Risk of cancer in long‐term levothyroxine users: Retrospective population‐based study
Levothyroxine is a widely prescribed medication for the treatment of an underactive thyroid. The relationship between levothyroxine use and cancer risk is largely underdetermined. To investigate the magnitude of the possible association between levothyroxine use and cancer risk, this retrospective c...
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| Veröffentlicht in: | Cancer science 2021-06, Vol.112 (6), p.2533-2541 |
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| creator | Wu, Chieh‐Chen Islam, Md. Mohaimenul Nguyen, Phung‐Anh Poly, Tahmina Nasrin Wang, Ching‐Huan Iqbal, Usman Li, Yu‐Chuan (Jack) Yang, Hsuan‐Chia |
| description | Levothyroxine is a widely prescribed medication for the treatment of an underactive thyroid. The relationship between levothyroxine use and cancer risk is largely underdetermined. To investigate the magnitude of the possible association between levothyroxine use and cancer risk, this retrospective case‐control study was conducted using Taiwan’s Health and Welfare Data Science Center database. Cases were defined as all patients who were aged ≥20 years and had a first‐time diagnosis for cancer at any site for the period between 2001 and 2011. Multivariable conditional logistic regression models were used to calculate an adjusted odds ratio (AOR) to reduce potential confounding factors. A total of 601 733 cases and 2 406 932 controls were included in the current study. Levothyroxine users showed a 50% higher risk of cancer at any site (AOR: 1.50, 95% CI: 1.46‐1.54; P |
| doi_str_mv | 10.1111/cas.14908 |
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| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8177794</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A710741112</galeid><sourcerecordid>A710741112</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5628-ffb582a3e526f76deb5a1662c6e77d78213bce0edb70e0a8b3d367a387de7f993</originalsourceid><addsrcrecordid>eNp9ks1u1DAQxyMEoqVw4AVQJC5wyNYficfhgLRa8SVVQipw4GQ5zmTrktipnSzsjUfgGXkS3N1StQiwD7bs3_zHnvln2WNKFjSNY6PjgpY1kXeyQ8rLugBCxN3dHoqacHaQPYjxnBAuyrq8nx1wDjUnXB5mn09t_JL7LjfaGQy5dXnv3frn9x8ThiHvceOns23w36zDfI4Y4ov8FKfg44hmshvMRz_OvZ6sdymo0RHbPE5zu32Y3et0H_HR1XqUfXr96uPqbXHy_s271fKkMJVgsui6ppJMc6yY6EC02FSaCsGMQIAWJKO8MUiwbYAg0bLhLReguYQWoatrfpS93OuOczNga9BNQfdqDHbQYau8tur2jbNnau03SlIAqMsk8OxKIPiLGeOkBhsN9r126OeoWEUAOGc79Okf6Lmfg0vfUwwSQQTl8F-q4kImpL5BrXWPyrrOp9eZy9RqCZRAmTrLErX4C5Vmi4M13mFn0_mtgOf7AJN6FAN215WgRF26RSW3qJ1bEvvkZumuyd_2SMDxHviasmz_raRWyw97yV8SKMqH</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2536837397</pqid></control><display><type>article</type><title>Risk of cancer in long‐term levothyroxine users: Retrospective population‐based study</title><source>Wiley Online Library Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>Wiley Online Library Journals Frontfile Complete</source><source>PubMed Central</source><creator>Wu, Chieh‐Chen ; Islam, Md. Mohaimenul ; Nguyen, Phung‐Anh ; Poly, Tahmina Nasrin ; Wang, Ching‐Huan ; Iqbal, Usman ; Li, Yu‐Chuan (Jack) ; Yang, Hsuan‐Chia</creator><creatorcontrib>Wu, Chieh‐Chen ; Islam, Md. Mohaimenul ; Nguyen, Phung‐Anh ; Poly, Tahmina Nasrin ; Wang, Ching‐Huan ; Iqbal, Usman ; Li, Yu‐Chuan (Jack) ; Yang, Hsuan‐Chia</creatorcontrib><description>Levothyroxine is a widely prescribed medication for the treatment of an underactive thyroid. The relationship between levothyroxine use and cancer risk is largely underdetermined. To investigate the magnitude of the possible association between levothyroxine use and cancer risk, this retrospective case‐control study was conducted using Taiwan’s Health and Welfare Data Science Center database. Cases were defined as all patients who were aged ≥20 years and had a first‐time diagnosis for cancer at any site for the period between 2001 and 2011. Multivariable conditional logistic regression models were used to calculate an adjusted odds ratio (AOR) to reduce potential confounding factors. A total of 601 733 cases and 2 406 932 controls were included in the current study. Levothyroxine users showed a 50% higher risk of cancer at any site (AOR: 1.50, 95% CI: 1.46‐1.54; P < .0001) compared with non–users. Significant increased risks were also observed for brain cancer (AOR: 1.90, 95% CI: 1.48‐2.44; P < .0001), skin cancer (AOR: 1.42, 95% CI: 1.17‐1.72; P < .0001), pancreatic cancer (AOR: 1.27, 95% CI: 1.01‐1.60; P = .03), and female breast cancer (AOR: 1.24, 95% CI: 1.15‐1.33; P < .0001). Our study results showed that levothyroxine use was significantly associated with an increased risk of cancer, particularly brain, skin, pancreatic, and female breast cancers. Levothyroxine remains a highly effective therapy for hypothyroidism; therefore, physicians should carefully consider levothyroxine therapy and monitor patients’ condition to avoid negative outcomes. Additional studies are needed to confirm these findings and to evaluate the potential biological mechanisms.
This retrospective case‐control study analyzed 23 million patients from Taiwan’s claims data. Levothyroxine use was significantly associated with an increased risk of brain, skin, pancreatic, and female breast cancers.</description><identifier>ISSN: 1347-9032</identifier><identifier>EISSN: 1349-7006</identifier><identifier>DOI: 10.1111/cas.14908</identifier><identifier>PMID: 33793038</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Age ; association research ; Breast cancer ; Cancer ; cancer risk ; Cancer therapies ; Care and treatment ; case‐control study ; Chronic illnesses ; Comorbidity ; Drug dosages ; Health care ; Health insurance ; Hypothyroidism ; Kidney diseases ; levothyroxine ; Liver diseases ; long‐term drug use ; Medical diagnosis ; National health insurance ; Oncology, Experimental ; Original ; Oxidative stress ; Pancreatic cancer ; Patients ; Population studies ; Population-based studies ; Regression analysis ; Risk factors ; Skin cancer ; Thyroid ; Thyroid gland ; Thyroxine ; Ulcers</subject><ispartof>Cancer science, 2021-06, Vol.112 (6), p.2533-2541</ispartof><rights>2021 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.</rights><rights>2021 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.</rights><rights>COPYRIGHT 2021 John Wiley & Sons, Inc.</rights><rights>2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5628-ffb582a3e526f76deb5a1662c6e77d78213bce0edb70e0a8b3d367a387de7f993</citedby><cites>FETCH-LOGICAL-c5628-ffb582a3e526f76deb5a1662c6e77d78213bce0edb70e0a8b3d367a387de7f993</cites><orcidid>0000-0002-7449-4838 ; 0000-0001-9198-0697 ; 0000-0002-7436-9041</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177794/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177794/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33793038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Chieh‐Chen</creatorcontrib><creatorcontrib>Islam, Md. Mohaimenul</creatorcontrib><creatorcontrib>Nguyen, Phung‐Anh</creatorcontrib><creatorcontrib>Poly, Tahmina Nasrin</creatorcontrib><creatorcontrib>Wang, Ching‐Huan</creatorcontrib><creatorcontrib>Iqbal, Usman</creatorcontrib><creatorcontrib>Li, Yu‐Chuan (Jack)</creatorcontrib><creatorcontrib>Yang, Hsuan‐Chia</creatorcontrib><title>Risk of cancer in long‐term levothyroxine users: Retrospective population‐based study</title><title>Cancer science</title><addtitle>Cancer Sci</addtitle><description>Levothyroxine is a widely prescribed medication for the treatment of an underactive thyroid. The relationship between levothyroxine use and cancer risk is largely underdetermined. To investigate the magnitude of the possible association between levothyroxine use and cancer risk, this retrospective case‐control study was conducted using Taiwan’s Health and Welfare Data Science Center database. Cases were defined as all patients who were aged ≥20 years and had a first‐time diagnosis for cancer at any site for the period between 2001 and 2011. Multivariable conditional logistic regression models were used to calculate an adjusted odds ratio (AOR) to reduce potential confounding factors. A total of 601 733 cases and 2 406 932 controls were included in the current study. Levothyroxine users showed a 50% higher risk of cancer at any site (AOR: 1.50, 95% CI: 1.46‐1.54; P < .0001) compared with non–users. Significant increased risks were also observed for brain cancer (AOR: 1.90, 95% CI: 1.48‐2.44; P < .0001), skin cancer (AOR: 1.42, 95% CI: 1.17‐1.72; P < .0001), pancreatic cancer (AOR: 1.27, 95% CI: 1.01‐1.60; P = .03), and female breast cancer (AOR: 1.24, 95% CI: 1.15‐1.33; P < .0001). Our study results showed that levothyroxine use was significantly associated with an increased risk of cancer, particularly brain, skin, pancreatic, and female breast cancers. Levothyroxine remains a highly effective therapy for hypothyroidism; therefore, physicians should carefully consider levothyroxine therapy and monitor patients’ condition to avoid negative outcomes. Additional studies are needed to confirm these findings and to evaluate the potential biological mechanisms.
This retrospective case‐control study analyzed 23 million patients from Taiwan’s claims data. Levothyroxine use was significantly associated with an increased risk of brain, skin, pancreatic, and female breast cancers.</description><subject>Age</subject><subject>association research</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>cancer risk</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>case‐control study</subject><subject>Chronic illnesses</subject><subject>Comorbidity</subject><subject>Drug dosages</subject><subject>Health care</subject><subject>Health insurance</subject><subject>Hypothyroidism</subject><subject>Kidney diseases</subject><subject>levothyroxine</subject><subject>Liver diseases</subject><subject>long‐term drug use</subject><subject>Medical diagnosis</subject><subject>National health insurance</subject><subject>Oncology, Experimental</subject><subject>Original</subject><subject>Oxidative stress</subject><subject>Pancreatic cancer</subject><subject>Patients</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Skin cancer</subject><subject>Thyroid</subject><subject>Thyroid gland</subject><subject>Thyroxine</subject><subject>Ulcers</subject><issn>1347-9032</issn><issn>1349-7006</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>BENPR</sourceid><recordid>eNp9ks1u1DAQxyMEoqVw4AVQJC5wyNYficfhgLRa8SVVQipw4GQ5zmTrktipnSzsjUfgGXkS3N1StQiwD7bs3_zHnvln2WNKFjSNY6PjgpY1kXeyQ8rLugBCxN3dHoqacHaQPYjxnBAuyrq8nx1wDjUnXB5mn09t_JL7LjfaGQy5dXnv3frn9x8ThiHvceOns23w36zDfI4Y4ov8FKfg44hmshvMRz_OvZ6sdymo0RHbPE5zu32Y3et0H_HR1XqUfXr96uPqbXHy_s271fKkMJVgsui6ppJMc6yY6EC02FSaCsGMQIAWJKO8MUiwbYAg0bLhLReguYQWoatrfpS93OuOczNga9BNQfdqDHbQYau8tur2jbNnau03SlIAqMsk8OxKIPiLGeOkBhsN9r126OeoWEUAOGc79Okf6Lmfg0vfUwwSQQTl8F-q4kImpL5BrXWPyrrOp9eZy9RqCZRAmTrLErX4C5Vmi4M13mFn0_mtgOf7AJN6FAN215WgRF26RSW3qJ1bEvvkZumuyd_2SMDxHviasmz_raRWyw97yV8SKMqH</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Wu, Chieh‐Chen</creator><creator>Islam, Md. Mohaimenul</creator><creator>Nguyen, Phung‐Anh</creator><creator>Poly, Tahmina Nasrin</creator><creator>Wang, Ching‐Huan</creator><creator>Iqbal, Usman</creator><creator>Li, Yu‐Chuan (Jack)</creator><creator>Yang, Hsuan‐Chia</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7449-4838</orcidid><orcidid>https://orcid.org/0000-0001-9198-0697</orcidid><orcidid>https://orcid.org/0000-0002-7436-9041</orcidid></search><sort><creationdate>202106</creationdate><title>Risk of cancer in long‐term levothyroxine users: Retrospective population‐based study</title><author>Wu, Chieh‐Chen ; Islam, Md. Mohaimenul ; Nguyen, Phung‐Anh ; Poly, Tahmina Nasrin ; Wang, Ching‐Huan ; Iqbal, Usman ; Li, Yu‐Chuan (Jack) ; Yang, Hsuan‐Chia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5628-ffb582a3e526f76deb5a1662c6e77d78213bce0edb70e0a8b3d367a387de7f993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>association research</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>cancer risk</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>case‐control study</topic><topic>Chronic illnesses</topic><topic>Comorbidity</topic><topic>Drug dosages</topic><topic>Health care</topic><topic>Health insurance</topic><topic>Hypothyroidism</topic><topic>Kidney diseases</topic><topic>levothyroxine</topic><topic>Liver diseases</topic><topic>long‐term drug use</topic><topic>Medical diagnosis</topic><topic>National health insurance</topic><topic>Oncology, Experimental</topic><topic>Original</topic><topic>Oxidative stress</topic><topic>Pancreatic cancer</topic><topic>Patients</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Skin cancer</topic><topic>Thyroid</topic><topic>Thyroid gland</topic><topic>Thyroxine</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Chieh‐Chen</creatorcontrib><creatorcontrib>Islam, Md. Mohaimenul</creatorcontrib><creatorcontrib>Nguyen, Phung‐Anh</creatorcontrib><creatorcontrib>Poly, Tahmina Nasrin</creatorcontrib><creatorcontrib>Wang, Ching‐Huan</creatorcontrib><creatorcontrib>Iqbal, Usman</creatorcontrib><creatorcontrib>Li, Yu‐Chuan (Jack)</creatorcontrib><creatorcontrib>Yang, Hsuan‐Chia</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Chieh‐Chen</au><au>Islam, Md. Mohaimenul</au><au>Nguyen, Phung‐Anh</au><au>Poly, Tahmina Nasrin</au><au>Wang, Ching‐Huan</au><au>Iqbal, Usman</au><au>Li, Yu‐Chuan (Jack)</au><au>Yang, Hsuan‐Chia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of cancer in long‐term levothyroxine users: Retrospective population‐based study</atitle><jtitle>Cancer science</jtitle><addtitle>Cancer Sci</addtitle><date>2021-06</date><risdate>2021</risdate><volume>112</volume><issue>6</issue><spage>2533</spage><epage>2541</epage><pages>2533-2541</pages><issn>1347-9032</issn><eissn>1349-7006</eissn><abstract>Levothyroxine is a widely prescribed medication for the treatment of an underactive thyroid. The relationship between levothyroxine use and cancer risk is largely underdetermined. To investigate the magnitude of the possible association between levothyroxine use and cancer risk, this retrospective case‐control study was conducted using Taiwan’s Health and Welfare Data Science Center database. Cases were defined as all patients who were aged ≥20 years and had a first‐time diagnosis for cancer at any site for the period between 2001 and 2011. Multivariable conditional logistic regression models were used to calculate an adjusted odds ratio (AOR) to reduce potential confounding factors. A total of 601 733 cases and 2 406 932 controls were included in the current study. Levothyroxine users showed a 50% higher risk of cancer at any site (AOR: 1.50, 95% CI: 1.46‐1.54; P < .0001) compared with non–users. Significant increased risks were also observed for brain cancer (AOR: 1.90, 95% CI: 1.48‐2.44; P < .0001), skin cancer (AOR: 1.42, 95% CI: 1.17‐1.72; P < .0001), pancreatic cancer (AOR: 1.27, 95% CI: 1.01‐1.60; P = .03), and female breast cancer (AOR: 1.24, 95% CI: 1.15‐1.33; P < .0001). Our study results showed that levothyroxine use was significantly associated with an increased risk of cancer, particularly brain, skin, pancreatic, and female breast cancers. Levothyroxine remains a highly effective therapy for hypothyroidism; therefore, physicians should carefully consider levothyroxine therapy and monitor patients’ condition to avoid negative outcomes. Additional studies are needed to confirm these findings and to evaluate the potential biological mechanisms.
This retrospective case‐control study analyzed 23 million patients from Taiwan’s claims data. Levothyroxine use was significantly associated with an increased risk of brain, skin, pancreatic, and female breast cancers.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>33793038</pmid><doi>10.1111/cas.14908</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7449-4838</orcidid><orcidid>https://orcid.org/0000-0001-9198-0697</orcidid><orcidid>https://orcid.org/0000-0002-7436-9041</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; Wiley Online Library Journals Frontfile Complete; PubMed Central |
| subjects | Age association research Breast cancer Cancer cancer risk Cancer therapies Care and treatment case‐control study Chronic illnesses Comorbidity Drug dosages Health care Health insurance Hypothyroidism Kidney diseases levothyroxine Liver diseases long‐term drug use Medical diagnosis National health insurance Oncology, Experimental Original Oxidative stress Pancreatic cancer Patients Population studies Population-based studies Regression analysis Risk factors Skin cancer Thyroid Thyroid gland Thyroxine Ulcers |
| title | Risk of cancer in long‐term levothyroxine users: Retrospective population‐based study |
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