Identifying Patterns of Late Effects With Latent Class Analysis Among Adolescent and Young Adult Thyroid Cancer Survivors in California and Utah
Year: 2025
Type: article
Study design: Observational Study
Abstract: ABSTRACT Introduction Thyroid cancer is one of the most common cancers in adolescents and young adults (AYA, 15 to 39 years), with an excellent 5‐year survival of 98%. However, treatments for thyroid cancer such as radioactive iodine and thyroid hormone suppression may increase the risk for multiple late effects (LEs). We investigated the incidence of severe LE that clustered in AYA thyroid cancer survivors in a large population‐based cohort. Methods California and Utah Cancer Registry records identified AYAs diagnosed with first thyroid cancer during 2006–2018 linked to statewide hospitalization, ambulatory surgery, and emergency department data. Cohort entry began 2 years from diagnosis. Severe LE included cardiovascular, respiratory, renal, and liver diseases, diabetes, and second cancers. Cumulative incidence of each LE, accounting for the competing risk of death, was calculated. Latent class analysis (LCA) identified clustering of LE over the study period. The number of LE classes was identified by selecting models with the lowest likelihood‐ratio G 2 statistic, Akaike's Information Criterion, and Bayesian Information Criterion. Probabilities of each LE are presented in each class. Results Of 14,268 survivors, median follow‐up time was 7 years. The LCA model identified 3 classes: 88% with low LEs, 9% experiencing moderate LEs with elevated probability of diabetes, liver, and respiratory conditions, and the remaining 3% experiencing the highest probability of all LEs, including cardiovascular disease. Non‐Hispanic (nH)‐Black and Hispanic survivors, those on public insurance, residing in lower socioeconomic status neighborhoods, or diagnosed with distant stage disease experience greater odds of being in the moderate and cardiovascular classes. Conclusion While most survivors of AYA thyroid cancer have a low incidence of LEs, a small proportion have a high probability of multiple morbidities. Multidisciplinary survivorship care should include identifying and supporting thyroid cancer survivors at higher risk for developing multiple LEs through early screening.
Source: Cancer Medicine
DOI: 10.1002/cam4.71316
Institutions: University of Utah, Huntsman Cancer Institute, UC Davis Comprehensive Cancer Center, Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Northern California, Kaiser Permanente, Kaiser Permanente Bernard J. Tyson School of Medicine, University of North Carolina at Chapel Hill
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,700
Awards: G1192507251, G1352184354, G1395202410, G1517530671, G2337224928, G2612351997, G2995161194, G3448447748, G3467199957, G3509688676, G4332884407, G4771140405, G4854421162, G504639888, G5110743314, G5631299761, G5848925640, G6220138500, G671936517, CANCER PREVENTION AND CONTROL PROGRAM 3: NATIONAL PROGRAM OF CANCER REGISTRIES - THE MISSION OF THE UTAH CANCER REGISTRY (UCR), AS AUTHORIZED BY THE UTAH CANCER REPORTING RULE, IS TO PROMOTE PUBLIC HEALTH BY COLLECTING AND MANAGING CANCER INCIDENCE AND MORTALITY DATA FOR THE STATE OF UTAH. UCR HAS OPERATED AS A STATEWIDE, POPULATION-BASED REGISTRY IN UTAH SINCE 1966. UCR JOINED THE NATIONAL PROGRAM OF CANCER REGISTRIES (NPCR) IN 2017. UCR DATA SUBMITTED TO CDC HAVE MET THE NATIONAL DATA QUALITY STANDARD FOR EACH YEAR OF OUR NPCR PARTICIPATION, AND THE REGISTRY HAS RECEIVED MULTIPLE ANNUAL AWARDS RECOGNIZING HIGHEST DATA QUALITY AS ASSESSED BY THE SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS PROGRAM (SEER) OF THE NATIONAL CANCER INSTITUTE AND BY THE NORTH AMERICAN ASSOCIATION OF CENTRAL CANCER REGISTRIES (NAACCR). IN THIS APPLICATION, THE UNIVERSITY OF UTAH REQUESTS SUPPORT FOR UCR UNDER CDC-RFA-DP22-2202 PROGRAM 3, NPCR. WE REQUEST THIS SUPPORT TO ENHANCE OUR SURVEILLANCE QUALITY, PERFORM PROGRAM MONITORING AND EVALUATION, AND COLLABORATE WITH PARTNERS IN CANCER CONTROL AND PREVENTION THROUGH DISSEMINATION OF DATA TO IMPROVE HEALTH EQUITY AND CANCER OUTCOMES. IN THIS APPLICATION, WE PRESENT A COMPREHENSIVE WORK PLAN THAT ENCOMPASSES ACTIVITIES TO ADDRESS THE FOUR APPLICABLE STRATEGIES OF THE NOTICE OF FUNDING OPPORTUNITY. A COMPREHENSIVE AND COORDINATED APPROACH IS VITAL TO DEVELOPING AND IMPLEMENTING STRATEGIES AND ACTIVITIES TO CONTROL AND PREVENT CANCER. UCR COLLABORATES CLOSELY WITH UTAH DEPARTMENT OF HEALTH (UDOH) CANCER PROGRAMS TO SUPPORT AND ADVANCE CANCER CONTROL AND PREVENTION IN UTAH THROUGH DISSEMINATION OF DATA AND PARTICIPATION IN JOINT PROJECTS AND INITIATIVES. IN THIS APPLICATION, WE PROPOSE ACTIVITIES THAT SUPPORT OUR COLLABORATORS’ PROGRAM PLANNING AND IMPLEMENTATION BY MAINTAINING OUR STRONG SURVEILLANCE INFRASTRUCTURE AND DISSEMINATING HIGH QUALITY DATA. WE ALSO PROPOSE TO COLLABORATE WITH OUR PARTNERS AT UDOH TO IMPLEMENT A POPULATION-BASED SURVEY OF CANCER SURVIVORS FOR SURVEILLANCE OF HEALTH IN THIS POPULATION AND IMPROVE HEALTH EQUITY. THROUGH THE PROPOSED ACTIVITIES, UCR WILL IMPROVE THE TIMELINESS, QUALITY, COMPLETENESS, AND CONFIDENTIALITY OF NPCR SURVEILLANCE DATA THROUGH RIGOROUS PROGRAM MONITORING AND INCREASED ADOPTION OF DATA MODERNIZATION STRATEGIES. WE WILL ALSO INCREASE COLLABORATION WITH OUR PUBLIC HEALTH PARTNERS AND THE DISSEMINATION OF USE OF SURVEILLANCE DATA., G6951404960, G7290139498, G8083727551, G8380263711, G8509442309, G9000026874, G9000033968, G9000055636, G946791773
OpenAlex ID: W4416747431