Thyroid Cancer in HCV-related Chronic Hepatitis Patients: a Case-control Study

Objective: The present study prospectively investigated prevalence and features of thyroid cancer in patients with hepatitis C virus-related chronic hepatitis (HCV+) in comparison to two samples from the general population with different iodine intake.

Design: We studied the prevalence of thyroid cancer in 308 unselected HCV+ patients in comparison to two population-based, gender- and age-matched control groups: 1) 616 subjects from an iodine deficient area; 2) 616 subjects from an iodine-sufficient area. Thyroid status was assessed by measurement of circulating thyroid hormones and autoantibodies, thyroid ultrasonography, and when indicated, fine-needle aspiration cytology.

Main Outcome: Circulating thyrotropin, anti-thyroglobulin, and anti-thyroperoxidase antibodies levels, and the prevalence of hypothyroidism were significantly higher in HCV+ patients (p < 0.001 for all). Six patients with papillary thyroid cancer were detected among HCV+ patients, whereas no case was observed in control 1 (p = 0.001), and only one case was observed in control 2 (p = 0.003). In HCV+ patients 83% with thyroid cancer had evidence of thyroid autoimmunity vs 31% of the other HCV+ patients (p = 0.02).

Conclusions: These data suggest a high prevalence of thyroid papillary cancer in HCV+ patients, overall in presence of thyroid autoimmunity; careful thyroid monitoring is indicated during the follow-up of these patients.