CLINICAL THYROIDOLOGY FOR PATIENTS
A publication of the American Thyroid Association
Male sex is not an independent prognostic factor for thyroid cancer
ABBREVIATIONS & DEFINITIONS
SEER: Surveillance, Epidemiology and End Results program, a nation-wide anonymous cancer registry generated by the National Cancer Institute that contains information on 26% of the United States population. Website: http://seer.cancer.gov/
Papillary thyroid cancer: the most common type of thyroid cancer.
Lymph node: bean-shaped organ that plays a role in removing what the body considers harmful, such as infections and cancer cells.
Thyroid cancer is more common in women than men and is frequently noted to be the fastest rising cancer in women. However, it is also a fast rising cancer in men as well. Thyroid cancer in men has generally been felt to have a worse prognosis than in women. The present study examined sex as a prognostic factor in thyroid cancer through an analysis of more than 60,000 cases in the Surveillance, Epidemiology, and End Results (SEER) database.
THE FULL ARTICLE TITLE:
Nilubol N et al. Multivariate analysis of the relationship between male sex, disease-specific survival, and features of tumor aggressiveness in thyroid cancer of follicular cell origin. Thyroid 2013;23:695-702. Epub May 28, 2013; doi: 10.1089/thy.2012.0269.
SUMMARY OF THE STUDY
Over 61,523 adult patients with thyroid cancer were analyzed from the SEER database. Patients were divided into four groups based on cancer pathology: group 1 had moderately differentiated thyroid cancer, group 2 had papillary thyroid cancer with Hurthle cells, group 3 had poorly differentiated thyroid and group 4 had undifferentiated thyroid cancer. At a mean follow-up time of 54 months, men had significantly more thyroid cancer in aggressive groups (group 3 and 4) than women. Furthermore, men had significantly more advanced disease at presentation with larger primary cancer size, higher rates of spread of the cancer outside the thyroid and more cancer spread to the lymph nodes within the neck and spread to sites outside the neck. Further analysis suggested that sex was a significant prognostic factor associated with death from thyroid cancer, although it was not an independent predictor of death.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study shows that men with thyroid cancer are more likely to present with more advanced and aggressive cancers. Male sex, however, is not an independent prognostic factor for survival and the worse survival of men with thyroid cancer can be attributed to more advanced cancer at the time of presentation. More aggressive screening of men to detect thyroid cancer at an earlier stage might be expected to improve outcomes.
—Frank Crantz, MD
ATA THYROID BROCHURE LINKS
Thyroid cancer: http://www.thyroid.org/cancer-of-the-thyroid-gland