Sexual disparity and the risk of second primary thyroid cancer: a paradox

Mohammad Hussein; Lauren Mueller; Peter P Issa; Muhib Haidari; Lily Trinh; Eman Toraih; Emad Kandil

doi:10.21037/gs-22-411

Sexual disparity and the risk of second primary thyroid cancer: a paradox

Gland Surg. 2023 Apr 28;12(4):432-441. doi: 10.21037/gs-22-411. Epub 2023 Mar 28.

Authors

Mohammad Hussein¹, Lauren Mueller², Peter P Issa³, Muhib Haidari², Lily Trinh^{2

4}, Eman Toraih^{1

5}, Emad Kandil¹

Affiliations

¹ Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA.
² School of Medicine, Tulane University, New Orleans, LA, USA.
³ School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
⁴ Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
⁵ Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Abstract

Background: Despite extensive research on sex differences in primary thyroid cancer, there is a lack of data on the role of sex in the risk of developing second primary thyroid cancer (SPTC). We aimed to investigate the risk of SPTC development according to patient sex, with an emphasis concerning previous malignancy location as well as age.

Methods: Cancer survivors diagnosed with SPTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The SEER*Stat software package obtained standardized incidence ratios (SIR) and absolute excess risks of subsequent thyroid cancer development.

Results: Data for 9,730 (62.3%) females and 5,890 (37.7%) males were extracted for a total of 15,620 SPTC individuals. Asian/Pacific Islanders had the highest incidence of SPTC [SIR =2.67, 95% confidence interval (CI): 2.49-2.86]. The risk of SPTC was higher in males (SIR =2.01, 95% CI: 1.94-2.08) than when compared to females (SIR =1.83, 95% CI: 1.79-1.88; P<0.001). Head and neck tumors had significantly higher SIRs for SPTC development in males when compared to females.

Conclusions: Survivors of primary malignancies have an increased risk SPTC, especially males. Our work suggests that oncologists and endocrinologists may consider the need for increased surveillance of both male and female patients given their increased risk of SPTC.

Keywords: Sexual disparity; Surveillance, Epidemiology, and End Results (SEER); second malignancy; second primary thyroid cancer (SPTC); thyroid cancer.