Aim:

In recent years, dramatic changes in treatment approaches and conflicting publications on thyroid cancer have been reported from endemic regions. The probability of cancer has increased in endemic areas especially in the presence of hyperactive adenoma (HA) and/or hyperthyroidism (HT). It has been suggested that subclinical and clinical hyperthyroidism increase the risk of several solid malignancies while hypothyroidism may reduce aggressiveness or delay the onset of cancer.

Methods:

In this retrospective study, a total of 162 patients, who were operated for HA and/or HT between 2004 and 2009 in a training and research hospital, were compared with 332 controls who were operated for other thyroid diseases. The study group consisted of 33 patients with HA alone, 89 patients with HT alone, and 40 patients with both. Statistical analysis was performed with NCSS 2007 package program.

Results:

The cancer rate was 8.7% in patients with HA and 9.5% in those with HT. There was no statistically significant difference between patients with HA or HT and controls. Three of 13 patients with cancer in the study group and 13 of 26 in the control group had microinvasive papillary cancer. LDH and ALP values in the study group were statistically lower than in the control group. When compared with the control group, the diameter of dominant nodule was statistically significantly larger in the whole study group (p=0.008), in patients with HA (p=0.003) and those with HT (p=0.021).

Conclusion:

Cancer risk does not decrease in the presence of HA and/or HT.

Keywords: Cancer, thyroid, hyperactive adenoma, hyperthyroidism