title: Thyroid malignancies in survivors of Hodgkin lymphoma.
abstract: OBJECTIVE
  To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes.
  
  
  METHODS
  Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model.
  
  
  RESULTS
  With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively.
  
  
  CONCLUSIONS
  Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time.
authors: Department of Radiation Oncology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, and the Children's Hospital, Boston, Massachusetts.
authors: Evan M
authors: EM
authors: Michaelson
authors: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors: Yu-Hui
authors: YH
authors: Chen
authors: Department of Radiation Oncology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, and the Children's Hospital, Boston, Massachusetts.
authors: Barbara
authors: B
authors: Silver
authors: Department of Radiation Oncology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, and the Children's Hospital, Boston, Massachusetts.
authors: Roy B
authors: RB
authors: Tishler
authors: Department of Radiation Oncology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, and the Children's Hospital, Boston, Massachusetts.
authors: Karen J
authors: KJ
authors: Marcus
authors: Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors: Mary Ann
authors: MA
authors: Stevenson
authors: Department of Radiation Oncology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, and the Children's Hospital, Boston, Massachusetts. Electronic address: ang@lroc.harvard.edu.
authors: Andrea K
authors: AK
authors: Ng
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003606:Dacarbazine / Q000627:therapeutic use; D016208:Databases, Factual; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D016012:Poisson Distribution; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D017741:Survivors / Q000706:statistics & numerical data*; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D014747:Vinblastine / Q000627:therapeutic use; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D011241:Prednisone; D000093542:Gemcitabine