The relationship between secondary hyperparathyroidism and thyroid cancer in end stage renal disease: a population based cohort study

Shih-Yi Lin; Wei-Ming Lin; Cheng-Li Lin; Tse-Yen Yang; Fung-Chang Sung; Yuan-Hung Wang; Chia-Hung Kao

doi:10.1016/j.ejim.2014.01.001

The relationship between secondary hyperparathyroidism and thyroid cancer in end stage renal disease: a population based cohort study

Eur J Intern Med. 2014 Mar;25(3):276-80. doi: 10.1016/j.ejim.2014.01.001. Epub 2014 Jan 17.

Authors

Shih-Yi Lin¹, Wei-Ming Lin², Cheng-Li Lin³, Tse-Yen Yang⁴, Fung-Chang Sung³, Yuan-Hung Wang⁵, Chia-Hung Kao⁶

Affiliations

¹ Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taiwan; Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.
² Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; Chang Gung University, Tao Yuan, Taiwan.
³ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, College of Medicine, China Medical University, Taichung, Taiwan.
⁴ Molecular and Genomic Epidemiology Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.
⁵ Division of Urology, Department of Surgery, Taipei Medical University, Shuang Ho Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁶ Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

PMID: 24440084
DOI: 10.1016/j.ejim.2014.01.001

Abstract

Objectives: We conducted a retrospective cohort study to investigate the risk of cancer in end stage renal disease (ESRD) patients with secondary hyperparathyroidism (HPT).

Patients and methods: This study investigated the elevated overall cancer risk in ESRD patients with secondary HPT in Taiwan. We used a population-based retrospective cohort consisting of original claims data of 1 million beneficiaries randomly sampled from the Taiwan National Health Insurance Research Database (NHIRD). We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer in the ESRD with secondary HPT and comparison cohorts, using the Cox proportional hazards regression model.

Results: We observed that ESRD patients with secondary HPT exhibited a 10.1-fold increased risk of thyroid cancer than did ESRD patients without this parathyroid complication, after adjusting for comorbidities (95% confidence interval=1.12-91.0).

Conclusion: These phenomena indicate that ESRD patients with secondary HPT are at greater risk of thyroid cancer. Physicians should be alert for occult thyroid cancer in ESRD patients with secondary HPT.

Keywords: End-stage renal disease; Hyperparathyroidism; Thyroid cancer.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cohort Studies
Female
Humans
Hyperparathyroidism, Secondary / complications*
Kidney Failure, Chronic / complications*
Male
Middle Aged
Retrospective Studies
Risk Assessment
Taiwan
Thyroid Neoplasms / epidemiology
Thyroid Neoplasms / etiology*