The global incidence of thyroid cancer (TC) has risen considerably during the last three decades, while prognosis is generally favorable. We assessed the long-term all-cause mortality in TC survivors compared to the general population, and its association with cardiovascular risk factors. Individuals diagnosed with TC during 2001–2014 (TC group) and age- and sex-matched individuals from the same Israeli healthcare system without thyroid disease or a cancer history (non-TC group) were compared. Cox regression hazard ratios (HRs) and 95% confidence intervals (95%CIs) for all-cause mortality were calculated by exposure status. During a 15-year follow-up (median 8 years), 577 TC survivors out of 5677 (10.2%) TC patients and 1235 individuals out of 23,962 (5.2%) non-TC patients died. The TC survivors had an increased risk of all-cause mortality (HR = 1.89, 95%CI 1.71–2.10), after adjusting for cardiovascular risk factors already present at follow-up initiation. This increased risk was most pronounced in the 55- to 64-year-old age group (HR = 1.49, 95%CI 1.33–1.67). The TC survivors who died by study closure had more hypertension (14.6% vs. 10.3%, P = 0.002), more dyslipidemia (11.4% vs. 7.2%, P < 0.001), and more cardiovascular disease (33.6% vs. 22.3%, P = 0.05) compared to those who died in the non-TC group. This large cohort study showed higher all-cause mortality with a higher prevalence of hypertension, dyslipidemia, and cardiovascular disease among TC survivors compared to matched non-TC individuals. Primary and secondary prevention of cardiovascular risk factors in TC survivors is mandatory.

中文翻译：

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甲状腺癌幸存者的长期全因死亡率及其与心血管危险因素的关联：一项基于以色列人群的研究。


过去三十年来，甲状腺癌（TC）的全球发病率大幅上升，而预后总体良好。我们评估了 TC 幸存者与普通人群的长期全因死亡率及其与心血管危险因素的关系。对 2001 年至 2014 年期间诊断出 TC 的个体（TC 组）和来自同一以色列医疗系统的年龄和性别匹配的无甲状腺疾病或癌症病史的个体（非 TC 组）进行了比较。根据暴露状态计算全因死亡率的 Cox 回归风险比 (HR) 和 95% 置信区间 (95%CI)。在 15 年的随访期间（中位时间为 8 年），5677 名 TC 患者中有 577 名 TC 幸存者 (10.2%) 以及 23,962 名非 TC 患者中有 1235 名 (5.2%) 死亡。在调整随访开始时已经存在的心血管危险因素后，TC 幸存者的全因死亡风险增加（HR = 1.89，95%CI 1.71-2.10）。这种增加的风险在 55 至 64 岁年龄组中最为明显（HR = 1.49，95% CI 1.33-1.67）。研究结束时死亡的 TC 幸存者有更多的高血压（14.6% vs. 10.3%，P = 0.002）、更多的血脂异常（11.4% vs. 7.2%，P < 0.001）和更多的心血管疾病（33.6% vs. 22.3%） ，P = 0.05）与非 TC 组死亡者相比。这项大型队列研究显示，与匹配的非 TC 个体相比，TC 幸存者的全因死亡率更高，高血压、血脂异常和心血管疾病的患病率也更高。对 TC 幸存者的心血管危险因素进行一级和二级预防是强制性的。