CARCINOMA OF THE THYROID GLAND IN YOUTH: A SECOND LOOK TEN YEARS LATER
Resurvey of a previously published group of 22 young (< 25 yr) thyroid cancer patients after an interval of 10 yr revealed two to be dead, one of thyroid cancer and one of another malignancy, two living with pulmonary metastases, and 18 alive without evidence of disease. During the 10-yr interval it was learned that 11 of the patients had received thymic irradiation in infancy. The data so far accumulated still do not prove that irradiation causes thyroid cancer in man or that children are more susceptible than adults. It has been consistently established, however, that the majority of children with thyroid cancer diagnosed now have a history of prior therapeutic irradiation, if sufficient effort is made to elicit it. The probability of detecting an association between childhood irradiation and thyroid cancer will diminish with the age at which the thyroid cancer is diagnosed. Both the availability of parents for questioning and their ability to recall events from the patient's early childhood decreases with the age of the patient. Also, physicians may be more likely to search for radiation histories in young thyroid cancer patients than in old, since the association has been reported primarily in children to date. If an association between irradiation and thyroid cancer is more likely to be found when it occurs in the young, then an exaggerated impression of greater susceptibility of the youthful thyroid to carcinogenic influences of radiation might be created. This might be further augmented by a skew in the age- distribution of therapeutic radiation exposure. Most of the reported cases received their irradiation for some benign disease of childhood, predominantly so- called thymic enlargement or lymphoid hyperplasia. There is little to support the notion that thyroid cancer is more likely to follow irradiation of children than of adults. Case reports of childhood thyroid cancer are almost nonexistent before 1930 and rise very sharply after 1940. This increasing incidence of thyroid cancer cannot be estimated well from death certificates because of the relatively long survival of young thyroid cancer patients. It is concluded that the question of a causal relation of thyroid cancer with previous irradiation cannot be profitably investigated by study of the reported incidence rates for the disease or for radiation exposure, since both data are highly incomplete and subject to serious biases. (BBB)
- Research Organization:
- Univ. of Pennsylvania, Philadelphia
- Sponsoring Organization:
- USDOE
- NSA Number:
- NSA-17-035517
- OSTI ID:
- 4669078
- Journal Information:
- Journal of Clinical Endocrinology and Metabolism (U.S.), Vol. Vol: 22; Other Information: Orig. Receipt Date: 31-DEC-63
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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