Actual causes of death in thyroid cancer patients in Korea: A Nationwide Case Control Cohort Study.

Kyeong Jin Kim; Sujung Jang; Kyoung Jin Kim; Jee Hyun An; Nam Hoon Kim; Dong Yeob Shin; Hye Jin Yoo; Hee Young Kim; Seo, Ji A.; Nan Hee Kim; Juneyoung Lee; Kyung Mook Choi; Sei Hyun Baik; Sin Gon Kim

Objective: Thyroid cancer (TC) incidence has increased robustly in Korea. However, the actual cause of death, overall mortality risk, and cause-specific mortality risk in TC patients have not been clearly elucidated. Design: Retrospective cohort study. Methods: We analyzed 4082 TC patients from the Korean National Health I nsurance Service-National Health Screening Cohort (NHIS-HEALS, 2002-2013) with a median of 48-month follow -up. We compared these patients with 12 246 controls matched for age, sex, and histories of major cardiovas cular disease (CVD) to investigate the cause of death and risks of overall and cause-specific mortality. Results: Overall, 61 deaths (1.5%) occurred in the TC group. The most c ommon cause of death was TC-specific mortality (32.8%), followed by other malignancy-related mortality (31.1%) and CVD mortality (13.1%). The overall mortality risk was comparable between the TC and control groups (unadjusted ha zard ratio (HR): 1.17; 95% confidence interval (CI): 0.87-1.58); the adjusted HR remained at 1.25 (95% CI: 0.90-1.74) after multivariate adjustment for body mass index (BMI), socioeconomic status (SES), smoking, alcohol consumption, and histories of hypertension, diabetes mellitus, and dyslipidemia. In addition, there was not enough evidence agains t the surmise that the CVD mortality risk was similar between the TC and control groups, with an HR of 0.50 (95% CI: 0.22-1.16) after adjustment for CVD risk factors. Conclusions: Excellent overall survival was observed in TC patients. The mo st common cause of death was TC-specific mortality, suggesting the importance of thyroid cancer treatmen t. The overall and cause-specific mortality risks, particularly CVD mortality risk, did not differ between TC patie nts and the general population.

SOUTH Korea; CAUSES of death; CANCER patients; BODY mass index; DYSLIPIDEMIA; COHORT analysis; THYROID cancer

European Journal of Endocrinology, 2020, Vol 182, Issue 1, p103

0804-4643

Academic Journal

10.1530/EJE-19-0548