Second primary malignancies following thyroid cancer: a population-based study in Taiwan.
Second primary malignancies following thyroid cancer: a population-based study in Taiwan.
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DOI：
10.1530/eje-13-0309
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发表时间：
2013-11-01
影响因子：
5.8
通讯作者：
Chen, Min-Chi
中科院分区：
文献类型：
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作者：
Lu, Chang-Hsien;Lee, Kuan-Der;Chen, Min-Chi
目的：美国和欧洲对甲状腺癌后继发第二原发癌的研究较多。这些研究中SPM之间的差异可能归因于地理和种族的异质性。因此，显然有必要进行另一项大规模流行病学研究，特别是在亚洲国家，以确定SPM在甲状腺癌幸存者中的发病率和风险。设计：一项基于人群的研究使用了来自台湾癌症登记处的全国数据库。方法：我们量化了19068人(男性4205人，女性14863人)原发性甲状腺癌SPM的标准化发病率比(SIRS)和累积发病率。结果：在134,678人年的随访中，共有644例(3.38%)至少发生了SPM。继发SPM的危险性显著高于一般人群(SIR=1.33，95%可信区间1.23~1.44)。患主要唾液腺、鼻咽癌、肺癌、胸腺、乳腺癌(女性)、膀胱癌、脑癌、白血病和淋巴瘤的风险更大。我们观察到，在诊断为甲状腺癌的前5年内风险最高(≤5、5-10和>；10的SIR分别为5.29、1.68和0.68)，并且在年轻患者中(SIR=1.81vs1.61
OBJECTIVE: Most studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors.DESIGN: A population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006.METHODS: We quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19,068 individuals (4205 males and 14,863 females) with primary thyroid cancer.RESULTS: A total of 644 cases (3.38%) developed at least a SPM during 134,678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23-1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR=5.29, 1.68, and 0.68 for ≤ 5, 5-10, and >10 respectively) and in the younger patients (SIR=1.81 vs 1.61 for