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Importance: Whether radioactive iodine (RAI) treatment of hyperthyroidism (hyperthyroidism) will increase the risk of cancer is still a controversial issue in the fields of medicine and public health
.
.
OBJECTIVE: To study the incidence and mortality of cancer in a specific site after RAI treatment for hyperthyroidism (hyperthyroidism), and to evaluate the radiation dose-response relationship
.
Data source: Medline and Cochrane library electronic databases, using medical subject terms and text keywords, Embase, using Emtree, filtering until October 2020
.
Study selection: The inclusion criteria are as follows: (1) Include patients with hyperthyroidism receiving RAI treatment and follow-up until cancer diagnosis or death; (2) Include at least 1 individual who has not received RAI treatment (for example, the general population or undergoing thyroidectomy or Patients with hyperthyroidism treated with antithyroid drugs) or a control group consisting of patients with hyperthyroidism treated with different doses of RAI; (3) The effect size measurement standards (ie standardized morbidity rate [SIR], standardized mortality rate [SMR], hazard ratio [HR] ]), and (3) include effect size measurement (i.
e.
standardized incidence rate [SIR], standardized mortality [SMR], hazard ratio [HR]), and (3) include effect size measurement (i.
e.
standardized incidence rate [SIR] , Standardized Mortality [SMR], [HR])
.
Data extraction and analysis: Two independent researchers extracted data according to the Meta-analysis (MOOSE) guidelines for epidemiological observational studies
.
The comprehensive quality assessment followed the recommendations of the United Nations Scientific Committee on the Effects of Atomic Radiation
.
Main results and measures: The incidence and mortality of cancers exposed to and without RAI treatment, and the level of RAI treatment activity
.
Results: Based on data from 12 studies (including 479,452 participants), the overall cancer combined incidence rate ratio between exposure to RAI treatment and non-exposure to RAI treatment was 1.
02 (95% CI, 0.
95-1.
09), and the combined cancer mortality ratio It is 0.
98 (95% CI, 0.
92-1.
04)
.
Except for the incidence of thyroid cancer (SIR, 1.
86; 95% CI, 1.
Table 1 Meta-analysis of cancer risk incidence and mortality after radioactive iodine treatment of hyperthyroidism
Table 1 Meta-analysis of cancer risk incidence and mortality after radioactive iodine treatment of hyperthyroidismTable 2 The relationship between regulatory factors and overall cancer risk after radioactive iodine therapy in hyperthyroidism
Table 2 The relationship between regulatory factors and overall cancer risk after radioactive iodine therapy in hyperthyroidismFigure Dose-effect relationship of linear and non-linear models of radioactive iodine dose and cancer mortality
Figure Dose-effect relationship of linear and non-linear models of radioactive iodine dose and cancer mortalityConclusions and correlation: In this meta-analysis, there was no significant difference in overall cancer risk between RAI treatment and no exposure, but there was a linear dose-response correlation between RAI treatment and solid cancer mortality
.
These findings indicate that the risk of radiation-induced cancer after RAI treatment of hyperthyroidism is small, and in observational studies, it may only be detected at higher doses
.
In this meta-analysis, there was no significant difference in the overall cancer risk between RAI treatment and no exposure, but there was a linear dose-response correlation between RAI treatment and solid cancer mortality
Shim SR, Kitahara CM, Cha ES,et al.
Cancer Risk After Radioactive Iodine Treatment for Hyperthyroidism: A Systematic Review and Meta-analysis.
Cancer Risk After Radioactive Iodine Treatment for Hyperthyroidism: A Systematic Review and Meta-analysis.
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