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Risk of thyroid as a first or second primary cancer. A population-based study in Italy, 1998–2012

  • Autori: Crocetti E.; Mattioli V.; Buzzoni C.; Franceschi S.; Serraino D.; Vaccarella S.; Ferretti S.; Busco S.; Fedeli U.; Varvara M.; Falcini F.; Zorzi M.; Carrozzi G.; Mazzucco W.; Gasparotti C.; Iacovacci S.; Toffolutti F.; Cavallo R.; Stracci F.; Russo A.G.; Caldarella A.; Rosso S.; Musolino A.; Mangone L.; Casella C.; Fusco M.; Tagliabue G.; Piras D.; Tumino R.; Guarda L.; Dinaro Y.M.; Piffer S.; Pinna P.; Mazzoleni G.; Fanetti A.C.; Dal Maso L.
  • Anno di pubblicazione: 2021
  • Tipologia: Articolo in rivista
  • OA Link:


Background: The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. Methods: We analyzed two population-based cohorts of individuals with TC or other neoplasms diagnosed between 1998 and 2012, in 28 Italian areas covered by population-based cancer registries. Standardized incidence ratios (SIRs) of SPC were stratified by sex, age, and time since first cancer. Results: A total of 38,535 TC patients and 1,329,624 patients with other primary cancers were included. The overall SIR was 1.16 (95% CI: 1.12–1.21) for SPC in TC patients, though no increase was shown for people with follicular (1.06) and medullary (0.95) TC. SPC with significantly increased SIRs was bone/soft tissue (2.0), breast (1.2), prostate (1.4), kidney (2.2), and hemolymphopoietic (1.4) cancers. The overall SIR for TC as a SPC was 1.49 (95% CI: 1.42–1.55), similar for all TC subtypes, and it was significantly increased for people diagnosed with head and neck (2.1), colon–rectum (1.4), lung (1.8), melanoma (2.0), bone/soft tissue (2.8), breast (1.3), corpus uteri (1.4), prostate (1.5), kidney (3.2), central nervous system (2.3), and hemolymphopoietic (1.8) cancers. Conclusions: The increased risk of TC after many other neoplasms and of few SPC after TC questions the best way to follow-up cancer patients, avoiding overdiagnosis and overtreatment for TC and, possibly, for other malignancies.