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Izkhakov et al. J Cancer Metastasis Treat 2021;7:24 Journal of Cancer
DOI: 10.20517/2394-4722.2021.24
Metastasis and Treatment

Review Open Access

Cardiovascular morbidity and mortality as a
confounder of prognosis in thyroid cancer

3,4
1,2
Elena Izkhakov , Lital Keinan-Boker , Naftali Stern 1,2,5
1
Institute of Endocrinology, Metabolism and Hypertension1, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel.
2
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
3
Israel Center for Disease Control, Ministry of Health, Sheba Medical Center, Tel Hashomer Ramat - Gan 5262160, Israel.
4
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel.
5
The Sagol Epigenetics Center, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel.
Correspondence to: Dr. Naftali Stern, The Sagol Epigenetics Center, Institute of Endocrinology, Metabolism and Hypertension,
Tel Aviv-Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann street, Tel Aviv 6423906,
Israel. E-mail: naftalis@tlvmc.gov.il; nafstern66@gmail.com
How to cite this article: Izkhakov E, Keinan-Boker L, Stern N. Cardiovascular morbidity and mortality as a confounder of
prognosis in thyroid cancer. J Cancer Metastasis Treat 2021;7:24. https://dx.doi.org/10.20517/2394-4722.2021.24

Received: 28 Jan 2021 Accepted: 22 Apr 2021 Published: 8 May 2021
Academic Editor: Jerome M. Hershman Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

Abstract
Thyroid cancer (TC) constitutes more than 95% of all endocrine tumors. Differentiated thyroid carcinoma (DTC),
which includes the papillary and follicular types, constitutes about 90% of all TCs and 2.1% of all cancers. The
incidence of DTC has increased significantly worldwide, with papillary cancer leading this trend and being the most
prevalent. Whereas the prognosis of patients with DTC is generally favorable, with the overall 5-year survival rate
reaching up to 95%, long-term follow-up also discloses increased propensity for cardiovascular and
cerebrovascular risk factors, morbidity, and mortality. Cardiovascular events are linked to TC particularly in
subjects aged 45 years or more. The present review and analysis seek to highlight the significance of
cardiovascular disease in the overall prognosis among TC survivors and explore potential mechanisms which might
link treatment choices in DTC to cardiovascular risk and disease outcome.

Keywords: Thyroid cancer, cardiovascular morbidity, cardiovascular mortality, cardiovascular risk factors

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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