Association of Radioactive Iodine Treatment of Hyperthyroidism With Cancer Mortality: An Unjustified Warning?

Hindié, Elif; Ain, Kenneth B.; Zerdoud, Slimane; Avram, Anca M.

doi:10.1210/clinem/dgz305

Cited by 11 publications

(13 citation statements)

References 7 publications

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“…Methodological limitations of this study were underlined by different authors [63,64], but even more interestingly, two of Kitahara's co-authors re-analyzed data from the same cohort and showed that the standardized mortality ratio (SMR) for breast cancer was higher for patients treated with ATDs compared with patients treated with RAI [65].…”

Section: Radioiodine and Risk Of Cancermentioning

confidence: 97%

Higher thyroid hormone levels and cancer

Ovčariček

Verburg

Hoffmann

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose This narrative review aims to summarize the relationship between hyperthyroidism, upper reference range thyroid hormone (TH) levels, and cancer, and to address the clinical management of hyperthyroidism in cancer patients. Methods A comprehensive search was performed by an independent reviewer through Google Scholar and PubMed Electronic databases. All searches were restricted to English language manuscripts published between 2000 and 2020.Results Numerous in vitro, in vivo, and population-based studies suggest cancer-stimulating effect of triiodothyronine and thyroxin. THs are presented as mediators for tumor growth, proliferation, and progression. Many population and case-control studies suggest an increased risk of several solid but also hematologic malignancies in relation to hyperthyroidism and upper normal range TH levels. However, results are not unambiguous. In this review, we will summarize population and case-control studies that investigated the relationship between hyperthyroidism, upper reference range TH levels, lower thyrotropin (TSH) levels, lower reference range TSH levels with cancer risk, cancer prognosis, and cancer outcome. The vast majority of evidence suggests an association between clinical and subclinical hyperthyroidism with the risk of developing several types of cancer. Furthermore, hyperthyroidism is also linked with a poorer cancer prognosis. In this review, we will also discuss the diagnosis of hyperthyroidism in patients with pre-existing cancer and cover the management of hyperthyroidism in cancer patients, with special attention on the role of nuclear medicine. Conclusions It is crucial to emphasize the importance of the rapid establishment of euthyroidism, and consequently, the importance of radioiodine therapy, as the therapy of choice in most cancer patients. We want to show that in this day and age there still is a high relevance for I-131 to achieve a permanent solution and thus likely reduce the risk of adverse influence of hyperthyroidism on the occurrence of new and course of existing cancer cases.

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Section: Radioiodine and Risk Of Cancermentioning

confidence: 97%

Higher thyroid hormone levels and cancer

Ovčariček

Verburg

Hoffmann

et al. 2020

Eur J Nucl Med Mol Imaging

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“…[31] caused considerable reaction, suggesting that RAI treatment may be associated with excess mortality from solid cancer in hyperthyroid patients, whereas previous reports did not find any evidence for an increased incidence of non-thyroid cancers [32][33][34][35][36]. This controversial issue will be thoroughly discussed in another article of this review (Elif Hindie), pointing out the limitations of that study [37] and providing an objective view of the risk of cancer in hyperthyroid patients treated with RAI.…”

Section: Rai Therapy and The Risk Of Second Cancer?mentioning

confidence: 84%

131I Radioiodine therapy in Graves’ disease: Us et coutumes, controversies and guidelines

Bardet¹

2020

Médecine Nucléaire

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“…e recent data from a large, longitudinal cohort study showed RAI for hyperthyroidism could affect, in the long-term, increased I-131 dose-dependent mortality from solid cancers [18]. However, there were widespread criticisms on the previously mentioned study because of the lack of appropriate controls and novel nonvalidated analysis [19][20][21][22]. Several studies reported no correlation between the development of cancer and RAI [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Graves’ Disease in Thailand: A Survey of Current Practice

Sriphrapradang

2020

Journal of Thyroid Research

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Background. The data on clinical practice patterns in the evaluation and management of Graves’ disease (GD) are limited in Asia. The aims of this survey were to report the current practices in the management of GD in Thailand and to examine any international differences in the management of GD. Methods. Members of the Endocrine Society of Thailand who were board certified in endocrinology (N = 392) were invited to participate in an electronic survey on the management of GD using the same index case and questionnaire as in previous North American and European surveys. Results. One hundred and twenty responses (30.6%) from members were included. TSH receptor antibody measurement (29.2%), thyroid ultrasound (6.7%), and isotopic studies (5.9%) were used less frequently to confirm the etiology compared with those in North American and European surveys. Treatment with an antithyroid drug (ATD) was the preferred first choice of therapy (90.8%). Methimazole at 10–15 mg/day with a beta-blocker was the initial treatment of choice. The preferred ATD in pregnancy was propylthiouracil in the first trimester and methimazole in the second and third trimesters, which was similar to the North American and European surveys. Conclusion. Ultrasound and isotopic studies will be requested only by a small proportion of Thai endocrinologists. Higher physician preference for ATD is similar to Europe, Latin America, and other Asian countries. Geographical differences in the use of ATD, radioactive iodine, and thyroidectomy exist.

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Association of Radioactive Iodine Treatment of Hyperthyroidism With Cancer Mortality: An Unjustified Warning?

Cited by 11 publications

References 7 publications

Higher thyroid hormone levels and cancer

Higher thyroid hormone levels and cancer

131I Radioiodine therapy in Graves’ disease: Us et coutumes, controversies and guidelines

Diagnosis and Management of Graves’ Disease in Thailand: A Survey of Current Practice

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