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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  ;  Ji A Seo  ;  Nan Hee Kim  ;  Juneyoung Lee  ;  Kyung Mook Choi  ;  Sei Hyun Baik  ;  Sin Gon Kim 
 EUROPEAN JOURNAL OF ENDOCRINOLOGY, Vol.182(1) : 103-110, 2020-01 
Journal Title
Issue Date
Adult ; Aged ; Body Mass Index ; Case-Control Studies ; Cause of Death ; Female ; Humans ; Incidence ; Korea / epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Risk Factors ; Thyroid Neoplasms / epidemiology* ; Thyroid Neoplasms / etiology*
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 Insurance 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 cardiovascular 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 common 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 hazard 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 against 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 most common cause of death was TC-specific mortality, suggesting the importance of thyroid cancer treatment. The overall and cause-specific mortality risks, particularly CVD mortality risk, did not differ between TC patients and the general population.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Dong Yeob(신동엽) ORCID logo https://orcid.org/0000-0003-1048-7978
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