Cancer risk after medical exposure to radioactive iodine in benign thyroid diseases: a meta-analysis

Hieu, Trinh Trung, Russell, Anthony W., Cuneo, Ross, Clark, Justin, Kron, Tomas, Hall, Per and Doi, Suhail A. R. (2012) Cancer risk after medical exposure to radioactive iodine in benign thyroid diseases: a meta-analysis. Endocrine - Related Cancer, 19 5: 645-655.

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Author Hieu, Trinh Trung
Russell, Anthony W.
Cuneo, Ross
Clark, Justin
Kron, Tomas
Hall, Per
Doi, Suhail A. R.
Title Cancer risk after medical exposure to radioactive iodine in benign thyroid diseases: a meta-analysis
Journal name Endocrine - Related Cancer  (ERA 2012 Listed)    (ERA 2010 Rank A)   Check publisher's open access policy
Publication date 2012-07-31
Sub-type Article
DOI 10.1530/ERC-12-0176
Volume number 19
Issue number 5
ISSN 1351-0088; 1479-6821
Start page 645
End page 655
Total pages 11
Place of publication Bristol, United Kingdom
Publisher BioScientifica
Collection year 2013
Language eng
Abstract Radioiodine (131I) is widely used for diagnosis and treatment of benign thyroid diseases. Observational studies have not been conclusive about the carcinogenic potential of 131I and we therefore conducted a meta-analysis. We performed a literature search till September 2011 which included 131I as a diagnostic or treatment modality (131I for treatment of thyroid cancer was excluded). Data on 64 different organ or organ group subsets comprising of 22,029 exposed subjects in the therapeutic cohorts and 24,799 in the diagnostic cohorts in seven studies were included. Outcome was pooled as the relative risk (RR) using both standard and bias adjusted methods. Quality assessment was performed with a study specific instrument. No increase in overall (RR 1.06, 95 % CI 0.94 - 1.19), main organ group or combined organ group (four groups known to concentrate 131I; RR 1.11, 95 % CI 0.94-1.31) risks was demonstrable. Individual organs, demonstrated a higher risk for kidney (RR 1.70, 95 % CI 1.15 - 2.51) and thyroid (RR: 1.99, 95 % CI 1.22 - 3.26) cancers with a strong trend for stomach cancer (RR 1.11; 95% CI 0.92 - 1.33). A thyroid dose effect was seen for diagnostic doses. While there is no increase in the overall burden of cancer, an increase in risk to a few organs is seen that requires substantiation. The possible increase in thyroid cancer risk following diagnostic 131I use should no longer be of concern given that it has effectively been replaced by as the use of 99mTc-pertechnetate.
Keyword Meta-analysis
Carcinogenesis
Radioiodine
Benign thyroid diseases
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Accepted Preprint first posted on 31 July 2012

 
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Created: Fri, 14 Sep 2012, 13:09:41 EST by Justin M Clark on behalf of Research Computing Centre