Show simple item record

dc.contributor.authorImsirovic, Harisen
dc.date.accessioned2020-02-03T22:31:45Z
dc.date.available2020-02-03T22:31:45Z
dc.identifier.urihttp://hdl.handle.net/1974/27593
dc.description.abstractBackground: Unnecessary treatment of thyroid cancer as a result of increased surveillance may be associated with substantial side effects, including infertility, often without improvements in survival rates. Objective: To examine the association between thyroid cancer treatment and subsequent infertility diagnosis. Study Design: Population-based cohort study of female Adolescent and Young Adults (AYAs, 15-39 years) who have been treated for thyroid cancer between 1992 and 2011 in Ontario and lived at least 5 years after cancer diagnosis. Exposure data were obtained through the CIHI/DAD, which was linked to several health care data sources through ICES. Thyroid cancer treatment, from less invasive to more aggressive, was categorized as: less than total thyroidectomy-LTT, total thyroidectomy-TOT, or TOT accompanied with radioactive iodine therapy-TOT+RAI. Women were followed in the cohort until December 31, 2016. Infertility diagnosis was identified using information on physician billed claims through the OHIP database (ICD-9 628). Modified Poisson regression models were used to examine associations between type of thyroid cancer treatment and infertility diagnosis, adjusting for confounding factors. Results: From 4,926 female AYAs with thyroid cancer during the study period, 849 (17%) received LTT, 2457 (50%) TOT, 1620 (33%) TOT + RAI. Mean age at cancer diagnosis was 31.04 years (SD=5.99). The median follow-up time for cancer survivors was 10.78 years (IQR=6.96-15.77). A total of 563 (11%) had a subsequent diagnosis of infertility. The frequency of infertility diagnosis was similar among treatments (p=0.99), with a similar mean time to infertility diagnosis (p=0.69). Mean age at infertility diagnosis was 35.26 years (SD=5.48). Compared to women with LTT, women who received TOT or TOT+RAI did not have a higher risk of subsequent infertility diagnosis (RR=0.98, 95% CI: 0.78, 1.24, p=0.86; RR=0.93, 95% CI: 0.72, 1.20, p=0.55 respectively). Conclusions: More aggressive types of thyroid cancer treatment are not associated with an increased risk of infertility diagnosis when compared to the least aggressive type of treatment. Findings of this study are similar to those of others that have examined treatment effects on female reproductive outcomes. Further research is needed to elucidate whether ICD-9 628 code for female infertility is a valid measure of female infertility.en
dc.language.isoengen
dc.relation.ispartofseriesCanadian thesesen
dc.rightsQueen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canadaen
dc.rightsProQuest PhD and Master's Theses International Dissemination Agreementen
dc.rightsIntellectual Property Guidelines at Queen's Universityen
dc.rightsCopying and Preserving Your Thesisen
dc.rightsThis publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.en
dc.subjectInfertilityen
dc.subjectThyroid Canceren
dc.subjectRadioactive Iodine Therapyen
dc.subjectCancer Treatmenten
dc.subjectFemaleen
dc.titleThyroid Cancer Treatment and Subsequent Infertility Diagnosis in Female Adolescents and Young Adults: A Population-Based Cohort Studyen
dc.typethesisen
dc.description.degreeM.Sc.en
dc.contributor.supervisorVelez, Mariaen
dc.contributor.departmentPublic Health Sciencesen
dc.embargo.termsMy thesis supervisor and I are looking to publish the work presented in this thesis in the journal Fertility and Sterility. I am currently in the middle of finishing writing a manuscript which will be submitted for review. I want to restrict the results of this study to the public until I have published a manuscript.en
dc.embargo.liftdate2025-01-31T16:46:06Z
dc.degree.grantorQueen's University at Kingstonen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record