Abstract
(1) Background: This study aimed to investigate the association between radioactive iodine (RAI) and long-term cardiovascular disease (CVD) morbidity/mortality in thyroid cancer. (2) Methods: The study was conducted using data from the Taiwan National Health Insurance Database during 2000–2015. Thyroid cancer patients aged ≥20 years were categorized into RAI (thyroidectomy with RAI) and non-RAI (thyroidectomy only) groups. The Cox proportional hazard regression model and Kaplan–Meier method were used for analysis. (3) Results: A total of 13,310 patients were included. Kaplan–Meier analysis demonstrated that the two groups had similar cumulative risks of CVD (log-rank p = 0.72) and CVD-specific mortality (log-rank p = 0.62). On Cox regression analysis of different RAI doses, the risk of CVD was higher in the cumulative dosage >3.7 GBq (hazard ratio = 1.69, 95% confidence interval = 1.24–2.40, p < 0.001). (4) Conclusions: RAI was not associated with an increased risk of CVD in thyroid cancer. However, CVD surveillance is indicated in the patients receiving the cumulative RAI dosage above 3.7 GBq.
Highlights
Thyroid cancer is the fifth most common cancer in women in the USA, and an estimated 52,890 new cases are expected in 2020 [1]
Data were extracted from the Longitudinal Health Insurance Database (LHID), a subset of the Taiwan National Health Insurance Research Database (NHIRD), which is a secondary database consisting of fully anonymous, comprehensive information, such as demographic data, dates of clinical visits, and disease diagnoses for 1 million enrollees, and is derived from the medical claims records of the National Health Insurance (NHI) program
cardiovascular disease (CVD)-specific mortality at the end of study were comparable in radioactive iodine (RAI) and non-RAI
Summary
Thyroid cancer is the fifth most common cancer in women in the USA, and an estimated 52,890 new cases are expected in 2020 [1]. RAI has some potential adverse effects, such as gastrointestinal symptoms, radiation thyroiditis, sialadenitis/xerostomia, bone marrow suppression, gonadal damage, dry eye, secondary cancers, pulmonary fibrosis, and genetic effects. These adverse effects are associated with the cumulative RAI dosage [5]. Radiation has direct and indirect effects on our cells, and it is thought to be the mechanism of the known adverse effects [8] It is not clear whether the RAI may directly damage the heart, blood vessels, or other organs and indirectly cause damage through reactive oxygen species produced by radiolysis of water. The association between RAI and CVD is still not clear
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