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. 2021 Oct;10(19):6855-6867.
doi: 10.1002/cam4.4193. Epub 2021 Sep 17.

Risk of thyroid as a first or second primary cancer. A population-based study in Italy, 1998-2012

Emanuele Crocetti  1 , Veronica Mattioli  1 , Carlotta Buzzoni  2   3 , Silvia Franceschi  1 , Diego Serraino  1 , Salvatore Vaccarella  4 , Stefano Ferretti  5 , Susanna Busco  6 , Ugo Fedeli  7 , Massimo Varvarà  8 , Fabio Falcini  9 , Manuel Zorzi  10 , Giuliano Carrozzi  11 , Walter Mazzucco  12 , Cinzia Gasparotti  13 , Silvia Iacovacci  6 , Federica Toffolutti  1 , Rossella Cavallo  14 , Fabrizio Stracci  15 , Antonio G Russo  16 , Adele Caldarella  17 , Stefano Rosso  18 , Antonino Musolino  19 , Lucia Mangone  20 , Claudia Casella  21 , Mario Fusco  22 , Giovanna Tagliabue  23 , Daniela Piras  24 , Rosario Tumino  25 , Linda Guarda  26 , Ylenia M Dinaro  27 , Silvano Piffer  28 , Pasquala Pinna  29 , Guido Mazzoleni  30 , Anna C Fanetti  31 , Luigino Dal Maso  1 ; for AIRTUM working group
Affiliations

Risk of thyroid as a first or second primary cancer. A population-based study in Italy, 1998-2012

Emanuele Crocetti et al. Cancer Med. 2021 Oct.

Abstract

Background: The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC.

Methods: We analyzed two population-based cohorts of individuals with TC or other neoplasms diagnosed between 1998 and 2012, in 28 Italian areas covered by population-based cancer registries. Standardized incidence ratios (SIRs) of SPC were stratified by sex, age, and time since first cancer.

Results: A total of 38,535 TC patients and 1,329,624 patients with other primary cancers were included. The overall SIR was 1.16 (95% CI: 1.12-1.21) for SPC in TC patients, though no increase was shown for people with follicular (1.06) and medullary (0.95) TC. SPC with significantly increased SIRs was bone/soft tissue (2.0), breast (1.2), prostate (1.4), kidney (2.2), and hemolymphopoietic (1.4) cancers. The overall SIR for TC as a SPC was 1.49 (95% CI: 1.42-1.55), similar for all TC subtypes, and it was significantly increased for people diagnosed with head and neck (2.1), colon-rectum (1.4), lung (1.8), melanoma (2.0), bone/soft tissue (2.8), breast (1.3), corpus uteri (1.4), prostate (1.5), kidney (3.2), central nervous system (2.3), and hemolymphopoietic (1.8) cancers.

Conclusions: The increased risk of TC after many other neoplasms and of few SPC after TC questions the best way to follow-up cancer patients, avoiding overdiagnosis and overtreatment for TC and, possibly, for other malignancies.

Keywords: Italy; cancer survivors; population-based cancer registries; relative risk; second primary cancer; thyroid cancer.

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Conflict of interest statement

The authors have declared no competing interests.

Figures

FIGURE 1
FIGURE 1
Riska of second primary cancer after thyroid cancer and risk of thyroid cancer as second tumor by time since the first tumor. Italy, 1998–2012. Obs, observed cases. aMeasured as standardized incidence ratio (SIR) and 95% confidence intervals (CIs). bExcluded from subsequent analyses (4% of cancer subsequent to TC and 8% of TC after another malignancy)
See this image and copyright information in PMC

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