Reproductive and gynecological complication risks among thyroid cancer survivors

Brenna E. Blackburn; Patricia A. Ganz; Kerry Rowe; John Snyder; Yuan Wan; Vikrant Deshmukh; Michael Newman; Alison Fraser; Ken Smith; Kimberley Herget; Jaewhan Kim; Anne C. Kirchhoff; Christina Porucznik; Heidi Hanson; Dev Abraham; Marcus Monroe; Mia Hashibe

doi:10.1007/s11764-018-0707-7

Reproductive and gynecological complication risks among thyroid cancer survivors

Brenna E. Blackburn
, Patricia A. Ganz
, Kerry Rowe
, John Snyder
, Yuan Wan
, Vikrant Deshmukh
, Michael Newman
, Alison Fraser
, Ken Smith
, Kimberley Herget
, Jaewhan Kim
, Anne C. Kirchhoff
, Christina Porucznik
, Heidi Hanson
, Dev Abraham
, Marcus Monroe
, Mia Hashibe

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Purpose: Thyroid cancer is the most rapidly increasing cancer in the USA, affects a young, mostly female population, and has high survival. The aim of this study was to determine if there is an increased risk of reproductive system adverse events or pregnancy complications among women diagnosed with thyroid cancer under the age of 50. Methods: Up to five female cancer-free individuals were matched to each female thyroid cancer survivor diagnosed before the age of 50 based on birth year, birth state, and follow-up time, within the Utah Population Database. Medical records were used to identify disease diagnoses stratified over three time periods: 0–1, > 1–5, and > 5–10 years after cancer diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HR) with adjustment on matching factors, race, BMI, and Charlson Comorbidity Index. Results: There were 1832 thyroid cancer survivors and 7921 matched individuals. Thyroid cancer survivors had higher rates of having multiple health conditions associated with the gynecological system (15.4% vs. 9.4%) and pregnancy (14.3% vs 9.5%) > 1–5 years after cancer diagnosis. Increased risks persisted > 5–10 years after cancer diagnosis for menopausal disorders (HR = 1.78, 99% CI = 1.37, 2.33) and complications related to pregnancy (HR = 2.13, 99% CI = 1.14, 3.98). Stratified analyses showed these risks remained increased across different treatment types. Conclusions: There were significant risk increases in reproductive system and pregnancy complications among female thyroid cancer survivors within this study. Implications for Cancer Survivors: Although radiation has been linked to reproductive risks in previous studies, we found risks were increased in patients regardless of treatment.

Original language	English
Pages (from-to)	702-711
Number of pages	10
Journal	Journal of Cancer Survivorship
Volume	12
Issue number	5
DOIs	https://doi.org/10.1007/s11764-018-0707-7
State	Published - Oct 1 2018
Externally published	Yes

Funding

Funding information This work was supported by grants from the NCI (R03 CA159357; R21 CA185811), the Huntsman Cancer Institute, Cancer Control and Population Sciences Program (HCI Cancer Center Support Grant P30CA042014), and the NCRR grant, BSharing Statewide Health Data for Genetic Research^ (R01 RR021746, G. Mineau, PI) with additional support from the Utah State Department of Health and the University of Utah. We thank the Pedigree and Population Resource of the Huntsman Cancer Institute, University of Utah (funded in part by the Huntsman Cancer Foundation) for its role in the ongoing collection, maintenance, and support of the Utah Population Database (UPDB). We thank the University of Utah Center for Clinical and Translational Science (CCTS) (funded by NIH Clinical and Translational Science Awards), the Pedigree and Population Resource, University of Utah Information Technology Services, and Biomedical Informatics Core for establishing the Master Subject Index between the Utah Population Database, the University of Utah Health Sciences Center, and Intermountain Health Care.

Keywords

Gynecological risks
Pregnancy complications
Reproductive risks
Thyroid cancer survivors

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10.1007/s11764-018-0707-7

Cite this

Blackburn, B. E., Ganz, P. A., Rowe, K., Snyder, J., Wan, Y., Deshmukh, V., Newman, M., Fraser, A., Smith, K., Herget, K., Kim, J., Kirchhoff, A. C., Porucznik, C., Hanson, H., Abraham, D., Monroe, M., & Hashibe, M. (2018). Reproductive and gynecological complication risks among thyroid cancer survivors. Journal of Cancer Survivorship, 12(5), 702-711. https://doi.org/10.1007/s11764-018-0707-7

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title = "Reproductive and gynecological complication risks among thyroid cancer survivors",

abstract = "Purpose: Thyroid cancer is the most rapidly increasing cancer in the USA, affects a young, mostly female population, and has high survival. The aim of this study was to determine if there is an increased risk of reproductive system adverse events or pregnancy complications among women diagnosed with thyroid cancer under the age of 50. Methods: Up to five female cancer-free individuals were matched to each female thyroid cancer survivor diagnosed before the age of 50 based on birth year, birth state, and follow-up time, within the Utah Population Database. Medical records were used to identify disease diagnoses stratified over three time periods: 0–1, > 1–5, and > 5–10 years after cancer diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HR) with adjustment on matching factors, race, BMI, and Charlson Comorbidity Index. Results: There were 1832 thyroid cancer survivors and 7921 matched individuals. Thyroid cancer survivors had higher rates of having multiple health conditions associated with the gynecological system (15.4\% vs. 9.4\%) and pregnancy (14.3\% vs 9.5\%) > 1–5 years after cancer diagnosis. Increased risks persisted > 5–10 years after cancer diagnosis for menopausal disorders (HR = 1.78, 99\% CI = 1.37, 2.33) and complications related to pregnancy (HR = 2.13, 99\% CI = 1.14, 3.98). Stratified analyses showed these risks remained increased across different treatment types. Conclusions: There were significant risk increases in reproductive system and pregnancy complications among female thyroid cancer survivors within this study. Implications for Cancer Survivors: Although radiation has been linked to reproductive risks in previous studies, we found risks were increased in patients regardless of treatment.",

keywords = "Gynecological risks, Pregnancy complications, Reproductive risks, Thyroid cancer survivors",

author = "Blackburn, \{Brenna E.\} and Ganz, \{Patricia A.\} and Kerry Rowe and John Snyder and Yuan Wan and Vikrant Deshmukh and Michael Newman and Alison Fraser and Ken Smith and Kimberley Herget and Jaewhan Kim and Kirchhoff, \{Anne C.\} and Christina Porucznik and Heidi Hanson and Dev Abraham and Marcus Monroe and Mia Hashibe",

note = "Publisher Copyright: {\textcopyright} 2018, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2018",

month = oct,

day = "1",

doi = "10.1007/s11764-018-0707-7",

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Blackburn, BE, Ganz, PA, Rowe, K, Snyder, J, Wan, Y, Deshmukh, V, Newman, M, Fraser, A, Smith, K, Herget, K, Kim, J, Kirchhoff, AC, Porucznik, C, Hanson, H, Abraham, D, Monroe, M & Hashibe, M 2018, 'Reproductive and gynecological complication risks among thyroid cancer survivors', Journal of Cancer Survivorship, vol. 12, no. 5, pp. 702-711. https://doi.org/10.1007/s11764-018-0707-7

TY - JOUR

T1 - Reproductive and gynecological complication risks among thyroid cancer survivors

AU - Blackburn, Brenna E.

AU - Ganz, Patricia A.

AU - Rowe, Kerry

AU - Snyder, John

AU - Wan, Yuan

AU - Deshmukh, Vikrant

AU - Newman, Michael

AU - Fraser, Alison

AU - Smith, Ken

AU - Herget, Kimberley

AU - Kim, Jaewhan

AU - Kirchhoff, Anne C.

AU - Porucznik, Christina

AU - Hanson, Heidi

AU - Abraham, Dev

AU - Monroe, Marcus

AU - Hashibe, Mia

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Purpose: Thyroid cancer is the most rapidly increasing cancer in the USA, affects a young, mostly female population, and has high survival. The aim of this study was to determine if there is an increased risk of reproductive system adverse events or pregnancy complications among women diagnosed with thyroid cancer under the age of 50. Methods: Up to five female cancer-free individuals were matched to each female thyroid cancer survivor diagnosed before the age of 50 based on birth year, birth state, and follow-up time, within the Utah Population Database. Medical records were used to identify disease diagnoses stratified over three time periods: 0–1, > 1–5, and > 5–10 years after cancer diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HR) with adjustment on matching factors, race, BMI, and Charlson Comorbidity Index. Results: There were 1832 thyroid cancer survivors and 7921 matched individuals. Thyroid cancer survivors had higher rates of having multiple health conditions associated with the gynecological system (15.4% vs. 9.4%) and pregnancy (14.3% vs 9.5%) > 1–5 years after cancer diagnosis. Increased risks persisted > 5–10 years after cancer diagnosis for menopausal disorders (HR = 1.78, 99% CI = 1.37, 2.33) and complications related to pregnancy (HR = 2.13, 99% CI = 1.14, 3.98). Stratified analyses showed these risks remained increased across different treatment types. Conclusions: There were significant risk increases in reproductive system and pregnancy complications among female thyroid cancer survivors within this study. Implications for Cancer Survivors: Although radiation has been linked to reproductive risks in previous studies, we found risks were increased in patients regardless of treatment.

AB - Purpose: Thyroid cancer is the most rapidly increasing cancer in the USA, affects a young, mostly female population, and has high survival. The aim of this study was to determine if there is an increased risk of reproductive system adverse events or pregnancy complications among women diagnosed with thyroid cancer under the age of 50. Methods: Up to five female cancer-free individuals were matched to each female thyroid cancer survivor diagnosed before the age of 50 based on birth year, birth state, and follow-up time, within the Utah Population Database. Medical records were used to identify disease diagnoses stratified over three time periods: 0–1, > 1–5, and > 5–10 years after cancer diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HR) with adjustment on matching factors, race, BMI, and Charlson Comorbidity Index. Results: There were 1832 thyroid cancer survivors and 7921 matched individuals. Thyroid cancer survivors had higher rates of having multiple health conditions associated with the gynecological system (15.4% vs. 9.4%) and pregnancy (14.3% vs 9.5%) > 1–5 years after cancer diagnosis. Increased risks persisted > 5–10 years after cancer diagnosis for menopausal disorders (HR = 1.78, 99% CI = 1.37, 2.33) and complications related to pregnancy (HR = 2.13, 99% CI = 1.14, 3.98). Stratified analyses showed these risks remained increased across different treatment types. Conclusions: There were significant risk increases in reproductive system and pregnancy complications among female thyroid cancer survivors within this study. Implications for Cancer Survivors: Although radiation has been linked to reproductive risks in previous studies, we found risks were increased in patients regardless of treatment.

KW - Gynecological risks

KW - Pregnancy complications

KW - Reproductive risks

KW - Thyroid cancer survivors

UR - https://www.scopus.com/pages/publications/85052580041

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DO - 10.1007/s11764-018-0707-7

M3 - Article

C2 - 30128858

AN - SCOPUS:85052580041

SN - 1932-2259

VL - 12

SP - 702

EP - 711

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

IS - 5

ER -

Reproductive and gynecological complication risks among thyroid cancer survivors

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