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April 15, 1974

Thyroid Cancer After Radioactive Iodine Therapy

Author Affiliations

Santa Barbara, Calif

JAMA. 1974;228(3):290. doi:10.1001/jama.1974.03230280018019

To the Editor.—  In reference to the letter, "Thyroid Cancer After Iodine-131 Therapy" (227:438, 1974), by I. Ross McDougall, MB, ChB, I think several things should be mentioned for completeness:Although a long-term follow-up series reports no incidence of thyroid cancer, it cannot be cited as proof that cancer does not occur.1Not only low-dose radioactive iodine therapy but all other forms of treatment seem to result in eventual hypothyroidism.Radiation-induced cancers of the thyroid gland are the well-differentiated types.Thyrotoxicosis has a real probability of fatal outcome. (It may be small, but it's real.)Well-differentiated thyroid cancer has an excellent prognosis.Morbidity associated with thyroidectomy is significant, and there is a real probability of surgical death. There is essentially no morbidity and no probability of fatal outcome with radioactive iodine treatment.Antithyroid drugs seem to be inducing a much smaller proportion of remission.I take the position that