{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:16:43Z","timestamp":1771334203563,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P01CA233432"],"award-info":[{"award-number":["P01CA233432"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Thyroid cancer is one of the most common cancers in adolescents and young adults (AYA, 15 to 39\u2009years), with an excellent 5\u2010year survival of 98%. However, treatments for thyroid cancer such as radioactive iodine and thyroid hormone suppression may increase the risk for multiple late effects (LEs). We investigated the incidence of severe LE that clustered in AYA thyroid cancer survivors in a large population\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      California and Utah Cancer Registry records identified AYAs diagnosed with first thyroid cancer during 2006\u20132018 linked to statewide hospitalization, ambulatory surgery, and emergency department data. Cohort entry began 2\u2009years from diagnosis. Severe LE included cardiovascular, respiratory, renal, and liver diseases, diabetes, and second cancers. Cumulative incidence of each LE, accounting for the competing risk of death, was calculated. Latent class analysis (LCA) identified clustering of LE over the study period. The number of LE classes was identified by selecting models with the lowest likelihood\u2010ratio G\n                      <jats:sup>2<\/jats:sup>\n                      statistic, Akaike's Information Criterion, and Bayesian Information Criterion. Probabilities of each LE are presented in each class.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 14,268 survivors, median follow\u2010up time was 7\u2009years. The LCA model identified 3 classes: 88% with low LEs, 9% experiencing moderate LEs with elevated probability of diabetes, liver, and respiratory conditions, and the remaining 3% experiencing the highest probability of all LEs, including cardiovascular disease. Non\u2010Hispanic (nH)\u2010Black and Hispanic survivors, those on public insurance, residing in lower socioeconomic status neighborhoods, or diagnosed with distant stage disease experience greater odds of being in the moderate and cardiovascular classes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While most survivors of AYA thyroid cancer have a low incidence of LEs, a small proportion have a high probability of multiple morbidities. Multidisciplinary survivorship care should include identifying and supporting thyroid cancer survivors at higher risk for developing multiple LEs through early screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71316","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T17:54:09Z","timestamp":1764266049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying Patterns of Late Effects With Latent Class Analysis Among Adolescent and Young Adult Thyroid Cancer Survivors in California and Utah"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7326-067X","authenticated-orcid":false,"given":"Judy Y.","family":"Ou","sequence":"first","affiliation":[{"name":"Huntsman Cancer Institute at the University of Utah  Salt Lake City Utah USA"},{"name":"Department of Pediatrics University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Keegan","sequence":"additional","affiliation":[{"name":"University of California, Davis Comprehensive Cancer Center  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian W.","family":"Li","sequence":"additional","affiliation":[{"name":"University of California, Davis Comprehensive Cancer Center  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heydon K.","family":"Kaddas","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute at the University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Abrah\u00e3o","sequence":"additional","affiliation":[{"name":"University of California, Davis Comprehensive Cancer Center  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Brunson","sequence":"additional","affiliation":[{"name":"University of California, Davis Comprehensive Cancer Center  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6869-8634","authenticated-orcid":false,"given":"Candice A. M.","family":"Sauder","sequence":"additional","affiliation":[{"name":"University of California, Davis Comprehensive Cancer Center  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1630-9021","authenticated-orcid":false,"given":"Jessica","family":"Chubak","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence H.","family":"Kushi","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8419-2331","authenticated-orcid":false,"given":"Erin E.","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation Kaiser Permanente Southern California  Pasadena California USA"},{"name":"Department of Health Systems Science Kaiser Permanente Bernard J. Tyson School of Medicine  Pasadena California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6072-4954","authenticated-orcid":false,"given":"Chun","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-1560","authenticated-orcid":false,"given":"Hazel B.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of North Carolina Gillings School of Global Public Health  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne C.","family":"Kirchhoff","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute at the University of Utah  Salt Lake City Utah USA"},{"name":"Department of Pediatrics University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Surveillance Epidemiology and End Results Program \u201cThyroid Cancer\u2014Cancer Stat Facts \u201dSeptember 20 2022 accessed September 20 2022 https:\/\/seer.cancer.gov\/statfacts\/html\/thyro.html."},{"issue":"1","key":"e_1_2_12_3_1","first-page":"30","article-title":"Diagnosis and Treatment of Patients With Thyroid Cancer","volume":"8","author":"Nguyen Q. 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