The Risk of overlooking thyroid cancer in radioiodine treatment of hyperthyreosis and goiter

1
The Risk of overlooking thyroid cancer in
radioiodine treatment of hyperthyreosis and
goiter

• Anders Vej-Hansen (1), Lars Thorbjørn Jensen (2),
• Kaj Siersbæk-Nielsen (3) og Birte Nygaard (1)
• 1) Dep. of Endocrinology, Herlev Hospital, 2)
  Dep. of Clinical Fysiology, Glostrup Hospital, 3)
  Dep. of Endocrinology, Frederiksberg Hospital,
  Denmark

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Introduction

• About 3,000 patients are treated with radioiodine
  in Denmark for thyroid diseases each year
• Alternative treatment is surgery but radioiodine
  is more gentle
• Evaluation strategy includes bloodsamples and a
  scintiscan

3
Previous studies
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Purpose

• To evaluate if the evaluation strategy is good
  enough to exclude thyroid cancer

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Materials and methods

• We collected information about all patients
  treated with radioiodine in 3 centre hospitals in
  Copenhagen
• Information was compared with information on
  reported thyroid cancers in the national cancer
  register

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Results I
 
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Results II
 
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Description of the cancers
No. Goiter Age Time to Time
to Age Sex -type RI cancer death death Patol
ogy 1 M Tox dif 61,2 -6,11- -0,5- 68,6 Anap
lastic 2 F Tox nod 82,8 -0,2- -0,2- 83,0 Unkn
own 3 F Tox nod 80,7 -4,5- -3,5- 88,5 Follicu
lary 4 M Tox nod 73,9 -0,8- -0,2- 74,7 Anapl
astic 5 F Tox nod 77,7 -7,0- -4,10- 89,5
(alive) Papillifery 6 F Tox nod 75,9 -2,8- -2,0
- 80,5 Anaplastic 7 M Atox nod 59,8 -4,5- -0,
1- 64,2 Folliculary 8 F Tox nod 53,9 -4,2- -1
,8- 59,7 (alive) Papillifery
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Discussion

• We have found more cancers than expected from the
  background population
• The cancer incidence is at the same level as
  earlier described in studies of patients with
  hyperthyreosis treated with medicine, surgery or
  radioiodine

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Previous studies
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Conclusion

• In this study it seems that we dont overlook
  cancer if we use scintiscan, and when it shows a
  cold nodule, we do a biopsy
• This is also the evaluation of patients with
  nontoxic goiter

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Thank You!!!

• Anders Vej-Hansen, Lars Thorbjørn Jensen, Kaj
  Siersbæk-Nielsen og Birte Nygaard