Second Primary Malignancy Risk in Thyroid Cancer Survivors: A Systematic Review and Meta-Analysis Academic Article uri icon

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  • OBJECTIVE: To determine the risk of second primary malignancies (SPMs) in thyroid cancer survivors. DESIGN: We performed a systematic review and meta-analysis examining the standardized incidence ratios (SIRs) of SPMs in thyroid cancer survivors (compared to individuals without thyroid cancer). Two independent reviewers screened citations and reviewed all full-text papers deemed potentially relevant. Final consensus was reached on inclusion of papers in the review. Data were pooled using fixed effects models. MAIN OUTCOMES: Thirteen full-text papers were included. The incidence of SPMs in thyroid cancer survivors was increased with an SIR of 1.20 (95% confidence interval 1.17, 1.24) (based on pooled data from six studies of 70,844 thyroid cancer survivors). The SIR of the following SPMs was significantly increased: salivary gland, stomach, colon/colorectal, breast, prostate, kidney, brain/central nervous system, soft tissue sarcoma, non-Hodgkin's lymphoma, multiple myeloma, leukemia, bone/joints, and adrenal. A significantly reduced risk of lung and cervical cancers was observed. CONCLUSIONS: Thyroid cancer survivors are at increased risk of SPMs, which may be related to disease-specific treatments or genetic predisposition.


  • Subramanian, Shoba
  • Goldstein, David P
  • Parlea, Luciana
  • Thabane, Lehana
  • Ezzat, Shereen
  • Ibrahim-Zada, Irada
  • Straus, Sharon
  • Brierley, James D
  • Tsang, Richard W
  • Gafni, Amiram Jacob
  • Rotstein, Lorne
  • Sawka, Anna M

publication date

  • December 2007