Higher risk for thyroid diseases in physicians than in the general population: a Taiwan nationwide population-based secondary analysis study.

BACKGROUND: Physicians have high work stress, responsibility for night shifts and chances of exposure to medical radiation, which may increase the risk for thyroid diseases. AIM: We conducted this study to assess the risk for thyroid diseases in physicians, which remain unclear. DESIGN: We used a secondary analysis of the Taiwan National Health Insurance Research Database for this study. METHODS: After excluding thyroid diseases occurring before 2006 and residents, physicians and general population were identified by matching with age and sex in 2009 in a 1:2 ratio. The risk for thyroid diseases was compared between the physicians and general population and among physicians by tracing their medical histories between 2006 and 2012. RESULTS: In total, 28,649 physicians and 57,298 general population were identified. Physicians had a higher risk for overall thyroid diseases than the general population [odds ratio (OR): 1.27; 95% confidence interval (CI): 1.10-1.47], including individual thyroid disease: thyroid cancer (OR: 1.89; 95% CI: 1.22-2.95), hypothyroidism (OR: 1.64; 95% CI: 1.23-2.18) and thyroiditis (OR: 1.48; 95% CI: 1.00-2.19). CONCLUSIONS: We showed that physicians had a significantly higher risk for thyroid diseases than the general population. This reminds us to pay more attention to thyroid diseases in physicians. Further studies about the underlying mechanisms are warranted.

The incidence and risk of second primary cancers in patients with nasopharyngeal carcinoma: a population-based study in Taiwan over a 25-year period (1979-2003).

BACKGROUND: Very few reports are available on the incidence and risk of second primary cancers in nasopharyngeal carcinoma (NPC) cases, and most of these are single-institution reviews with relatively small case numbers and short follow-up. PATIENTS AND METHODS: A population-based study was conducted. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second cancers among 23 639 individuals with initial diagnoses of NPC. RESULTS: We found a 24% increased risk of second cancers in NPC patients compared with the general population [SIR = 1.24, 95% confidence interval 1.15-1.33]. Elevated SIRs were observed in the following second primary cancers: oral/pharyngeal, salivary gland, sarcoma, skin and leukemia/lymphoma. The cumulative incidence >10 years was 3.26%. The risk was higher in younger patients, especially those <40 years old. After diagnosis of second cancers, the median survival time was 1.7 years. CONCLUSIONS: This is the largest population-based study to date from a high-incidence area. We found that NPC is associated with an increased risk of second malignancies, which had a negative impact on the survival of patients who survived NPC.