The average age at cancer diagnosis was 6 years and the average age at final follow-up was 32 years. In the survivor group, 83% were white, 5% black, and 5% Hispanic; the rest had either mixed or unknown ethnicity. Among the survivors, 44% had at least one self-reported endocrine disorder, 16.7% had at least two, and 6.6% had three or more. Hodgkin’s lymphoma survivors had the highest frequency of endocrine disorders.
All survivors, and especially those who were exposed to thyroid or hypothalamic-pituitary irradiation had a higher risk of developing thyroid disorders with increasing age, including an underactive or overactive thyroid, thyroid nodules, and thyroid cancer as compared to siblings.
Overall, survivors had the same risk for obesity but a higher risk for diabetes as compared to siblings. Survivors treated with higher doses of cranial irradiation had an almost two-fold greater risk of obesity, while survivors who received abdominal irradiation or total body irradiaiton had an almost two-fold greater risk of diabetes as compared to survivors not exposed.
The risk for ovarian/testicular failure was increased in survivors exposed to ovarian/ testicular irradiation, hypothalamic/pituitary irradiation or cyclophosphamide, as compared with survivors without those exposures.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
All childhood cancer survivors have a higher risk to develop an underactive or overactive thyroid, thyroid nodules, thyroid cancer, and other endocrine disorders than their siblings who did not have cancer, with the risk increasing steadily over time. The risk of thyroid disorders is particularly high in survivors with history of head or neck radiation exposure. These findings underscore the importance of life-long screening for endocrine abnormalities in childhood cancer survivors.
— Alina Gavrila, MD, MMSC
ATA THYROID BROCHURE LINKS
Thyroid cancer: http://www.thyroid.org/thyroid-cancer/