Hashimoto Thyroiditis and Progression of Papillary Thyroid Cancer - 10-Year Retrospective Cohort Study

Sep 29, 2026

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Thyroid cancer incidence continues to rise worldwide, and papillary thyroid cancer (PTC) is commonly managed with active surveillance in selected low-risk patients. This 10-year retrospective cohort study examines whether Hashimoto thyroiditis (HT) is associated with PTC progression during active surveillance. Two groups of PTC patients receiving surveillance for ≥6 months before surgery were compared using Cox models and subgroup analyses adjusting for key baseline covariates. No overall association between HT and progression was found, while BMI may modify the relationship.

LanguageEnglish

CategoryResearch & Report

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Pages11

Reading Time28 min

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Abstract

Introduction

JMIR CANCER Li et al Original Paper Hashimoto Thyroiditis and Progression of Papillary Thyroid Cancer: 10-Year Retrospective Cohort Study | Xin Li 1* , MD; Xiangyun Yao2* , MD; Rui Shan3 , MM; Fang Mei4,5 , PhD; Shibing Song 1 , MD; Bangkai Sun6 , MS; Chunhui Yuan 1 , MD; Zheng Liu3 , PhD | | --- | | 1Department of General Surgery, Peking University Third Hospital, Beijing, China 2Department of Ultrasound, Peking University Third Hospital, Beijing, China
3Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China 4Department of Pathology, Peking University Third Hospital, Beijing, China
5School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China 6Information Management and Big Data Center, Peking University Third Hospital, Beijing, China *these authors contributed equally
Corresponding Author:
Zheng Liu, PhD
Department of Maternal and Child Health School of Public Health, Peking University
38 Xueyuan Road , Haidian District Beijing 100191
China
Phone: 86 82801222
Email: [liuzheng@bjmu.edu.cn](liuzheng@bjmu.edu.cn)
Abstract | | Background: In recent years, the global incidence of thyroid cancer has been increasing.
Objective: This study aimed to examine the association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) progression under active surveillance (AS) .
Methods: Our retrospective study was conducted at Peking University Third Hospital and included 203 patients with PTC who underwent AS for ≥6 months before surgery. Patients were first categorized into 2 groups: the HT group (n=90) and the non-HT group (n=113) . Cox proportional hazards models were then used to evaluate the association between HT and PTC progression during AS, adjusting for age, sex, baseline tumor size, BMI, pregnancy status, number of tumor foci, and thyroid-stimulating hormone level. Subgroup analyses stratified by the 6 covariates mentioned above were also applied to explore the potential effect modification.
Results: No significant difference was observed between the HT and non-HT groups in PTC progression-free survival (hazard ratio [HR] 1.11, 95% CI 0.61‐1.99; P= .74), tumor enlargement-free survival (HR 1.02, 95% CI 0.56‐1.86; P= .95), or lymph node metastasis-free survival (HR 1.76, 95% CI 0.31‐10.12; P= .52) . Subgroup analyses revealed a potential interaction between HT and BMI. Among patients who were overweight or obese (BMI >24 kg/m²), HT was significantly associated with an increased risk of disease progression (HR 6 . 32, 95% CI 1.84‐21 .69; P= .003), while among patients with BMI ≤24 kg/m2 , no association between HT and progression risk was observed (P= .01) .
Conclusions: We found no evidence of association between HT and PTC progression during AS. However, the relationship between HT and PTC progression may be modified by overweight or obesity status.
JMIR Cancer 2026;12:e80535; doi: 10.2196/80535 | Keywords: papillary thyroid cancer; Hashimoto thyroiditis; progression; retrospective cohort.; progression-free survival; lymph node [https://cancer.jmir.org/2026/1/e80535](https://cancer.jmir.org/2026/1/e80535) JMIR Cancer 2026 | vol. 12 | e80535 | p. 1 (page number not for citation purposes) JMIR CANCER Li et al Introduction Thyroid cancer is not only the most common malignant tumor of the head and neck but also the most prevalent endocrine malignancy. In recent years, the global incidence of thyroid cancer has been steadily increasing. Between 1990 and 2020, the number of newly diagnosed cases worldwide rose from 95,000 to 586,000 [1-3] . In China, the age-standardized incidence rate increased from 3.21 per 100,000 in 2005 to 24.64 per 100,000 in 2022 [4,5] . Clinically, papillary thyroid cancer (PTC) is the most frequently encountered, representing approximately 80% of all thyroid cancer cases worldwide [6] . As understanding of PTC has evolved, active surveillance (AS) has been

FAQs

What was the study objective regarding Hashimoto thyroiditis and papillary thyroid cancer?

To examine the association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) progression during active surveillance.

How was the study conducted and what patient groups were compared?

A retrospective study included 203 PTC patients who underwent active surveillance for at least 6 months before surgery. Patients were categorized into HT and non-HT groups and analyzed using Cox proportional hazards models during surveillance.

What did the results show about HT and PTC progression during active surveillance?

Overall, there was no significant difference between HT and non-HT groups in progression-free survival, tumor enlargement-free survival, or lymph node metastasis-free survival. Subgroup analysis suggested an interaction between HT and BMI.

Sep 29, 2026

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