Risk factors for subsequent thyroid neoplasm development in childhood cancer survivors.
4 affiliations
- 1Department of Nuclear Medicine and Endocrinology, 2nd Faculty of Medicine, Charles University and Motol and Homolka University Hospital , Prague, Czech Republic.
- 2Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and Motol and Homolka University Hospital , Prague, Czech Republic.
- 3Department of Ear, Nose and Throat, 2nd Faculty of Medicine, Charles University and Motol and Homolka University Hospital , Prague, Czech Republic.
- 4Department of Oncology, 2nd Faculty of Medicine, Charles University and Motol and Homolka University Hospital , Prague, Czech Republic.
Abstract
Subsequent thyroid carcinomas (STCs) are common after childhood cancer treatment and have well-described risk factors, whereas information on subsequent thyroid adenomas (STAs) remains limited. This study compared treatment-related risk factors for STCs and STAs, assessed their associations with other subsequent neoplasms, and evaluated the incidence of STCs relative to that in the age-matched national general population. The study cohort included 4,348 childhood cancer survivors treated between 1975 and 2020; 48% were female, 23% had lymphomas, and 77% had solid tumors. STCs occurred in 44 survivors (59% female), and STAs occurred in 23 (65% female). Compared with the national general population, the risk of STCs was 7.6-fold higher in females and 23.6-fold higher in males. The median age at diagnosis was lower for STCs (25.8 vs 29.8 years). Hodgkin lymphoma was the most frequent primary cancer in both groups (48% vs 57%). The median age at first cancer diagnosis was similar between the groups (9.8 vs 9.4 years). Neck radiotherapy was a major risk factor in both groups (59% vs 83%). Additional subsequent malignant neoplasms occurred in 14% of patients with STCs and 13% of patients with STAs, whereas subsequent benign neoplasms occurred in 20% and 26%, respectively. The incidence of subsequent benign neoplasms was higher in patients with STCs than in patients with other first subsequent malignant neoplasms (P < 0.05). STCs predominated over STAs (66%). Shared risk factors included neck radiotherapy and Hodgkin lymphoma. STCs were diagnosed at a younger age. The frequent occurrence of additional subsequent neoplasms highlights the need for long-term surveillance.
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BibTeX
@article{novakova2026risk,
title = {{Risk factors for subsequent thyroid neoplasm development in childhood cancer survivors.}},
author = {Dana Nováková and Karel Švojgr and Rami Katra and Tereza Bartůňková and Petr Vlček and Anna Kindlová and Michaela Jirkovská and Sarah Blagodárná and Tomáš Eckschlager and Lucie Šrámková and Jarmila Kruseová},
journal = {Endocrine-related cancer},
year = {2026},
month = oct,
doi = {10.1530/erc-26-0210},
url = {https://europepmc.org/article/MED/42831777},
note = {CC BY},
}
RIS
TY - JOUR
TI - Risk factors for subsequent thyroid neoplasm development in childhood cancer survivors.
AU - Dana Nováková
AU - Karel Švojgr
AU - Rami Katra
AU - Tereza Bartůňková
AU - Petr Vlček
AU - Anna Kindlová
AU - Michaela Jirkovská
AU - Sarah Blagodárná
AU - Tomáš Eckschlager
AU - Lucie Šrámková
AU - Jarmila Kruseová
PY - 2026
DA - 2026/10/01
JO - Endocrine-related cancer
DO - 10.1530/erc-26-0210
UR - https://europepmc.org/article/MED/42831777
AB - Subsequent thyroid carcinomas (STCs) are common after childhood cancer treatment and have well-described risk factors, whereas information on subsequent thyroid adenomas (STAs) remains limited. This study compared treatment-related risk factors for STCs and STAs, assessed their associations with other subsequent neoplasms, and evaluated the incidence of STCs relative to that in the age-matched national general population. The study cohort included 4,348 childhood cancer survivors treated between 1975 and 2020; 48% were female, 23% had lymphomas, and 77% had solid tumors. STCs occurred in 44 survivors (59% female), and STAs occurred in 23 (65% female). Compared with the national general population, the risk of STCs was 7.6-fold higher in females and 23.6-fold higher in males. The median age at diagnosis was lower for STCs (25.8 vs 29.8 years). Hodgkin lymphoma was the most frequent primary cancer in both groups (48% vs 57%). The median age at first cancer diagnosis was similar between the groups (9.8 vs 9.4 years). Neck radiotherapy was a major risk factor in both groups (59% vs 83%). Additional subsequent malignant neoplasms occurred in 14% of patients with STCs and 13% of patients with STAs, whereas subsequent benign neoplasms occurred in 20% and 26%, respectively. The incidence of subsequent benign neoplasms was higher in patients with STCs than in patients with other first subsequent malignant neoplasms (P < 0.05). STCs predominated over STAs (66%). Shared risk factors included neck radiotherapy and Hodgkin lymphoma. STCs were diagnosed at a younger age. The frequent occurrence of additional subsequent neoplasms highlights the need for long-term surveillance.
SN - 1351-0088
SN - 1479-6821
ER -