Thyroid Cancer and Aging-Related Disease

Since cancer survivors are living longer today than ever before, the medical field must be able to support the health of those survivors as they age. One study of thyroid cancer survivors showed that as a group, they are more likely to experience aging-related diseases compared with age-matched, cancer-free individuals. In particular, patients diagnosed before the age of 40 were at the highest risk for some of these diseases, including heart disease and diabetes. These results were published in Cancer Epidemiology, Biomarkers & Prevention.

“[Cancer survivors] need to be aware of long-term disease risks that can be a result of a combination of their cancer treatment and lifestyle factors,” Mia Hashibe, PhD, associate professor in the Department of Family and Preventive Medicine at the University of Utah in Salt Lake City, said in an interview with Oncology Nursing News. “Thyroid cancer survivors are specifically a group we are concerned about for long-term experiences, since thyroid cancer is often diagnosed in young women and the five-year survival rates are very high at 98%.”

The researchers aimed to evaluate risks for more than 39 aging-related diseases using electronic medical records, statewide health care data, voter registration records, residential histories, family history records, and birth and death certificates from the Utah Population Database. In total, 3,706 patients from the database were diagnosed with thyroid cancer between 1997 and 2012, including 37% who were less than 40 years of age at diagnosis.

All thyroid cancer survivors had a significantly increased risk for hypertension and diabetes at all time points after diagnosis compared with age-matched, cancer-free individuals. However, patients diagnosed before 40 years had an increased risk for diseases such as diabetes, cardiomyopathy, osteoporosis and nutritional deficiencies compared with patients diagnosed after 40.

“We were surprised to see very high risks of aging-related diseases among young people,” said Hashibe, who is also a Huntsman Cancer Institute investigator. “Younger patients may be getting more aggressive treatment than older patients, which may contribute to these increased risks.”

In conjunction with these surprising data, the researchers also found that survivors diagnosed before age 40 had an almost eight-fold increased risk of osteoporosis one to five years after diagnosis compared with age-matched, cancer-free individuals, whereas survivors diagnosed at older ages had only a two-fold increase.

For future study, Hashibe would like to evaluate how genes may contribute to the increased risks of heart disease or other diseases among cancer survivors. “We are also developing risk prediction models, which can calculate individualized risks, for example, for heart disease among thyroid cancer survivors based on factors such as age, sex, family history of heart disease and cancer treatment,” she added. “We would also like to study recurrence among thyroid cancer patients and develop risk prediction models based on tumor mutations.”

In the meantime, Hashibe hopes these results warrant more awareness and additional screening measures for this survivor population. “As cancer patients finish their treatment, we hope that these research results help to make them aware of what other diseases they may be at increased risk for, so that they can make healthy lifestyle choices and live long healthy lives,” she said.