title: Hypothyroidism following childhood cancer therapy-an under diagnosed complication.
abstract: To determine the prevalence of hypothyroidism amongst most adult survivors of childhood cancer in Britain using the British Childhood Cancer Survivor Study (BCCSS). The BCCSS is a population based cohort of individuals diagnosed with childhood cancer between 1940 and 1991 and who survived at least 5 years from diagnosis (n = 17,981). 10483, 71% of those survivors aged at least 16 years, returned a completed questionnaire, which asked if hypothyroidism had been diagnosed. Of the whole cohort, 7.7% reported hypothyroidism with the highest risk among patients treated for Hodgkin's disease (HD) (19.9%), CNS neoplasms (15.3%), Non-Hodgkin's lymphoma (6.2%) and leukaemia (5.2%). Survivors were more likely to develop hypothyroidism if they had received radiotherapy for HD (p = 0.0001) or a CNS neoplasm (p < 0.00005) but not leukaemia (p = 0.3). In these three patient groups, the frequency of hypothyroidism was similar in men and women. Survivors of irradiated CNS tumours reported a prevalence of hypothyroidism, which was substantially lower if discharged to primary care compared with being on hospital follow-up and which declined substantially with increased follow-up in both primary care (p = 0.004) and hospital follow-up (p = 0.023) settings. Hypothyroidism is a common finding amongst adult survivors of childhood malignancy. The substantial differences in reported hypothyroidism prevalence after irradiated CNS neoplasms suggests substantial under-diagnosis, which increased with increased follow-up, and which increased among those followed-up in primary care compared with hospital settings.
authors: Department of Endocrinology, The Christie NHS Foundation Trust, Manchester, United Kingdom. georg.brabant@manchester.ac.uk
authors: Georg
authors: G
authors: Brabant
authors: Andrew A
authors: AA
authors: Toogood
authors: Stephen M
authors: SM
authors: Shalet
authors: Clare
authors: C
authors: Frobisher
authors: Emma R
authors: ER
authors: Lancashire
authors: Raoul C
authors: RC
authors: Reulen
authors: David L
authors: DL
authors: Winter
authors: Michael M
authors: MM
authors: Hawkins
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D015995:Prevalence; D011878:Radiotherapy / Q000009:adverse effects; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D017741:Survivors