ages. Thyroid cancer treatment, as well as obesity, increases the risk of these diseases among thyroid cancer patients.”

Hashibe and colleagues evaluated data from the Utah Population Database on 3,706 adult thyroid cancer survivors diagnosed between 1997 and 2012 (37% < 40 years at diagnosis) and 15,587 matched adults without cancer to determine the risks for diseases related to aging. Follow-up was conducted from date of thyroid cancer diagnosis to diagnosis of another disease or death.

Thyroid cancer survivors had higher mortality rates and greater BMI compared with controls (P < .0001 for both). Participants diagnosed with thyroid cancer before age 40 years were more likely to be women and to have been diagnosed before 2000 (P < .0001 for both) compared with those diagnosed after age 40 years.

The risks for circulatory conditions were greater among participants diagnosed with thyroid cancer before age 40 years compared with controls. One to 5 years after thyroid cancer diagnosis, those diagnosed before age 40 years had a significantly increased risk for hypertension compared with those who were older at diagnosis. The risk for heart disease was increased among all cancer survivors compared with controls. The risks for nutritional deficiencies were higher in the younger thyroid cancer survivor group compared with those diagnosed later. Risks for diabetes, disorders of lipid metabolism, eye disorders, ear conditions, diseases of the musculoskeletal system and connective tissue were increased among all cancer survivors.

Participants who were older at cancer diagnosis, men and those with obesity at baseline had increased risks for multiple circulatory health conditions compared with their counterparts.

“As cancer patients finish their treatment, we hope that these research results help to make them aware of what other diseases they may be at increased risk for so that they can make healthy lifestyle choices and live long healthy lives,” Hashibe said. “It would be up to clinical organizations such as the National Comprehensive Cancer Network to incorporate evidence from our study and other studies to develop specific monitoring and management guidelines. Our study suggests that screening for the aging-related diseases, such as diabetes, heart disease and osteoporosis, could be beneficial for thyroid cancer survivors.” – by Amber Cox

For more information:

Mia Hashibe, PhD, can be reached at mia.hashibe@utah.edu.

Disclosures: The authors report no relevant financial disclosures.

    Perspective

    Megan Haymart

    In this well-written case-control study, Blackburn and colleagues evaluate the risks for aging-related diseases in thyroid cancer survivors compared with matched cancer-free individuals. The authors subgroup the survivors into the age brackets younger than 40 years vs. older than 40 years. In this study, both survivors younger than 40 years and older than 40 years had increased risks for multiple medical conditions, including circulatory problems. Survivors younger than 40 years had greater risks for hypertension, cardiomyopathy and nutritional deficiencies. Strengths of this study include the use of the statewide Utah Population Database, which allowed for a large sample size and a population-based cohort. Limitations include the risk for screening bias in the cancer cohort and the lack of detail on the role of treatment in determining the risks for specific medical conditions. In particular, it is important to know the role of thyroid hormone suppression in the risk for circulatory problems. Despite limitations, this is an important study that helps build the foundation for additional studies evaluating thyroid cancer treatment and age-related risks.

    Megan R. Haymart, MD

    Associate Professor of Medicine
    Division of Metabolism, Endocrinology, & Diabetes
    Division of Hematology/Oncology
    University of Michigan Health System

    Disclosure: Haymart reports no relevant financial disclosures.