Objective To evaluate the association between rheumatoid arthritis (RA) and the risk of developing thyroid cancer using real-world data. Methods This retrospective cohort study was conducted in June 2025 using data from the TriNetX Research Network, a global federated health platform aggregating anonymized electronic medical records from 28 healthcare organizations. Patients aged 20–84 years with RA were identified and matched 1:1 to controls without RA using propensity score matching. Two time-windows were used for cancer outcome assessment: primary analysis with 1-year lag and sensitivity analysis with 180-day lag. Additionally, a Cox proportional hazards regression model was applied to estimate adjusted hazard ratio (HR), controlling for age, sex, and comorbidities. Results In the primary analysis (1-year lag), 77 of 42,068 patients with RA and 14 of 42,121 controls developed thyroid cancer (cumulative incidence: 0.18% vs. 0.03%; risk ratio: 5.51, 95% CI: 3.12–9.73). In the sensitivity analysis (180-day lag), the association between RA and thyroid cancer remained significant (cumulative incidence: 0.21% vs. 0.05%; risk ratio: 4.36, 95% CI: 2.68–7.08). The Cox model yielded an adjusted HR of 1.40 (95% CI: 1.18–1.67, P < 0.001), further supporting the association between RA and increased thyroid cancer risk. Conclusion Rheumatoid arthritis is associated with a significantly elevated risk of thyroid cancer. Further studies are needed to explore underlying mechanisms and guide cancer surveillance strategies in care of patients with rheumatoid arthritis. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="justify" colname="c1" colnum="1" /> <colspec align="justify" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> Key Points • Patients with rheumatoid arthritis experience a significantly increased burden of cancers. • The Cox model yielded an adjusted hazard ratio of 1.40 (95% CI: 1.18–1.67), further supporting the association between rheumatoid arthritis and increased thyroid cancer risk. • Further studies are warranted to explore underlying mechanisms and guide cancer surveillance strategies in care of patients with rheumatoid arthritis. </entry> </row> </tbody> </tgroup> </Table>

Association between rheumatoid arthritis and thyroid cancer risk: a real-world cohort study using TriNetX

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发表日期：

2025年9月29日

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Shih-Wei Lai,
Yu-Hung Kuo,
Kuan-Fu Liao

摘要

Objective

To evaluate the association between rheumatoid arthritis (RA) and the risk of developing thyroid cancer using real-world data.

Methods

This retrospective cohort study was conducted in June 2025 using data from the TriNetX Research Network, a global federated health platform aggregating anonymized electronic medical records from 28 healthcare organizations. Patients aged 20–84 years with RA were identified and matched 1:1 to controls without RA using propensity score matching. Two time-windows were used for cancer outcome assessment: primary analysis with 1-year lag and sensitivity analysis with 180-day lag. Additionally, a Cox proportional hazards regression model was applied to estimate adjusted hazard ratio (HR), controlling for age, sex, and comorbidities.

Results

In the primary analysis (1-year lag), 77 of 42,068 patients with RA and 14 of 42,121 controls developed thyroid cancer (cumulative incidence: 0.18% vs. 0.03%; risk ratio: 5.51, 95% CI: 3.12–9.73). In the sensitivity analysis (180-day lag), the association between RA and thyroid cancer remained significant (cumulative incidence: 0.21% vs. 0.05%; risk ratio: 4.36, 95% CI: 2.68–7.08). The Cox model yielded an adjusted HR of 1.40 (95% CI: 1.18–1.67, P < 0.001), further supporting the association between RA and increased thyroid cancer risk.

Conclusion

Rheumatoid arthritis is associated with a significantly elevated risk of thyroid cancer. Further studies are needed to explore underlying mechanisms and guide cancer surveillance strategies in care of patients with rheumatoid arthritis.

Key Points

• Patients with rheumatoid arthritis experience a significantly increased burden of cancers.

• The Cox model yielded an adjusted hazard ratio of 1.40 (95% CI: 1.18–1.67), further supporting the association between rheumatoid arthritis and increased thyroid cancer risk.

• Further studies are warranted to explore underlying mechanisms and guide cancer surveillance strategies in care of patients with rheumatoid arthritis.