Men Who Survive Thyroid Cancer Have Higher Risk of CVD vs Women

September 10, 2018

Male thyroid cancer survivors are at a 50% increased risk for developing heart disease vs women, according to one of the first studies of its kind. 

Men who survive thyroid cancer have a 50% higher risk of developing heart disease vs women, according to one of the first population-based studies to assess the association between the potential risk factors for cardiovascular disease (CVD) among thyroid cancer survivors.

The results, published in The Journal of Clinical Endocrinology & Metabolism, suggest a critical need for clinicians to examine the effects of thyroid cancer diagnosis, cancer treatment, and demographic characteristics on the risk of CVD.

Thyroid cancer survivors are at high risk of developing multiple cardiac and vascular conditions as a consequence of cancer diagnosis and treatment. However, the role played by baseline and prognostic factors, as well as cancer treatments, in increasing cardiac and vascular disease risk remains unclear.

“Our study found that male thyroid cancer survivors have an almost 50% higher risk of developing CVD than women, while thyroid cancer survivors with obesity have a 41% higher risk,” said senior author Mia Hashibe, PhD, of Huntsman Cancer Institute in Salt Lake City, Utah.

Hashibe and colleagues conducted a cohort study of 3822 primary thyroid cancer survivors who were diagnosed from 1997 to 2012 and identified using the statewide Utah Population Database. The medical records were used to ascertain information on risk factors and CVD outcomes.

Among thyroid cancer survivors, age and year at cancer diagnosis, cancer stage, sex, baseline body mass index, baseline comorbidities, and thyroid stimulating hormone (TSH) suppression therapy were significantly associated with CVD risk from 1 to 5 years after cancer diagnosis.

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Those who were male, overweight or obese, older at cancer diagnosis, and diagnosed with cancer since 2005 had an increased risk of CVD vs those who were female, had a normal body mass index, were younger at cancer diagnosis, and diagnosed with cancer from 1997 to 1999.

Administration of TSH suppression therapy, distant metastases at cancer diagnosis, and a higher Charlson comorbidity index score were associated with an increased CVD risk among thyroid cancer survivors. Patients whose TSH levels were suppressed as part of their cancer treatment had a 25% higher risk of developing CVD.

Radiation therapy after surgery was marginally associated with an elevated risk of cerebrovascular disease vs surgery only. “The findings suggest that thyroid cancer survivors who received radiation therapy after surgery have an increased risk of developing cerebrovascular disease within 1 to 5 years after the cancer diagnosis compared with those who only underwent surgery,” the researchers stated.

Long-term TSH suppressive therapy is known to predispose thyroid cancer survivors to skeletal conditions, including arthritis, osteoporosis, and bone mineral density loss, and to increase their risk of chronic cardiovascular outcomes, including tachycardia and stroke volume decrease, they noted.

“Our findings suggest that thyroid cancer survivors should be continuously monitored and screened for CVD for both earlier detection and better preventative care,” said Hashibe.

Future research is needed to demonstrate the long-term health effects after cancer diagnosis, not only to provide individualized clinical intervention, but also to prevent the risk of fatal conditions, the researchers stated.