TY - JOUR
T1 - Actual causes of death in thyroid cancer patients in Korea
T2 - A nationwide case control cohort study
AU - Kim, Kyeong Jin
AU - Jang, Sujung
AU - Kim, Kyoung Jin
AU - An, Jee Hyun
AU - Kim, Nam Hoon
AU - Shin, Dong Yeob
AU - Yoo, Hye Jin
AU - Kim, Hee Young
AU - Seo, Ji A
AU - Kim, Nan Hee
AU - Lee, Juneyoung
AU - Choi, Kyung Mook
AU - Baik, Sei-Hyun
AU - Kim, Sin Gon
N1 - Funding Information:
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health 阀ndustry Development 阀nstitute (KH 阀D 阀), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: H 阀17C1926).
Publisher Copyright:
© 2020 European Society of Endocrinology Printed in Great Britain
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2019
Y1 - 2019
N2 - Objective: Thyroid cancer (TC) incidence has increased robustly in Korea. However, the actual cause of death, overall mortality risk, and cause-specific mortality risk in TC patients have not been clearly elucidated. Design: Retrospective cohort study. Methods: We analyzed 4082 TC patients from the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS, 2002-2013) with a median of 48-month follow-up. We compared these patients with 12 246 controls matched for age, sex, and histories of major cardiovascular disease (CVD) to investigate the cause of death and risks of overall and cause-specific mortality. Results: Overall, 61 deaths (1.5%) occurred in the TC group. The most common cause of death was TC-specific mortality (32.8%), followed by other malignancy-related mortality (31.1%) and CVD mortality (13.1%). The overall mortality risk was comparable between the TC and control groups (unadjusted hazard ratio (HR): 1.17; 95% confidence interval (CI): 0.87-1.58); the adjusted HR remained at 1.25 (95% CI: 0.90-1.74) after multivariate adjustment for body mass index (BMI), socioeconomic status (SES), smoking, alcohol consumption, and histories of hypertension, diabetes mellitus, and dyslipidemia. In addition, there was not enough evidence against the surmise that the CVD mortality risk was similar between the TC and control groups, with an HR of 0.50 (95% CI: 0.22-1.16) after adjustment for CVD risk factors. Conclusions: Excellent overall survival was observed in TC patients. The most common cause of death was TC-specific mortality, suggesting the importance of thyroid cancer treatment. The overall and cause-specific mortality risks, particularly CVD mortality risk, did not differ between TC patients and the general population.
AB - Objective: Thyroid cancer (TC) incidence has increased robustly in Korea. However, the actual cause of death, overall mortality risk, and cause-specific mortality risk in TC patients have not been clearly elucidated. Design: Retrospective cohort study. Methods: We analyzed 4082 TC patients from the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS, 2002-2013) with a median of 48-month follow-up. We compared these patients with 12 246 controls matched for age, sex, and histories of major cardiovascular disease (CVD) to investigate the cause of death and risks of overall and cause-specific mortality. Results: Overall, 61 deaths (1.5%) occurred in the TC group. The most common cause of death was TC-specific mortality (32.8%), followed by other malignancy-related mortality (31.1%) and CVD mortality (13.1%). The overall mortality risk was comparable between the TC and control groups (unadjusted hazard ratio (HR): 1.17; 95% confidence interval (CI): 0.87-1.58); the adjusted HR remained at 1.25 (95% CI: 0.90-1.74) after multivariate adjustment for body mass index (BMI), socioeconomic status (SES), smoking, alcohol consumption, and histories of hypertension, diabetes mellitus, and dyslipidemia. In addition, there was not enough evidence against the surmise that the CVD mortality risk was similar between the TC and control groups, with an HR of 0.50 (95% CI: 0.22-1.16) after adjustment for CVD risk factors. Conclusions: Excellent overall survival was observed in TC patients. The most common cause of death was TC-specific mortality, suggesting the importance of thyroid cancer treatment. The overall and cause-specific mortality risks, particularly CVD mortality risk, did not differ between TC patients and the general population.
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U2 - 10.1530/EJE-19-0548
DO - 10.1530/EJE-19-0548
M3 - Article
C2 - 31721722
AN - SCOPUS:85078132139
VL - 182
SP - 103
EP - 110
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
SN - 0804-4643
IS - 1
ER -