Increased Risk of Second Primary Malignancy in Pediatric and Young Adult Patients Treated with Radioactive Iodine for Differentiated Thyroid Cancer

Abstract

Pediatric and young adult patients who receive RAI for DTC experience an elevated risk of SPM, mainly salivary gland cancer. These risks appear to be only slightly higher than in adult patients. Over a decade, approximately 1 in 227 RAI-treated patients will develop an SPM, and 1 in 588 RAI-treated patients will develop a salivary cancer, attributable to RAI. Because the expected survival time for young DTC patients is long, it is critical to weigh the benefits of RAI carefully against the small, but real, increase in SPM risk.