However, these latter two studies were likely underpowered for the hypothyroidism-breast cancer association. In the models of incident hypothyroidism, we used a time-varying approach to eliminate immortal time bias and lagged the exposure to eliminate reverse causation [ 31 , 35 ]. Thyroid hormone, thyroid hormone receptors, and cancer: a clinical perspective. Due to systematic follow-up, all cases of recurrence are reported in the DBCG including the date and anatomical site of recurrence. Hypothyroidism is a well-documented late effect after radiation therapy in head and neck cancer [ 5 ].
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Furthermore, no differences were seen for all-cause mortality for prevalent or incident hypothyroidism adjusted HR prevalent 1.
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In addition, the systematic collection of data on clinical, tumour, and treatment characteristics on all breast cancer patients enabled us to account for important potential confounders that could affect the risk of recurrence and mortality. Conclusion This prospective cohort study suggests that hypothyroidism present at the time of diagnosis or incident during follow-up is not associated with breast cancer recurrence or all-cause mortality. Second, we investigated the association between hypothyroidism and all-cause mortality.