Second Primary Differentiated Thyroid Carcinoma in Adult Cancer Survivors: A Surveillance, Epidemiology, and End Results (SEER) Database Analysis
Authors' conclusion
Given the characteristics and outcomes of 2-DTC, aggressive treatment for 2-DTC, particularly for PPM with a high mortality risk, may not be advisable.
Study context
- Population
- Adult cancer survivors with DTC, SEER database 2000–2017
- Participants
- 9,253 vs 138,555
- Exposure
- Second primary DTC vs first primary DTC
- 2-DTCn = 9,253
- 1-DTCn = 138,555reference
- Outcome
- Mortality risk by stage (multivariable competing risk analysis)
Methodological detailsSEER database (2000-2017), multivariable competing risk regression
- SEER database (2000-2017)
- Multivariable competing risk regression
Main finding
As reported in the abstract
2-DTC vs 1-DTCSubdistribution hazard ratio (95% CI)
Stage I
1.16(0.65–2.07)
Stage II
0.67(0.45–1.01)
Stage III
0.47(0.27–0.83)
Stage IV
0.72(0.52–0.99)
Observational data: associations, not effects.
Further findings
Baseline characteristics
- 2-DTC patients predominantly older, male and White vs 1-DTC (all P < .05)
Aggressive DTC characteristics by PPM (multivariable logistic regression)
- PPM types associated with higher rates of aggressive characteristics (all P < .05)
- 4
- PPM types with lower rates of aggressive characteristics (all P < .05)
- 19
DTC-specific and cancer-specific death by PPM
- Most prior primary malignancies (PPMs) that developed into 2-DTC had a lower risk of DTC-specific death than 1-DTC, but many PPMs had a higher risk of cancer-specific death
Original publication
Second Primary Differentiated Thyroid Carcinoma in Adult Cancer Survivors: A SEER Database Analysis. J Clin Endocrinol Metab. Published 24 July 2024. doi:10.
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