甲状腺機能障害に対する放射性ヨウ素治療とがんの発生率と死亡率との関連
Harry D Momo1, Megan R Haymart2, Xu Shi3
1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
The Journal of clinical endocrinology and metabolism
|February 17, 2026
まとめ
甲状腺機能障害に対する放射性ヨウ素 (RAI) 治療は,全体的ながんリスクの増加を示さなかったが,女性における乳がん発生率の上昇と,臓がんによる死亡率の上昇と関連していた. RAIで治療される患者にとって,長期的な安全性モニタリングは極めて重要です.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 腫瘍学 腫瘍学
- 公衆衛生は公衆衛生である.
背景:
- 放射性ヨウ素 (RAI) は,1940年代以来,甲状腺機能過剰症の主要な治療法となっています.
- 長期的な安全性,特に癌のリスクについては,依然として議論の対象となっています.
- この研究は,RAIとがん発生率/死亡率の関連性を調査しています.
研究 の 目的:
- 甲状腺機能過剰症に対する放射性ヨウ素 (RAI) 治療の長期的な安全性を評価する.
- RAI治療と全体および部位特有のがん発生率および死亡率との関連性を評価する.
- 抗甲状腺薬や甲状腺切除手術に比べ,RAIで治療された患者のがんリスクを比較する.
主な方法:
- 識別解除された電子医療記録 (2006年−2019年) を用いた遡及的なコホート研究.
- 新たに発症した甲状腺機能過剰症 (18歳以上),がん歴なし,RAI,抗甲状腺薬,または甲状腺切除術で治療を受けた成人を含む.
- 時間依存のコックスモデルは,がん発生率と死亡率を分析し,共変数に調整し,2022年12月までの追跡調査を行った.
主要な成果:
- RAI治療は,全体的ながん発生率 (mv HR=1.02) または死亡率 (mv HR=0.81) と関連しませんでした.
- RAIは女性 (mv HR=2.24),特に閉経後の女性 (mv HR=2.65) の乳がんリスクを大幅に増加させた.
- 2年以上のフォローアップで,臓がんによる死亡率の有意な増加が観察されました (age-adj HR=4.05).
結論:
- RAI治療は,がん全体の発生率や死亡率ではなく,乳がんの発生率の増加と関連しています.
- 臓がんによる死亡率の発見は,さらなる調査が必要である.
- RAI治療を受けている患者の継続的な長期的な安全性監視の必要性を強調する.
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