Thyroid Cancer Survivors at Higher Risk for Cardiovascular Disease
Assessment of the long-term effect of therapy following treatment for thyroid cancer is beneficial, considering favorable survival rates and the relatively younger age at diagnosis.
The risk for cardiovascular disease (CVD) was found to be elevated in thyroid cancer survivors within 5 years of diagnosis, according to results of a study recently published in The Journal of Clinical Endocrinology & Metabolism. These results underline the need for including outcomes of cancer treatment when caring for survivors of thyroid cancer.
The Utah Population Database was used to identify subjects for this study. This study included 3822 survivors of thyroid cancer who received a diagnosis between 1997 and 2012, and most of whom were diagnosed with papillary carcinoma. Risk factors and CVD outcomes were determined through medical records. The study researchers calculated CVD risk using Cox proportional hazards models, while taking clinical and baseline factors into account.
Cancer stage, year and age at diagnosis, sex, body mass index (BMI) and comorbidities at baseline, and thyroid-stimulating hormone (TSH) suppression therapy showed significant correlation with risk for CVD within 5 years of diagnosis.
There was an increased risk associated with subjects who were obese, overweight, male, older at the time of diagnosis, and diagnosed since the year 2005; by comparison, female patients with normal BMI who were younger at the time of diagnosis and had been diagnosed between 1997 and 1999 were at lower risk. Other factors associated with higher risk for CVD were a higher score on the Charlson Comorbidity Index (CCI), use of TSH suppression therapy, and presence of distant metastases at the time of cancer diagnosis.
The study researchers conclude that “age and year of cancer diagnosis, cancer stage, sex, baseline BMI and CCI score, and TSH suppression therapy were significantly associated with an elevated CVD risk in 1-5 years after thyroid cancer diagnosis… [Thyroid] cancer survivors' risk of CVD events in the first five years after cancer diagnosis suggest that evaluating not only patient specific risk factors but also consequences of cancer diagnosis and its treatment is important to improve quality of life among thyroid cancer survivors.”
Park J, Blackburn BE, Ganz PA, et al. Risk factors for cardiovascular disease among thyroid cancer survivors: findings from the Utah Cancer Survivors Study [published online May 29, 2018]. J Clin Endocrinol Metab. doi: 10.1210/jc.2017-02629