BACKGROUND: Data on primary hypothyroidism and its long-term impact on the health, cognition, and quality of life (QOL) of childhood cancer survivors are limited. This study examined the prevalence of and risk factors for primary hypothyroidism and its associations with physical, neurocognitive, and psychosocial outcomes. METHODS: This was a retrospective study with a cross-sectional health outcome analysis of an established cohort comprising 2965 survivors of childhood cancer (52.8% male; median current age, 30.9 years, median time since cancer diagnosis, 22.3 years). Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between primary hypothyroidism and cancer-related risk factors, cardiovascular disease risk factors, frailty, neurocognitive and QOL outcomes, social attainment, and subsequent thyroid carcinoma. Associations between serum free thyroxine and thyrotropin levels at assessment and health outcomes were explored. RESULTS: The prevalence of primary hypothyroidism was 14.7% (95% CI, 13.5%-16.0%). It was more likely in females (OR, 1.06; 95% CI, 1.03-1.08), was less likely in non-Whites (OR, 0.96; 95% CI, 0.93-0.99), was associated with thyroid radiotherapy (higher risk at higher doses), and was more common if cancer was diagnosed at an age ≥ 15.0 years versus an age < 5 years (OR, 1.05; 95% CI, 1.01-1.09). Primary hypothyroidism was associated with frailty (OR, 1.54; 95% CI, 1.05-2.26), dyslipidemia (OR, 1.52; 95% CI, 1.14-2.04), impaired physical QOL (OR, 1.66; 95% CI, 1.12-2.48), and having health care insurance (OR, 1.51; 95% CI, 1.07-2.12). CONCLUSIONS: Primary hypothyroidism is common in survivors and is associated with unfavorable physical health and QOL outcomes. The impact of thyroid hormone replacement practices on these outcomes should be investigated further.
BACKGROUND: Data on primary hypothyroidism and its long-term impact on the health, cognition, and quality of life (QOL) of childhood cancer survivors are limited. This study examined the prevalence of and risk factors for primary hypothyroidism and its associations with physical, neurocognitive, and psychosocial outcomes. METHODS: This was a retrospective study with a cross-sectional health outcome analysis of an established cohort comprising 2965 survivors of childhood cancer (52.8% male; median current age, 30.9 years, median time since cancer diagnosis, 22.3 years). Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between primary hypothyroidism and cancer-related risk factors, cardiovascular disease risk factors, frailty, neurocognitive and QOL outcomes, social attainment, and subsequent thyroid carcinoma. Associations between serum free thyroxine and thyrotropin levels at assessment and health outcomes were explored. RESULTS: The prevalence of primary hypothyroidism was 14.7% (95% CI, 13.5%-16.0%). It was more likely in females (OR, 1.06; 95% CI, 1.03-1.08), was less likely in non-Whites (OR, 0.96; 95% CI, 0.93-0.99), was associated with thyroid radiotherapy (higher risk at higher doses), and was more common if cancer was diagnosed at an age ≥ 15.0 years versus an age < 5 years (OR, 1.05; 95% CI, 1.01-1.09). Primary hypothyroidism was associated with frailty (OR, 1.54; 95% CI, 1.05-2.26), dyslipidemia (OR, 1.52; 95% CI, 1.14-2.04), impaired physical QOL (OR, 1.66; 95% CI, 1.12-2.48), and having health care insurance (OR, 1.51; 95% CI, 1.07-2.12). CONCLUSIONS: Primary hypothyroidism is common in survivors and is associated with unfavorable physical health and QOL outcomes. The impact of thyroid hormone replacement practices on these outcomes should be investigated further.
Authors: Carrie R Howell; Kari L Bjornard; Kirsten K Ness; Nicole Alberts; Gregory T Armstrong; Nickhill Bhakta; Tara Brinkman; Eric Caron; Wassim Chemaitilly; Daniel M Green; Tim Folse; I-Chan Huang; John L Jefferies; Sue Kaste; Kevin R Krull; Jennifer Q Lanctot; Daniel A Mulrooney; Geoffrey Neale; Kim E Nichols; Noah D Sabin; Kyla Shelton; Deo Kumar Srivastava; Zhaoming Wang; Carmen Wilson; Yutaka Yasui; Alia Zaidi; Jinghui Zhang; Leslie L Robison; Melissa M Hudson; Matthew J Ehrhardt Journal: Int J Epidemiol Date: 2021-03-03 Impact factor: 7.196
Authors: Melissa M Hudson; Matthew J Ehrhardt; Nickhill Bhakta; Malek Baassiri; Hesham Eissa; Wassim Chemaitilly; Daniel M Green; Daniel A Mulrooney; Gregory T Armstrong; Tara M Brinkman; James L Klosky; Kevin R Krull; Noah D Sabin; Carmen L Wilson; I-Chan Huang; Johnnie K Bass; Karen Hale; Sue Kaste; Raja B Khan; Deo Kumar Srivastava; Yutaka Yasui; Vijaya M Joshi; Saumini Srinivasan; Dennis Stokes; Mary Ellen Hoehn; Matthew Wilson; Kirsten K Ness; Leslie L Robison Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-12-29 Impact factor: 4.254
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: Parveen Bhatti; Lene H S Veiga; Cécile M Ronckers; Alice J Sigurdson; Marilyn Stovall; Susan A Smith; Rita Weathers; Wendy Leisenring; Ann C Mertens; Sue Hammond; Debra L Friedman; Joseph P Neglia; Anna T Meadows; Sarah S Donaldson; Charles A Sklar; Leslie L Robison; Peter D Inskip Journal: Radiat Res Date: 2010-10-06 Impact factor: 2.841
Authors: Daniel M Green; Vikki G Nolan; Pamela J Goodman; John A Whitton; DeoKumar Srivastava; Wendy M Leisenring; Joseph P Neglia; Charles A Sklar; Sue C Kaste; Melissa M Hudson; Lisa R Diller; Marilyn Stovall; Sarah S Donaldson; Leslie L Robison Journal: Pediatr Blood Cancer Date: 2013-08-12 Impact factor: 3.167
Authors: Kirsten K Ness; Kevin R Krull; Kendra E Jones; Daniel A Mulrooney; Gregory T Armstrong; Daniel M Green; Wassim Chemaitilly; Webb A Smith; Carmen L Wilson; Charles A Sklar; Kyla Shelton; Deo Kumar Srivastava; Sabeen Ali; Leslie L Robison; Melissa M Hudson Journal: J Clin Oncol Date: 2013-11-18 Impact factor: 44.544