Thyroid cancers, such as medullary thyroid carcinoma (MTC) and papillary thyroid cancer, could increase the risk of coronary heart disease (CHD) even after a long-term follow-up period, according to a recently published study in Scientific Reports.

Although the short-term adverse effects associated with thyroid cancer therapies, such as surgical resection and radioactive iodine therapy, are widely known, their long-term effects on cardiovascular function remain a controversial topic, Ming-Chieh Tsai, of Taiwan University in Taipei City, and colleagues noted.  

Some studies have found that patients with thyroid cancer have a higher risk of developing cardiovascular disease, and others have failed to find a clear association between the two, the authors added.


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Therefore, the investigators aimed to assess the correlation between thyroid cancer and cardiovascular disease through a nationwide population-based cohort in Taiwan and to determine if the cardiovascular risk in patients with thyroid cancer is the same across different demographical groups and follow-up periods. 

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The study authors used data from the National Taiwan Cancer Registry Database (NTCRD) collected between 2011 and 2016. The study included over 4300 patients with some subtype of thyroid cancer. 

“The NTCRD records cancer characteristics including staging; first-time surgical treatment; chemo-, radiation, hormone, and target therapy; and lifestyle habits such as smoking and alcohol and betel nut consumption,” the study team wrote. 

The incidence of cardiovascular disease in the general Taiwanese population and citizens with thyroid cancer was compared using standardized incidence ratio models. Incidences of CHD, ischemic stroke, and atrial fibrillation were individually analyzed. Incidence rates were age- and sex-standardized.

The total number of detected CHD events among the population with thyroid cancer was 69. Standardized incidence ratio analysis revealed that patients with thyroid cancer had a significantly higher risk of suffering from CHD than the standard population. However, there was no significant difference in ischemic stroke or atrial fibrillation incidence. 

Age stratification revealed that the correlation between thyroid cancer and CHD could be attenuated by age, as young patients with thyroid cancer had a higher risk than older patients. 

“From a public health perspective, considering cancer as a chronic disease with safe long-term treatment rather than a fatal disease requiring aggressive intervention may provide pragmatic benefits to cancer patients,” the authors concluded. 

Reference

Tsai M, Hsieh C, Hsu H, et al. Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study. Sci Rep. Published online November 2, 2022. doi:10.1038/s41598-022-22462-z