Increased cancer incidence after radioiodine treatment for hyperthyroidism

@article{Metso2007IncreasedCI,
  title={Increased cancer incidence after radioiodine treatment for hyperthyroidism},
  author={Saara Metso and Anssi Auvinen and Heini Huhtala and Jorma Salmi and Heikki Oksala and Pia Jaatinen},
  journal={Cancer},
  year={2007},
  volume={109}
}
Concerns remain about risk of cancer after radioactive iodine (RAI) treatment for hyperthyroidism, especially in organs that concentrate iodine. The objective was to assess the long‐term cancer risk from RAI treatment for hyperthyroidism. 

Increased long‐term cardiovascular morbidity among patients treated with radioactive iodine for hyperthyroidism

The aim of this study was to compare the rate and causes of hospitalization of hyperthyroid patients treated with radioactive iodine with those of an age and gender‐matched reference population in a long‐term follow-up study.

Radioiodine Therapy of Benign Thyroid Diseases

Thyrotoxicosis represents a clinical condition that results from excess thyroid hormone(s) levels and action in peripheral tissues, either with or without increased synthesis of thyroid hormone(s) by

Radioiodine is not the Preferred Choice of Treatment for Pediatric Graves Disease

Current evidences donot support routine use of RAI ablation in such situation, and concerns regarding development of both thyroid and non-thyroidal malignancy, and primary hyperparathyroidism in subjects receiving RAI.

Total thyroidectomy: Safe and curative treatment option for hyperthyroidism

While use of total thyroidectomy has increased in management of hyperthyroidism, concerns exist about increased surgical complication rates; most notably, hematoma, recurrent laryngeal nerve (RLN)

Does Radioactive Iodine Therapy for Hyperthyroidism Cause Cancer?

  • Brian W Kim
  • Medicine
    The Journal of clinical endocrinology and metabolism
  • 2021
A mini-review was inspired by the 2019 CTTFUS controversy, and is intended to provide the necessary context for clinicians to provide nuanced advice to their patients on the subject.

Cancer incidence and mortality following treatment of hyperthyroidism with radioactive iodine

In patients with hyperthyroidism, radioactive iodine is a popular and effective treatment option and two recent studies concluded that there is a dose-dependent increased risk of solid tumor mortality using a novel method of estimating organ-specific radiation exposure.

Initial Radioiodine Ablation

As the practice of radioactive iodine continues to evolve with the availability of large, rigorous clinical studies, it is likely that adjuvant radioactive iodine will be reserved for larger tumors with more aggressive histology and/or for recurrent disease.

Long-term Prognosis of Patients Treated with Radioactive Iodine for Hyperthyroidism

A population-based cohort study was conducted among all 2793 hyperthyroid patients treated with RAI at the Tampere University Hospital between 1965 and 2002, and 2793 ageand gender-matched reference subjects, finding that administration of a single dose of RAI resulted in the control ofhyperthyroidism in 75% of patients in both etiologic groups.

Reply to Increased cancer incidence after radioiodine treatment for hyperthyroidism

In this instance, a focused analysis of mortality among patients treated with 370–740 MBq seems to be of pivotal importance and the conclusion should be reformulated by underlining the differences between the administered activities and associated mortality risk.

Cancer Incidence and Mortality in Patients Treated Either With RAI or Thyroidectomy for Hyperthyroidism.

In this large-scale, long-term follow-up study, the overall risk of cancer was not increased, although an increased risk of gastric and respiratory tract cancers was seen in hyperthyroid patients.
...

References

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Long‐term follow‐up study of radioiodine treatment of hyperthyroidism

objective  To determine the cumulative incidence of hypothyroidism during long‐term follow‐up in patients treated for hyperthyroidism by radioactive iodine 131I (RAI) therapy, the significance of

Cancer incidence following treatment of hyperthyroidism.

Although based on small numbers of cases, an elevated risk of cancer was observed in organs that concentrate 131I (salivary glands, digestive tract, kidney and bladder), they indicate the need for larger surveys to evaluate the carcinogenic potential of 131I.

Thyroid cancer prevalence after radioiodine treatment of hyperthyroidism.

An accurate preliminary evaluation (clinical examination, sonography, and cytologic evaluation of fine-needle aspiration) is fundamental for a proper choice between radioiodine and surgical therapy.

Reply to Increased cancer incidence after radioiodine treatment for hyperthyroidism

In this instance, a focused analysis of mortality among patients treated with 370–740 MBq seems to be of pivotal importance and the conclusion should be reformulated by underlining the differences between the administered activities and associated mortality risk.

Cancer risk after iodine-131 therapy for hyperthyroidism.

Overall cancer risk did not increase with administered 131I dose or with time since exposure, and the absence of any increase in leukemia adds further support to the view that a radiation dose delivered gradually over time is less carcinogenic than the same total dose received over a short time.

Cancer Mortality Following Treatment for Adult Hyperthyroidism

Overall, 131I appears to be a safe therapy for hyperthyroidism, and there was an elevated risk of thyroid cancer mortality following 131I treatment, but the excess number of deaths was small, and the underlying thyroid disease appeared to play a role.

Cancer mortality following treatment for adult hyperthyroidism. Cooperative Thyrotoxicosis Therapy Follow-up Study Group.

While there was an elevated risk of thyroid cancer mortality following (131)I treatment, in absolute terms the excess number of deaths was small, and the underlying thyroid disease appeared to play a role, Overall, ( 131)I appears to be a safe therapy for hyperthyroidism.

Incidence of leukemia following treatment of hyperthyroidism. Preliminary report of the Cooperative Thyrotoxicosis Therapy Follow-Up Study.

Patients both undergoing surgery and receiving 131 I have a higher incidence of leukemia than any other treatment group, and the observed mortality from leukemia for hyperthyroid patients is 50% higher than that of the US population.

Breast cancer following iodine-131 therapy for hyperthyroidism.

Failure to detect an increased risk of breast cancer in the 131I-treated women was attributed to the moderately low doses from 131I therapy and the relatively small number of exposed women.