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Updated: Feb 13, 2026
Spontaneous Murine Model of Anaplastic Thyroid Cancer
Published on: February 3, 2023
Risk of second malignancies among survivors of pediatric thyroid cancer
Marwan H Adly1, Mohamed Sobhy2, Mohamed A Rezk2
1Research Department-Children's Cancer Hospital Egypt (CCHE-57357), 1 Seket Al-Emam Street, El-Madbah El-Kadeem Yard, El-Saida Zeinab, Cairo, Egypt.
Insights
Pediatric thyroid cancer survivors face an increased risk of developing second malignancies, particularly in the salivary glands, mouth, and kidneys. Radioactive iodine treatment further elevates this risk, necessitating careful long-term follow-up.
Area of Science:
- Oncology
- Pediatric Oncology
- Cancer Epidemiology
Background:
- Thyroid carcinoma is a rare pediatric malignancy, representing 1.5-3% of childhood cancers in the US and Europe.
- Understanding the long-term risks for survivors is crucial for effective management.
Purpose of the Study:
- To determine the risk of subsequent malignancies (SM) in pediatric thyroid cancer survivors.
- To identify potential prognostic factors associated with SM development.
Main Methods:
- A cohort analysis of pediatric patients (<20 years) diagnosed with primary thyroid cancer (ICD-0-3: C739) between 1973-2013 using the SEER 9 database.
- Follow-up until December 31, 2013, or patient death.
Main Results:
- Of 1769 patients, 42 developed 45 subsequent malignancies.
- The overall Standardized Incidence Ratio (SIR) for SM was 1.48, with significantly elevated risks for salivary glands (SIR=33.95), mouth (SIR=24.53), and kidneys (SIR=5.72).
- Radioactive iodine treatment was associated with a higher SM risk (SIR=4.41), and cumulative incidence increased over 40 years.
Conclusions:
- Race, gender, histology, and radioactive iodine are potential prognostic factors for SM in pediatric thyroid cancer survivors.
- Further research into the mechanisms driving SM risk is essential for optimizing treatment and follow-up strategies.
Background:
Thyroid carcinoma is a very rare tumor in the pediatric age group, accounting for only 1.5-3% of childhood carcinomas in the United States and Europe. We aimed to identify the risk of a second malignancy among pediatric thyroid cancer survivors.
Methods:
The cohort analysis consisted of pediatric cancer patients aged less than 20 years, diagnosed with a primary thyroid cancer, identified by site code ICD-0-3: C739, and reported to the SEER 9 database between 1973 and 2013. They were followed up until December 31, 2013; the end of the study period, or up to death if earlier.
Results:
Out of 1769 patients diagnosed primarily with thyroid carcinoma, 42 patients had a total of 45 incidences of subsequent malignancies. The mean age of patients at the initial diagnosis of thyroid cancer was 16 years. Females (90.5%) had a significantly higher incidence of second malignancies (SM) than males (9.5%). The overall Standardized Incidence Ratio (SIR) of SM in the study patients was higher than expected (SIR = 1.48). Some specific sites showed significantly higher incidences: the salivary glands (SIR = 33.95), the gum and other parts of the mouth [excluding the lips, tongue, salivary glands and floor of the mouth] (SIR = 24.53)*** and the kidneys (SIR = 5.72). The overall risk of SM in patients who had received radioactive iodine was higher than expected (SIR = 4.41). The cumulative incidence of SM after treatment of thyroid cancer in children increases steadily over 40 years (11.92%).
Conclusions:
Race, gender, histological subtypes, and radioactive iodine are potentially significant prognostic factors for the development of SM among pediatric thyroid cancer survivors. Identification of underlying mechanisms that raise the risk of SM is important for both treatment and follow-up strategies.
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