Comparison of secondary and primary thyroid cancer in adolescents and young adults (AYA)

2014-03-05Background: Thyroid cancer is one of the five most common malignancies in AYA patients (ages 15-39) and may develop de novo or in patients previously treated for cancer. We seek to compare the tumor characteristics, treatment, and overall survival (OS) of secondary (SMN) vs. primary thyroid cancer in AYA patients. ❧ Methods: All cases of AYA thyroid cancer contained in the 1998-2010 American College of Surgeons National Cancer Database were divided into two cohorts according to primary or secondary occurrence. Comparisons using appropriate statistical methods were performed. ❧ Results: Of 41,062 cases, 1349 (3.3%) had experienced a prior malignancy. Compared with cases of primary thyroid cancer, SMNs were more likely multifocal (OR:1.173, CI:1.049-1.313) microcarcinomas <1cm (OR:1.496, CI:1.327-1.687) with tell/columnar cells (OR:2.187, CI:0.534-0.692), of White race (2.643, CI:1.310-5.331) and age 35-39 (OR:1.239, CI:1.093-1.404) and less likely female (OR:0.608, CI:0.534-0.692), Hispanic (OR:0.779, CI:0.642-0.946) age 15-19 (OR:0.624, CI:0.510-0.763) or 25-29 (OR:0.711, CI:0.604-0.837), or less likely >4cm in size (OR:0.610, CI:0.493-0.758). There was a 6.63‐fold (CI:4.97-8.86, p