Regarding the manuscript entitled “Association of Radioactive Iodine Treatment With Cancer Mortality in Patients With Hyperthyroidism”

  • Xin Zhang
  • Guangliang Shan
  • Qiang Liu
  • Yansong LinEmail author
Letter to the Editor
Part of the following topical collections:
  1. Endocrinology

Dear Sir,

It is well known that as one of the time-tested safe and effective treatment modalities, RAI holds its superiority in hyperthyroidism control, particularly for patients who are not indicated for antithyroid drugs (ATDs) or surgery. We read, with great interest, the recent article by Kitahara and colleagues [1] published in “JAMA Internal Medicine” reporting the results of a “modest” positive association between greater organ-absorbed doses of radioactive iodine (RAI) and the risk of death from solid cancer.

We note that the authors did a great job in the field of low-dose radiation biological effects as a result of a large cohort size, a long-term follow-up, and an innovative method used to estimate organ- and tissue-absorbed doses. However, we are afraid that the conclusion might lead to anxiety and doubt of the value of RAI in hyperthyroidism from a simple glimpse of the conclusion. In fact, some essential issues should be noted for further discussion in case of any...


Funding information

This study was funded by the National Natural Science Foundation of China (grant numbers 81771875 and 81571714) and the Medicine and Technology Innovation Project of the Chinese Academy of Medical Sciences (grant number 2016-I2M-2-006).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.


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    Kitahara CM, Berrington de Gonzalez A, Bouville A, et al. Association of radioactive iodine treatment with cancer mortality in patients with hyperthyroidism. JAMA Intern Med. Published online July 1, 2019.Google Scholar
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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Nuclear Medicine, Peking Union Medical College (PUMC) HospitalChinese Academy of Medical Sciences & PUMCBeijingChina
  2. 2.Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear MedicineBeijingChina
  3. 3.Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical CollegeChinese Academy of Medical SciencesBeijingChina
  4. 4.Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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