The relationship between secondary hyperparathyroidism and thyroid cancer in end stage renal disease: a population based cohort study.
OBJECTIVE
We conducted a retrospective cohort study to investigate the risk of cancer in end stage renal disease (ESRD) patients with secondary hyperparathyroidism (HPT).


METHODS
This study investigated the elevated overall cancer risk in ESRD patients with secondary HPT in Taiwan. We used a population-based retrospective cohort consisting of original claims data of 1 million beneficiaries randomly sampled from the Taiwan National Health Insurance Research Database (NHIRD). We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer in the ESRD with secondary HPT and comparison cohorts, using the Cox proportional hazards regression model.


RESULTS
We observed that ESRD patients with secondary HPT exhibited a 10.1-fold increased risk of thyroid cancer than did ESRD patients without this parathyroid complication, after adjusting for comorbidities (95% confidence interval=1.12-91.0).


CONCLUSIONS
These phenomena indicate that ESRD patients with secondary HPT are at greater risk of thyroid cancer. Physicians should be alert for occult thyroid cancer in ESRD patients with secondary HPT.
Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taiwan; Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.
Shih-Yi
SY
Lin
Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; Chang Gung University, Tao Yuan, Taiwan.
Wei-Ming
WM
Lin
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, College of Medicine, China Medical University, Taichung, Taiwan.
Cheng-Li
CL
Lin
Molecular and Genomic Epidemiology Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Tse-Yen
TY
Yang
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, College of Medicine, China Medical University, Taichung, Taiwan.
Fung-Chang
FC
Sung
Division of Urology, Department of Surgery, Taipei Medical University, Shuang Ho Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Yuan-Hung
YH
Wang
Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
Chia-Hung
CH
Kao
D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D013624:Taiwan; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology*
End-stage renal disease; Hyperparathyroidism; Thyroid cancer