OBJECTIVES:

We conducted a retrospective cohort study to investigate the risk of cancer in end stage renal disease (ESRD) patients with secondary hyperparathyroidism (HPT).

PATIENTS AND METHODS:

This study investigated the elevated overall cancer risk in ESRD patients with secondary HPT in Taiwan. We used a population-based retrospective cohort consisting of original claims data of 1 million beneficiaries randomly sampled from the Taiwan National Health Insurance Research Database (NHIRD). We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer in the ESRD with secondary HPT and comparison cohorts, using the Cox proportional hazards regression model.

RESULTS:

We observed that ESRD patients with secondary HPT exhibited a 10.1-fold increased risk of thyroid cancer than did ESRD patients without this parathyroid complication, after adjusting for comorbidities (95% confidence interval=1.12-91.0).

CONCLUSION:

These phenomena indicate that ESRD patients with secondary HPT are at greater risk of thyroid cancer. Physicians should be alert for occult thyroid cancer in ESRD patients with secondary HPT.