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Increased cancer incidence after radioiodine treatment for hyperthyroidism.

Metso S, Auvinen A, Huhtala H, Salmi J, Oksala H, Jaatinen P

Department of Internal Medicine, Tampere University Hospital, Tampere, Finland. saara.metso@pshp.fi

BACKGROUND: Concerns remain about risk of cancer after radioactive iodine (RAI) treatment for hyperthyroidism, especially in organs that concentrate iodine. The objective was to assess the long-term cancer risk from RAI treatment for hyperthyroidism. METHODS: A total of 2793 hyperthyroid patients treated with RAI at Tampere University Hospital between 1965 and 2002, and 2793 age- and sex-matched reference subjects were followed for an average of 10 years through the Finnish Cancer Registry. RESULTS: Cancer incidence among hyperthyroid patients treated with RAI was higher than in the population-based control group (118.9 vs 94.9 per 10,000 person-years, rate ratio [RR], 1.25; 95% confidence interval [CI]: 1.08-1.46). Furthermore, incidence of stomach (RR, 1.75, 95% CI: 1.00-3.14), kidney (RR, 2.32; 95% CI: 1.06-5.09), and breast (RR, 1.53; 95% CI: 1.07-2.19) cancer was increased among RAI-treated patients. The relative risk of cancer increased with higher RAI dose administered. The increase in cancer incidence was statistically significant in patients treated at the age of 50-59 (RR, 1.44; 95% CI: 1.05-1.97) or older than 70 years (RR, 1.39; 95% CI: 1.05-1.82). There was a 5-year latent period after the RAI treatment before the cancer incidence began to differ between the RAI-treated hyperthyroid patients and the control group. CONCLUSIONS: Cancer incidence, especially cancer of the stomach, kidney, and breast, was higher in patients treated with RAI for hyperthyroidism.

Published 3 May 2007 in Cancer, 109(10): 1972-9.
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