1
|
Hu MJ, Zhao HH, Li GA, Zhang HS, He JL, Huang F. Body mass index and weight gain after middle adulthood are associated with risk of papillary thyroid cancer: A case-control study. Cancer Epidemiol 2021; 75:102039. [PMID: 34562748 DOI: 10.1016/j.canep.2021.102039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/18/2021] [Accepted: 09/09/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND It is unclear whether weight change after middle adulthood influences the risk of thyroid cancer. The aim of this study was to investigate associations between the risk of papillary thyroid cancer (PTC) and body mass index (BMI) and weight change after middle adulthood (age 35). METHODS A matched case-control study based on three hospitals included 516 pairs of cases newly diagnosed with PTC and controls. Current height and weight after defecation in the morning were measured by trained nurses. During measurement, all subjects were requested to wear lightweight clothing and no shoes. Weight at age 35 was self-reported. BMI and weight change were modeled as continuous and categorical variables. Conditional and unconditional logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95%CI) for the association between BMI and weight change after middle adulthood and PTC. RESULTS After adjustment for covariates, measured BMI at the time of current diagnosis was positively associated with PTC (OR 1.16, 95%CI 1.10-1.21). According to WHO BMI guidelines for Asia-Pacific populations, the OR (95%CI) for PTC risk in obesity was 2.99 (1.92-4.67) compared to normal weight (p-trend <0.001). Moreover, PTC was positively associated with BMI at age 35; the OR (95%CI) for PTC risk per unit increase in BMI was 1.06 (1.02-1.11). Compared to stable weight (changed <0.5 kg/year), weight gain ≥1.0 kg/year after middle adulthood was positively associated with PTC (OR 2.57, 95%CI 1.39-4.76, p-trend <0.001). Compared to maintaining non-overweight status, the PTC risk was significantly increased in those individuals who gained weight and became overweight after middle adulthood (OR 3.82, 95%CI 2.50-5.85). CONCLUSION This study showed that high BMI and obesity were positively associated with increased risk of PTC, and weight gain after middle adulthood also could elevate the PTC risk.
Collapse
Affiliation(s)
- Ming-Jun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China
| | - Huan-Huan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China
| | - Han-Shuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China; Laboratory for Environmental Toxicology, Anhui Medical University, Hefei 230032, Anhui, China.
| |
Collapse
|
2
|
Youssef MR, Reisner ASC, Attia AS, Hussein MH, Omar M, LaRussa A, Galvani CA, Aboueisha M, Abdelgawad M, Toraih EA, Randolph GW, Kandil E. Obesity and the prevention of thyroid cancer: Impact of body mass index and weight change on developing thyroid cancer - Pooled results of 24 million cohorts. Oral Oncol 2020; 112:105085. [PMID: 33171329 DOI: 10.1016/j.oraloncology.2020.105085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Body weight may be a modifiable risk factor predisposing to different cancers. To establish a potential impact of weight change on thyroid cancer risk, we conducted a meta-analysis to evaluate the effect of body mass index (BMI) and weight change over time as a risk of developing thyroid cancer (TC). METHODS A systematic search was performed up to February 25, 2020. Pooled relative risk (RR) were estimated using fixed and random models. Heterogeneity between articles was examined using Q-test and I2 index. Evaluation of publication bias was conducted with Egger's regression test. RESULTS A total of 31 studies including 24,489,477 cohorts were eligible. Pooled analysis revealed that normal and underweight cohorts were associated with a decreased risk of TC (RR = 0.68, 95%CI = 0.65-0.71, p < 0.001) and (RR = 0.92, 95%CI = 0.91-0.93, p < 0.001), respectively. In contrast, overweight and obese cohorts were more likely to develop TC (RR = 1.26, 95%CI = 1.24-1.28, p < 0.001 and RR = 1.50, 95%CI = 1.45-1.55, p < 0.001, respectively). Obesity was associated with higher risk of developing TC among women (RR = 1.29, 95%CI = 1.14-1.46, p < 0.001), but not men (RR = 1.25, 95%CI = 0.97-1.62, p = 0.08). Furthermore, weight gain increased the risk of developing TC (RR = 1.18, 95%CI = 1.14-1.22, p < 0.001), while weight loss decreased the risk (RR = 0.89, 95%CI = 0.85-0.93, p < 0.001). Results showed similar trends of weight change effect in both males and females. CONCLUSIONS Obesity is associated with higher risk of developing TC in women. However, maintaining a healthy weight is associated with reduced risk of TC in both women and men. Shifting our practice to include weight control strategies will help lead to cancer prevention.
Collapse
Affiliation(s)
- Mohanad R Youssef
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | | | - Abdallah S Attia
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | | | - Mahmoud Omar
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | - Anna LaRussa
- Tulane University, School of Medicine, New Orleans, LA, USA
| | - Carlos A Galvani
- Division of Minimally Invasive Surgery and Bariatric, Department of Surgery, Tulane University, New Orleans, LA 70112, USA
| | - Mohamed Aboueisha
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | - Mohamed Abdelgawad
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA; Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Eman Ali Toraih
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA
| | - Emad Kandil
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
| |
Collapse
|
3
|
Kim KN, Hwang Y, Kim KH, Lee KE, Park YJ, Kim SJ, Kwon H, Park DJ, Cho B, Choi HC, Kang D, Park SK. Adolescent overweight and obesity and the risk of papillary thyroid cancer in adulthood: a large-scale case-control study. Sci Rep 2020; 10:5000. [PMID: 32193459 PMCID: PMC7081310 DOI: 10.1038/s41598-020-59245-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/04/2019] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate the association between adolescent overweight and obesity and PTC risk in adulthood. We conducted a case-control study in the Republic of Korea with 1,549 PTC patients and 15,490 controls individually matched for age and sex. We estimated body mass index (BMI) at age 18 years from self-reported weight at this age. Compared with BMI < 23.0 at age 18 years, BMI ≥ 25.0 at age 18 years was associated with higher PTC risk (odds ratio [OR] = 4.31, 95% confidence interval [CI]: 3.57, 5.22). The association between BMI ≥ 25.0 at age 18 years and PTC risk was stronger among men (OR = 6.65, 95% CI: 4.78, 9.27) than among women (OR = 3.49, 95% CI: 2.74, 4.43), and stronger among individuals with current BMI ≥ 25.0 (OR = 8.21, 95% CI: 6.34, 10.62) than among those with current BMI < 25.0 (OR = 2.21, 95% CI: 1.49, 3.27). Among PTC patients, BMI ≥ 25.0 at age 18 years was associated with extra-thyroidal extension and T stage ≥2, but not with N stage ≥1 or BRAFV600E mutation. Adolescent overweight and obesity was associated with higher risk of PTC in adulthood. Our results emphasise the importance of weight management in adolescence to decrease the PTC risk.
Collapse
Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Division of Public Health and Preventive Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yunji Hwang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyu Hyung Kim
- Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Kyu Eun Lee
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Surgery, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea.,Division of Surgery, Thyroid Center, Seoul National University Cancer Hospital, Seoul, Republic of Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Su-Jin Kim
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Surgery, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea.,Division of Surgery, Thyroid Center, Seoul National University Cancer Hospital, Seoul, Republic of Korea
| | - Hyungju Kwon
- Breast and Thyroid Cancer Center, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - BeLong Cho
- Department of Family Medicine, Center for Health Promotion and Optimal aging, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea.,Institute of Aging, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho-Chun Choi
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea. .,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
4
|
Barrea L, Gallo M, Ruggeri RM, Giacinto PD, Sesti F, Prinzi N, Adinolfi V, Barucca V, Renzelli V, Muscogiuri G, Colao A, Baldelli R. Nutritional status and follicular-derived thyroid cancer: An update. Crit Rev Food Sci Nutr 2020; 61:25-59. [PMID: 31997660 DOI: 10.1080/10408398.2020.1714542] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The incidence of differentiated thyroid cancer has been increasing in the last decades all over the world. Such a steady growth cannot be entirely attributable to more intensive thyroid nodule screening and more sensitive diagnostic procedures. Several environmental factors have changed with sufficient rapidity in the same time frame and may represent credible candidates for this increase. They include modified iodine intake, lifestyle-associated risk factors, exposure to various toxic compounds, pollutants and xenobiotics, nutritional deficiencies, eating habits and comorbidities. Foremost, nutritional patterns have gained high interest as possible promoters and modifiable risk factors for thyroid cancer in recent years. The aim of this narrative review is to focus on the relationship between thyroid cancer and nutritional factors, dietary habits and obesity. Low iodine intake has been associated to increased risk of thyroid cancer, favoring the development of more aggressive histotypes. Moreover, correction of iodine deficiency can shift thyroid cancer subtypes toward less aggressive forms, without affecting the overall risk for cancer. Actually, evidence regarding the association between selenium and vitamin D deficiency and thyroid cancer is very limited, despite their well-known anti-cancer potentials, and the clinical usefulness of their supplementation is still uncertain in this setting. Albeit the relationship between single foods and thyroid cancer is difficult to examine, fish and iodine-rich foods, vegetables, and fruits might exert protective effects on thyroid cancer risk. Conversely, no clear association has been found for other foods to date. Lastly, a clear association between obesity and the risk of thyroid cancer, with more aggressive behavior, seems to emerge from most studies, likely involving variations in thyroid function and chronic inflammation mediated by cytokines, insulin, leptin and adiponectins. Although no definite association between dietary factors and thyroid cancer has been firmly established so far, some nutritional patterns, together with excessive weight, seem to play a relevant role in thyroid cancer carcinogenesis as well as in its severity and aggressiveness. These effects may play an additive role to the well-established one exerted by environmental carcinogens, such as pollutants and radiation exposure.
Collapse
Affiliation(s)
- Luigi Barrea
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosaria Maddalena Ruggeri
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paola Di Giacinto
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo-Forlanini, Rome, Italy
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Natalie Prinzi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Valerio Adinolfi
- Endocrinology and Diabetology Unit, ASL Verbano Cusio Ossola, Domodossola, Italy
| | - Viola Barucca
- Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Valerio Renzelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanna Muscogiuri
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Roberto Baldelli
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo-Forlanini, Rome, Italy
| | | |
Collapse
|
5
|
Kwon H, Han KD, Park CY. Weight change is significantly associated with risk of thyroid cancer: A nationwide population-based cohort study. Sci Rep 2019; 9:1546. [PMID: 30733504 PMCID: PMC6367378 DOI: 10.1038/s41598-018-38203-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022] Open
Abstract
Obesity is a risk factor for many cancers including breast, esophageal, colon, and thyroid cancer. We aimed to evaluate the association of thyroid cancer with body mass index (BMI), waist circumference (WC), and weight change. This nationwide population-based cohort study included 11,323,006 adults who joined the national health screening program. Weight change was defined as the difference between the weight of the subjects measured during the study period and the weight at the time of four years ago. For evaluating the association between the weight change and the risk of thyroid cancer, subjects without weight change for four years were defined as the reference group. Mean age was 50.1 ± 13.7 years and 44% were female. In total, 50,464 subjects (0.4%) had newly-diagnosed thyroid cancer. After multivariable analyses, the incidence of thyroid cancer increased significantly in subjects with larger WC as well as higher BMI (P < 0.001 and P < 0.001, respectively). In subjects who were lean and became obese, the incidence of thyroid cancers increased significantly (hazard ratio [HR] 1.15 [1.11-1.19]). In subjects who were obese and became lean, the incidence of thyroid cancers decreased significantly (HR 0.89 [0.86-0.93]). These results demonstrated that higher BMI and larger WC were significantly associated with an increased risk of thyroid cancer. Weight gain in lean subjects was associated with an increased risk of thyroid cancer, and weight reduction in subjects with obesity was associated with a decreased risk of thyroid cancer.
Collapse
Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Biostatics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
6
|
Hidayat K, Du X, Shi BM. Body fatness at a young age and risks of eight types of cancer: systematic review and meta-analysis of observational studies. Obes Rev 2018; 19:1385-1394. [PMID: 30047231 DOI: 10.1111/obr.12705] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/13/2018] [Accepted: 04/15/2018] [Indexed: 12/13/2022]
Abstract
The associations between body fatness at a young age (childhood, adolescence and young adulthood; age ≤ 30 years) and diffuse large B-cell lymphoma (DLBCL), oesophageal adenocarcinoma, gastric cardia cancer, hepatocellular carcinoma, multiple myeloma, pancreatic cancer, renal cell cancer and thyroid cancer remain inconclusive. We performed a comprehensive systematic literature review and meta-analysis of observational studies to clarify the associations between body fatness at a young age and the risks of these cancers. PubMed and Web of Science databases were searched for relevant observational studies. Fifty-six articles yielded data on 27,559 cancer cases, including 3,170 DLBCL, 1,491 oesophageal adenocarcinoma, 1,103 gastric cardia cancer, 1,067 hepatocellular carcinoma, 3,090 multiple myeloma, 7,220 pancreatic cancer, 6,212 renal cell cancer and 4,206 thyroid cancer cases. Each 5 kg m-2 increase in body mass index at a young age was positively associated with DLBCL (relative risk [RR] 1.21, 95% confidence interval [CI] 1.09, 1.35), oesophageal adenocarcinoma (RR 1.88, 95% CI 1.37, 2.57), gastric cardia cancer (RR 1.59, 95% CI 1.15, 2.21), hepatocellular carcinoma (RR 1.31, 95% CI 1.13, 1.51), multiple myeloma (RR 1.23, 95% CI 1.15, 1.30), pancreatic cancer (RR 1.17, 95% CI 1.11, 1.24), renal cell cancer (RR 1.22, 95% CI 1.16, 1.28) and thyroid cancer (RR 1.12, 95% CI 1.07, 1.17). In summary, higher body fatness at a young age increases the risks of developing various types of cancer later in life. Prevention of overweight and obesity in children, adolescents and young adults should therefore be emphasized to reverse the obesity epidemic and thereby avoid further increases in the burden of cancer attributed to excess body fatness.
Collapse
Affiliation(s)
- K Hidayat
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - X Du
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - B-M Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
7
|
Yin DT, He H, Yu K, Xie J, Lei M, Ma R, Li H, Wang Y, Liu Z. The association between thyroid cancer and insulin resistance, metabolic syndrome and its components: A systematic review and meta-analysis. Int J Surg 2018; 57:66-75. [PMID: 30081182 DOI: 10.1016/j.ijsu.2018.07.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/15/2018] [Accepted: 07/28/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Thyroid cancer is rapidly increasing in incidence worldwide in the past several decades, same as the incidence of metabolic syndrome. We performed a system review and meta-analysis of the association between metabolic syndrome, its components and insulin resistance and thyroid cancer incidence. METHODS We searched several computer-assisted databases PUBMED, EMBASE and ISI Web of Science to identify studies published before 31st January 2018. Every study must report either risk estimates of thyroid cancer incidence with 95% confidence interval (CI) or related data can speculate. Two investigators independently identified eligible studies and extracted data. Evaluating the summaries of relative risk estimates use both fixed and random effects methods. RESULTS We found 42 articles met the inclusion criteria of this review. There is an increased risk for thyroid cancer for patients with insulin resistance (relative risk [RR] = 1.59, 95%confidence interval [CI] = 1.12-2.27, P = 0.01), dysglycemia (RR = 1.40, 95%CI = 1.15-1.70,P < 0.001), high BMI (RR = 1.35,95%CI = 1.23-1.48,P < 0.001) and hypertension(RR = 1.34,95%CI = 1.22-1.47, p < 0.001). However, patients with dyslipidemia, both total cholesterol (RR = 1.09, 95%CI = 0.98-1.21, P = 0.13) and triglyceride (RR = 1.01, 95%CI = 0.91-1.12, P = 0.82) was not associated with thyroid cancer. CONCLUSIONS Our meta-analysis showed Insulin Resistance, dysglycemia, high BMI and hypertension significantly increased the thyroid cancer risk. These results may help identify people with high risk of thyroid cancer and change to healthy life style.
Collapse
Affiliation(s)
- De-Tao Yin
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China.
| | - Huanan He
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China; Department of General Surgery, the First People's Hospital of Pingdingshan, Pingdingshan, 467000, PR China
| | - Kun Yu
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Jing Xie
- Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Mengyuan Lei
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Runsheng Ma
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Hongqiang Li
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Yongfei Wang
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Zhen Liu
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| |
Collapse
|
8
|
Rotondi M, Castagna MG, Cappelli C, Ciuoli C, Coperchini F, Chiofalo F, Maino F, Palmitesta P, Chiovato L, Pacini F. Obesity Does Not Modify the Risk of Differentiated Thyroid Cancer in a Cytological Series of Thyroid Nodules. Eur Thyroid J 2016; 5:125-31. [PMID: 27493887 PMCID: PMC4949374 DOI: 10.1159/000445054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/05/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND A possible impact of obesity on the risk of thyroid cancer has been postulated in some studies, but it remains controversial. OBJECTIVE To investigate the association between obesity and differentiated thyroid carcinoma in a population of unselected patients subjected to fine-needle aspiration cytology (FNAC) for thyroid nodules. METHODS We retrospectively evaluated the results of FNAC of thyroid nodules in 4,849 patients (3,809 females and 1,040 males; mean age 55.9 ± 14.1 years). Patients were stratified according to their body mass index (BMI). There were 1,876 (38.7%) normal-weight patients (BMI 18-24.9), 1,758 (36.2%) overweight (BMI 25-29.9), 662 (13.7%) grade 1 obese (BMI 30-34.9), 310 (6.4%) grade 2 obese (BMI 35-39.9) and 243 (5.0%) grade 3 obese (BMI >40). RESULTS The prevalence of suspicious or malignant nodules (Thy4/Thy5) did not differ across the 5 BMI groups, i.e. it was 6.8% in normal-weight patients, 6.3% in overweight patients, 6.3% in grade 1 obese patients, 4.0% in grade 2 obese patients and 4.2% in grade 3 obese patients (p = 0.29). The prevalence of Thy4/Thy5 nodules did not differ when males and females were evaluated separately (p = 0.22 and p = 0.12, respectively). A significant, lower rate of Thy4/5 cytology was observed in female patients with grade 2-3 obesity (odds ratio 0.51; 95% confidence interval 0.284-0.920; p = 0.009). CONCLUSIONS The results of this study, in a retrospective series of patients with thyroid nodules, do not confirm previous findings reporting an association between obesity and differentiated thyroid carcinoma. Thus, obese patients with nodular thyroid disease should be managed the same as normal-weight patients.
Collapse
Affiliation(s)
- Mario Rotondi
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., ISPESL Laboratory for Endocrine Disruptors and Chair of Endocrinology, University of Pavia, Pavia, Italy
| | - Maria Grazia Castagna
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Carlo Cappelli
- Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
| | - Cristina Ciuoli
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Francesca Coperchini
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., ISPESL Laboratory for Endocrine Disruptors and Chair of Endocrinology, University of Pavia, Pavia, Italy
| | - Francesco Chiofalo
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Fabio Maino
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Paola Palmitesta
- Departments of Social, Political and Cognitive Sciences, University of Siena, Siena, Italy
| | - Luca Chiovato
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., ISPESL Laboratory for Endocrine Disruptors and Chair of Endocrinology, University of Pavia, Pavia, Italy
| | - Furio Pacini
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- *Furio Pacini, MD, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, IT–53100 Siena (Italy), E-Mail
| |
Collapse
|
9
|
Hwang Y, Lee KE, Park YJ, Kim SJ, Kwon H, Park DJ, Cho B, Choi HC, Kang D, Park SK. Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study. Medicine (Baltimore) 2016; 95:e2893. [PMID: 26945379 PMCID: PMC4782863 DOI: 10.1097/md.0000000000002893] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We evaluated the association between weight change in middle-aged adults and papillary thyroid cancer (PTC) based on a large-scale case-control study. Our study included data from 1551 PTC patients (19.3% men and 80.7% women) who underwent thyroidectomy at the 3 general hospitals in Korea and 15,510 individually matched control subjects. The subjects' weight history, epidemiologic information, and tumor characteristics confirmed after thyroidectomy were analyzed. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined for the annual average changes in weight and obesity indicators (body mass index (BMI), body surface area, and body fat percentage (BF%) in subjects since the age of 35 years. Subjects with a total weight gain ≥10 kg after age 35 years were more likely to have PTC (men, OR, 5.39, 95% CI, 3.88-7.49; women, OR, 3.36, 95% CI, 2.87-3.93) compared with subjects with a stable weight (loss or gain <5 kg). A marked increase in BMI since age 35 years (annual average change of BMI ≥0.3 kg/m/yr) was related to an elevated PTC risk, and the association was more pronounced for large-sized PTC risks (<1 cm, OR, 2.34, 95% CI, 1.92-2.85; ≥1 cm, OR, 4.00, 95% CI, 2.91-5.49, P heterogeneity = 0.005) compared with low PTC risks. Weight gain and annual increases in obesity indicators in middle-aged adults may increase the risk of developing PTC.
Collapse
Affiliation(s)
- Yunji Hwang
- From the Department of Preventive Medicine (YH, DK, SKP), Seoul National University College of Medicine; Department of Biomedical Science (YH, DK, SKP), Seoul National University Graduate School; Cancer Research Institute (YH, KEL, DK, SKP), Seoul National University College of Medicine; Department of Surgery (KEL, S-JK, HK), Seoul National University Hospital and College of Medicine; Division of Surgery (KEL), Thyroid Center, Seoul National University Cancer Hospital; Department of Internal Medicine (YJP, DJP), Seoul National University College of Medicine; Department of Family Medicine (BC, H-CC), Health Promotion Center for Cancer Survivor, Seoul National University Hospital, Seoul; and Advanced Institutes of Convergence Technology (BC, H-CC), Seoul National University, Suwon-si, Gyeonggi-do, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Kitahara CM, McCullough ML, Franceschi S, Rinaldi S, Wolk A, Neta G, Olov Adami H, Anderson K, Andreotti G, Beane Freeman LE, Bernstein L, Buring JE, Clavel-Chapelon F, De Roo LA, Gao YT, Gaziano JM, Giles GG, Håkansson N, Horn-Ross PL, Kirsh VA, Linet MS, MacInnis RJ, Orsini N, Park Y, Patel AV, Purdue MP, Riboli E, Robien K, Rohan T, Sandler DP, Schairer C, Schneider AB, Sesso HD, Shu XO, Singh PN, van den Brandt PA, Ward E, Weiderpass E, White E, Xiang YB, Zeleniuch-Jacquotte A, Zheng W, Hartge P, Berrington de González A. Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies. Thyroid 2016; 26:306-18. [PMID: 26756356 PMCID: PMC4754509 DOI: 10.1089/thy.2015.0319] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality. METHODS This large pooled analysis of 22 prospective studies (833,176 men and 1,260,871 women) investigated thyroid cancer incidence associated with greater height, BMI at baseline and young adulthood, and adulthood BMI gain (difference between young-adult and baseline BMI), overall and separately by sex and histological subtype using multivariable Cox proportional hazards regression models. Associations with thyroid cancer mortality were investigated in a subset of cohorts (578,922 men and 774,373 women) that contributed cause of death information. RESULTS During follow-up, 2996 incident thyroid cancers and 104 thyroid cancer deaths were identified. All anthropometric factors were positively associated with thyroid cancer incidence: hazard ratios (HR) [confidence intervals (CIs)] for height (per 5 cm) = 1.07 [1.04-1.10], BMI (per 5 kg/m2) = 1.06 [1.02-1.10], waist circumference (per 5 cm) = 1.03 [1.01-1.05], young-adult BMI (per 5 kg/m2) = 1.13 [1.02-1.25], and adulthood BMI gain (per 5 kg/m2) = 1.07 [1.00-1.15]. Associations for baseline BMI and waist circumference were attenuated after mutual adjustment. Baseline BMI was more strongly associated with risk in men compared with women (p = 0.04). Positive associations were observed for papillary, follicular, and anaplastic, but not medullary, thyroid carcinomas. Similar, but stronger, associations were observed for thyroid cancer mortality. CONCLUSION The results suggest that greater height and excess adiposity throughout adulthood are associated with higher incidence of most major types of thyroid cancer, including the least common but most aggressive form, anaplastic carcinoma, and higher thyroid cancer mortality. Potential underlying biological mechanisms should be explored in future studies.
Collapse
Affiliation(s)
- Cari M Kitahara
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | | | | | - Sabina Rinaldi
- 3 International Agency for Research on Cancer , Lyon, France
| | - Alicja Wolk
- 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden
| | - Gila Neta
- 5 Division of Cancer Control and Population Sciences; National Cancer Institute , Rockville, Maryland
| | - Hans Olov Adami
- 6 Department of Medical Epidemiology and Biostatistics; Karolinska Institutet , Stockholm, Sweden
- 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts
| | - Kristin Anderson
- 8 Division of Epidemiology and Community Health, School of Public Health; University of Minnesota , Minneapolis, Minnesota
- 9 Masonic Cancer Center; University of Minnesota , Minneapolis, Minnesota
| | - Gabriella Andreotti
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Laura E Beane Freeman
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Leslie Bernstein
- 10 Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute , City of Hope, Duarte, California
| | - Julie E Buring
- 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts
- 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts
| | - Francoise Clavel-Chapelon
- 12 Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France Paris South University , UMRS Inserm 1018 Team 9, Villejuif, France
| | - Lisa A De Roo
- 13 Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
- 14 Epidemiology Branch, National Institute of Environmental Health Sciences , Research Triangle Park, North Carolina
| | - Yu-Tang Gao
- 15 Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
| | - J Michael Gaziano
- 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts
- 16 Division of Aging; Brigham and Women's Hospital , Boston, Massachusetts
- 17 Massachusetts Veteran's Epidemiology, Research, and Information Center, Geriatric Research Education and Clinical Center , VA Boston Healthcare System, Boston, Massachusetts
| | - Graham G Giles
- 18 Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne, Australia
- 19 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Carlton, Australia
| | - Niclas Håkansson
- 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden
| | | | - Vicki A Kirsh
- 21 Prevention and Cancer Control, Cancer Care Ontario , Toronto, Canada
- 22 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada
| | - Martha S Linet
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Robert J MacInnis
- 18 Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne, Australia
- 19 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Carlton, Australia
| | - Nicola Orsini
- 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden
| | - Yikyung Park
- 23 Division of Public Health Sciences, Washington University School of Medicine in St. Louis , St. Louis, Missouri
| | - Alpa V Patel
- 2 Epidemiology Research Program, American Cancer Society , Atlanta, Georgia
| | - Mark P Purdue
- 24 Ontario Institute for Cancer Research , Toronto, Canada
| | - Elio Riboli
- 25 Imperial School of Public Health, Imperial College London , London, United Kingdom
| | - Kimberly Robien
- 26 Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University , Washington, DC
| | - Thomas Rohan
- 27 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, New York
| | - Dale P Sandler
- 14 Epidemiology Branch, National Institute of Environmental Health Sciences , Research Triangle Park, North Carolina
| | - Catherine Schairer
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Arthur B Schneider
- 28 Section of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago , Chicago, Illinois
| | - Howard D Sesso
- 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts
- 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts
- 16 Division of Aging; Brigham and Women's Hospital , Boston, Massachusetts
| | - Xiao-Ou Shu
- 29 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine , Nashville, Tennessee
| | - Pramil N Singh
- 30 Center for Health Research, School of Public Health, Loma Linda University , Loma Linda, California
| | - Piet A van den Brandt
- 31 Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University , Maastricht, Netherlands
| | - Elizabeth Ward
- 32 Intramural Research, American Cancer Society , Atlanta, Georgia
| | - Elisabete Weiderpass
- 6 Department of Medical Epidemiology and Biostatistics; Karolinska Institutet , Stockholm, Sweden
- 33 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway , Tromsø, Norway
- 34 Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research , Oslo, Norway
- 35 Genetic Epidemiology Group, Folkälsan Research Center , Helsinki, Finland
| | - Emily White
- 36 Public Health Services Division, Fred Hutchinson Cancer Research Center , Seattle, Washington
- 37 Department of Epidemiology, University of Washington , Seattle, Washington
| | - Yong-Bing Xiang
- 15 Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
| | - Anne Zeleniuch-Jacquotte
- 38 Division of Epidemiology, Department of Population Health and NYU Cancer Institute, NYU School of Medicine , New York, New York
| | - Wei Zheng
- 29 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine , Nashville, Tennessee
| | - Patricia Hartge
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | | |
Collapse
|
11
|
Xu W, Chen Z, Li N, Liu H, Huo L, Huang Y, Jin X, Deng J, Zhu S, Zhang S, Yu Y. Relationship of anthropometric measurements to thyroid nodules in a Chinese population. BMJ Open 2015; 5:e008452. [PMID: 26692553 PMCID: PMC4691709 DOI: 10.1136/bmjopen-2015-008452] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Previous studies have found that overweight and obesity are related to numerous diseases, including thyroid cancer and thyroid volume. This study evaluates the relationship between body size and the presence of thyroid nodules in a Chinese population. METHODS A total of 6793 adults and 2410 children who underwent thyroid ultrasonography were recruited in this cross-sectional study in Hangzhou, Zhejiang Province, China, from March to October, 2010. Sociodemographic characteristics and potential risk factors of thyroid nodules were collected by questionnaire. Height and weight were measured using standard protocols. Associations of height, weight, body mass index (BMI) and body surface area (BSA) with the presence of thyroid nodules were evaluated using multiple logistic regression models. RESULTS After adjustment for potential risk factors, an increased risk of thyroid nodule incidence was associated with height (OR 1.15, 95% CI 1.02 to 1.30), weight (OR 1.40, 95% CI 1.24 to 1.58), BMI (OR 1.26, 95% CI 1.11 to 1.42) and BSA (OR 1.43, 95% CI 1.27 to 1.62) in all adults, but most obviously in women. In children, similar associations were observed between risk of thyroid nodule incidence and weight, BMI and BSA, but not height. BSA was the measurement most significantly associated with thyroid nodules in both adults and children. CONCLUSIONS This study identified that the presence of thyroid nodules was positively associated with weight, height, BMI and BSA in both women and girls. It suggests that tall, obese individuals have increased susceptibility to thyroid nodules. TRIAL REGISTRATION NUMBER NCT01838629.
Collapse
Affiliation(s)
- Weimin Xu
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Zexin Chen
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Na Li
- Shangcheng Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Hui Liu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liangliang Huo
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yangmei Huang
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xingyi Jin
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jin Deng
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Sujuan Zhu
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Shanchun Zhang
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
12
|
Schmid D, Ricci C, Behrens G, Leitzmann MF. Adiposity and risk of thyroid cancer: a systematic review and meta-analysis. Obes Rev 2015; 16:1042-54. [PMID: 26365757 DOI: 10.1111/obr.12321] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/11/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Abstract
Thyroid cancer incidence has increased rapidly over time, as has obesity prevalence. A link between the two appears plausible, but the relation of adiposity to thyroid cancer remains incompletely understood. We performed a meta-analysis of adiposity measures and thyroid cancer using studies identified through October 2014. Twenty-one articles yielded data on 12,199 thyroid cancer cases. We found a statistically significant 25% greater risk of thyroid cancer in overweight individuals and a 55% greater thyroid cancer risk in obese individuals as compared with their normal-weight peers. Each 5-unit increase in body mass index (BMI), 5 kg increase in weight, 5 cm increase in waist or hip circumference and 0.1-unit increase in waist-to-hip ratio were associated with 30%, 5%, 5% and 14% greater risks of thyroid cancer, respectively. When evaluated by histologic type, obesity was significantly positively related to papillary, follicular and anaplastic thyroid cancers, whereas it revealed an inverse association with medullary thyroid cancer. Both general and abdominal adiposity are positively associated with thyroid cancer. However, relations with BMI vary importantly by tumour histologic type.
Collapse
Affiliation(s)
- D Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - C Ricci
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - G Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - M F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| |
Collapse
|
13
|
Arduc A, Dogan BA, Tuna MM, Tutuncu Y, Isik S, Berker D, Guler S. Higher body mass index and larger waist circumference may be predictors of thyroid carcinoma in patients with Hürthle-cell lesion/neoplasm fine-needle aspiration diagnosis. Clin Endocrinol (Oxf) 2015; 83:405-11. [PMID: 25296952 DOI: 10.1111/cen.12628] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/10/2014] [Accepted: 10/02/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE High body mass index (BMI) has been found to be associated with raised thyroid cancer risk, particularly in women. We examined the associations for BMI and waist circumference (WC) with thyroid cancer risk among women with Hürthle-cell lesion/neoplasm (HLN) on fine-needle aspiration biopsy (FNAB) with the hypothesis that BMI and WC could guide the management of these challenging indeterminate lesions. METHODS This cross-sectional study included 224 women with HLN who underwent thyroidectomy. In all patients, TSH and thyroid auto-antibodies were evaluated, and thyroid nodule features were recorded. Patients were grouped according to BMI (<30 or ≥30 kg/m(2)) and WC (<88 or ≥88 cm). Relationships of thyroid cancer with BMI and WC were assessed using logistic regression analysis. RESULTS Mean weight, BMI (31·26 ± 5·1 vs 26·47 ± 5·9, P < 0·001), WC (98·23 ± 7·6 vs 86·18 ± 11, P = 0·001), and proportion of patients with high BMI (≥30 kg/m(2)) (65·9 vs 33·8%, P < 0·001) or large WC (≥88 cm) (84·1 vs 47·9%, P < 0·001) were significantly higher in malignant group compared to benign group. In regression analysis, BMI and WC significantly associated with existence of malignancy. Malignancy risk was 3·819-fold higher (95% CI: 2·068-7·054) in BMI≥30 kg/m(2) group compared to BMI<30 kg/m(2), which was independent of TSH and age. Large WC was also associated with increased risk (OR = 5·593, 95% CI: 2·736-11·434). Baseline tumour characteristics were similar according to BMI and WC groups. CONCLUSIONS A great BMI and large WC were associated with higher thyroid cancer risk in patients with FNAB diagnosis of HLN. Further studies are needed to use BMI or WC in the management of patients with HLN.
Collapse
Affiliation(s)
- Ayse Arduc
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes, Endocrine and Obesity Branch, Bethesda, MD, USA
| | - Bercem Aycicek Dogan
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Mazhar Muslum Tuna
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Yasemin Tutuncu
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Serhat Isik
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Dilek Berker
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Serdar Guler
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hitit University, Corum, Turkey
| |
Collapse
|
14
|
Xhaard C, de Vathaire F, Cléro E, Maillard S, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Danzon A, Velten M, Marrer E, Bailly L, Barjoan EM, Schlumberger M, Orgiazzi J, Adjadj E, Rubino C. Anthropometric Risk Factors for Differentiated Thyroid Cancer in Young Men and Women From Eastern France: A Case-Control Study. Am J Epidemiol 2015; 182:202-14. [PMID: 26133374 DOI: 10.1093/aje/kwv048] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/12/2015] [Indexed: 12/26/2022] Open
Abstract
The incidence of thyroid cancer has risen over the past decade, along with a rise in obesity. We studied the role of anthropometric risk factors for differentiated thyroid cancer at the time of diagnosis and at age 20 years in a case-control study conducted in eastern France between 2005 and 2010. The study included 761 adults diagnosed with differentiated thyroid cancer before 35 years of age between 2002 and 2006. They were matched with 825 controls from the general population. Odds ratios were calculated using conditional logistic regression models and were reported for all participants, those with papillary cancer only, and women only. The risk of thyroid cancer was higher for participants with a high body surface area (BSA), great height, or excess weight and for women with a high body fat percentage. Conversely, no significant association was found between body mass index and the risk of thyroid cancer. In the present study, we provide further evidence of the role of BSA and excess weight in the risk of thyroid cancer. These epidemiologic observations should be confirmed by further exploration of the biological mechanisms responsible for the associations of obesity and BSA with thyroid cancer.
Collapse
|
15
|
Ma J, Huang M, Wang L, Ye W, Tong Y, Wang H. Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies. Med Sci Monit 2015; 21:283-91. [PMID: 25612155 PMCID: PMC4315628 DOI: 10.12659/msm.892035] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Several studies have evaluated the association between obesity and thyroid cancer risk. However, the results remain uncertain. In this study, we conducted a meta-analysis to assess the association between obesity and thyroid cancer risk. MATERIAL/METHODS Published literature from PubMed, EMBASE, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) were retrieved before 10 August 2014. We included all studies that reported adjusted risk ratios (RRs), hazard ratios (HRs) or odds ratios (ORs), and 95% confidence intervals (CIs) of thyroid cancer risk. RESULTS Thirty-two studies (n=12 620 676) were included in this meta-analysis. Obesity was associated with a significantly increased risk of thyroid cancer (adjusted RR=1.33; 95% CI, 1.24-1.42; I2=25%). In the subgroup analysis by study type, increased risk of thyroid cancer was found in cohort studies and case-control studies. In subgroup analysis by sex, both obese men and women were at significantly greater risk of thyroid cancer than non-obese subjects. When stratified by ethnicity, significantly elevated risk was observed in Caucasians and in Asians. In the age subgroup analysis, both young and old populations showed increased thyroid cancer risk. Subgroup analysis on smoking status showed that increased thyroid cancer risks were found in smokers and in non-smokers. In the histology subgroup analyses, increased risks of papillary thyroid cancer, follicular thyroid cancer, and anaplastic thyroid cancer were observed. However, obesity was associated with decreased risk of medullary thyroid cancer. CONCLUSIONS Our results indicate that obesity is associated with an increased thyroid cancer risk, except medullary thyroid cancer.
Collapse
Affiliation(s)
- Jie Ma
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Min Huang
- Department of Scientific Research and Education, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Li Wang
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Wei Ye
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Yan Tong
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Hanmin Wang
- Department of Stomatology, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| |
Collapse
|
16
|
Farfel A, Kark JD, Derazne E, Tzur D, Barchana M, Lazar L, Afek A, Shamiss A. Predictors for thyroid carcinoma in Israel: a national cohort of 1,624,310 adolescents followed for up to 40 years. Thyroid 2014; 24:987-93. [PMID: 24483833 DOI: 10.1089/thy.2013.0173] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Data on adolescent precursors of thyroid cancer in adulthood are scant. METHODS In order to evaluate potential risk factors for thyroid cancer, we linked two national data sources: the military recruitment health examinations and the Israel National Cancer Register. The study population (1,624,310 participants) included 1,145,865 Jewish males aged 16-19 years when examined between 1967 and 2005, and 478,445 Jewish females aged 16-19 years when examined between 1989 and 2005. The cancer follow-up extended up to 2006. Multivariable Cox proportional hazards modeling was used. RESULTS During 24,389,502 person years of follow-up, 760 incidence cases of thyroid cancer were identified. The mean age at diagnosis was 25.2±4.2 years for women and 37.2±10.0 years for men. Women had a substantially higher incidence (birth cohort-adjusted hazard ratio (HR)=5.70 [95% CI 4.45-7.31]; p<0.001). Height predicted incidence in both sexes, with birth cohort-adjusted HRs of 1.03 (p<0.001) in males and 1.04 (p<0.001) in females, per 1 cm increment in height. In males, but not in females, there was a graded association between education, as measured by years of schooling, and incidence of thyroid cancer. Body mass index was not associated with incidence. In a multivariable analysis of 617,613 males and 469,185 females examined from 1989 onwards, which included sex, birth year, height, and education, the excess risk in females persisted strongly (HR=5.67 [CI 4.30-7.13]), as did the association with height. CONCLUSIONS Female sex, measured height in adolescence, and later birth cohorts were independent predictors of thyroid cancer in young and middle-aged adults in Israel. Further study is needed to unravel the mechanisms whereby height is associated with thyroid cancer.
Collapse
Affiliation(s)
- Alon Farfel
- 1 Institute for Endocrinology and Diabetes , National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Xu L, Port M, Landi S, Gemignani F, Cipollini M, Elisei R, Goudeva L, Müller JA, Nerlich K, Pellegrini G, Reiners C, Romei C, Schwab R, Abend M, Sturgis EM. Obesity and the risk of papillary thyroid cancer: a pooled analysis of three case-control studies. Thyroid 2014; 24:966-74. [PMID: 24555500 PMCID: PMC4046192 DOI: 10.1089/thy.2013.0566] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is a correlation between temporal trends of obesity prevalence and papillary thyroid cancer (PTC) incidence in the United States. Obesity is a well-recognized risk factor for many cancers, but there are few studies on the association between obesity and PTC risk. We investigated the association between anthropometric measurements and PTC risk using pooled individual data from three case-control populations. METHODS Height and weight information were obtained from three independent case-control studies, including 1917 patients with PTC (1360 women and 557 men) and 2127 cancer-free controls from the United States, Italy, and Germany. Body mass index (BMI), body fat percentage, and body surface area (BSA) were calculated. An unconditional logistic regression model was used to calculate odds ratios (ORs) and confidence intervals (CIs) with respect to risk of PTC, adjusted by age, sex, race/ethnicity, and study site. RESULTS In the pooled population, for both men and women, an increased risk of PTC was found to be associated with greater weight, BMI, body fat percentage, and BSA, whereas a reduced risk of PTC was associated with greater height, in the pooled population for both men and women. Compared with normal-weight subjects (BMI 18.5-24.9 kg/m2), the ORs for overweight (BMI 25-29.9 kg/m2) and obese (BMI≥30 kg/m2) subjects were 1.72 [CI 1.48-2.00] and 4.17 [CI 3.41-5.10] respectively. Compared with the lowest quartile of body fat percentage, the ORs for the highest quartile were 3.83 [CI 2.85-5.15] in women and 4.05 [CI 2.67-6.15] in men. CONCLUSION Anthropometric factors, especially BMI and body fat percentage, were significantly associated with increased risk of PTC. Future studies of anthropometric factors and PTC that incorporate intermediate factors, including adiposity and hormone biomarkers, are essential to help clarify potential mechanisms of the relationship.
Collapse
Affiliation(s)
- Li Xu
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matthias Port
- Department for Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Stefano Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | | | | | - Rossella Elisei
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
- Department of Orthopedics and Traumatology, University of Pisa, Pisa, Italy
- Department of Occupational Medicine, University of Pisa, Pisa, Italy
| | - Lilia Goudeva
- Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | | | - Kai Nerlich
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Giovanni Pellegrini
- Operative Unit of Laboratory of Clinical Chemistry Analyses, University Hospital of Cisanello, Pisa, Italy
| | - Christoph Reiners
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Cristina Romei
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
- Department of Orthopedics and Traumatology, University of Pisa, Pisa, Italy
- Department of Occupational Medicine, University of Pisa, Pisa, Italy
| | - Robert Schwab
- Department of General, Visceral, and Thoracic Surgery, Armed Forces Hospital, Koblenz, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Erich M. Sturgis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
18
|
Xhaard C, Ren Y, Clero E, Maillard S, Brindel P, Rachedi F, Boissin JL, Sebbag J, Shan L, Bost-Bezeaud F, Petitdidier P, Drozdovitch V, Doyon F, Rubino C, de Vathaire F. Differentiated Thyroid Carcinoma Risk Factors in French Polynesia. Asian Pac J Cancer Prev 2014; 15:2675-80. [DOI: 10.7314/apjcp.2014.15.6.2675] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
19
|
Nakao M, Hosono S, Ito H, Oze I, Watanabe M, Mizuno N, Yatabe Y, Yamao K, Niimi A, Tajima K, Tanaka H, Matsuo K. Cigarette smoking and pancreatic cancer risk: a revisit with an assessment of the nicotine dependence phenotype. Asian Pac J Cancer Prev 2014; 14:4409-13. [PMID: 23992012 DOI: 10.7314/apjcp.2013.14.7.4409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is a well-established risk factor of pancreatic cancer (PC). Although an association between nicotine dependence phenotype, namely time to first cigarette (TTFC) after waking, and the risk of several smoking-related cancers has been reported, an association between TTFC and PC risk has not been reported. We assessed the impact of smoking behavior, particularly TTFC, on PC risk in a Japanese population. MATERIALS AND METHODS We conducted a case-control study using 341 PC and 1,705 non-cancer patients who visited Aichi Cancer Center in Nagoya, Japan. Exposure to risk factors, including smoking behavior, was assessed from the results of a self-administered questionnaire. The impact of smoking on PC risk was assessed with multivariate logistic regression analysis adjusted for potential confounders to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Cigarettes per day (CPD) and/or smoking duration were significantly associated with PC risk, consistent with previous studies. For TTFC and PC risk, we found only a suggestive association: compared with a TTFC of more than 60 minutes, ORs were 1.15 (95%CI, 0.65- 2.04) for a TTFC of 30-60 minutes and 1.35 (95%CI, 0.85-2.15) for that of 0-30 minutes (p trend=0.139). After adjustment for CPD or smoking duration, no association was observed between TTFC and PC. CONCLUSIONS In this study, we found no statistically significant association between TTFC and PC risk. Further studies concerning TTFC and PC risk are warranted.
Collapse
Affiliation(s)
- Makoto Nakao
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Abstract
BACKGROUND In the last decade, significant contributions have been made to our knowledge on the connection between the thyroid and adipose tissue. Modern society is faced with climbing rates of obesity and metabolic syndrome, and there is accumulating evidence of an association between obesity and increased cancer risk. The aim of this review is to summarize clinical data on the association between thyroid cancer (TC) and obesity and briefly to present plausible hypotheses explaining this interplay. SUMMARY We performed a search on the PubMed database for studies published in English from 1980 to March 2013 using the terms "thyroid cancer," "obesity," and "body mass index." Although there is inconsistency among the clinical studies, it seems that overweight and obesity are related to a modestly increased TC risk. Various factors, such as sex, ethnicity, and body changes during certain life periods, for example adolescence, may influence the association between obesity and TC risk. There are preliminary data linking obesity with a less favorable clinicopathologic profile of TC. However, validation with larger multicenter studies is needed. The precise underlying mechanisms have not yet been elucidated, but the insulin-IGF axis and adipokines, such as leptin and adiponectin, might be implicated in the link between excess weight and TC. CONCLUSIONS Given the rising prevalence of TC and the development of obesity as an epidemic, it is important to clarify its connection with TC as well as the mediating pathways. However, unless this association is confirmed and causation proven, screening for TC in overweight and obese subjects-a rapidly increasing body of the general population-does not seem justified.
Collapse
Affiliation(s)
- Theodora Pappa
- 1 Endocrine Unit, Department of Medical Therapeutics, Alexandra Hospital, Athens University School of Medicine , Athens, Greece
| | | |
Collapse
|
21
|
Kitahara CM, Gamborg M, de González AB, Sørensen TI, Baker JL. Childhood height and body mass index were associated with risk of adult thyroid cancer in a large cohort study. Cancer Res 2014; 74:235-42. [PMID: 24247722 PMCID: PMC3891884 DOI: 10.1158/0008-5472.can-13-2228] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Taller stature and obesity in adulthood have been consistently associated with an increased risk of thyroid cancer, but few studies have investigated the role of childhood body size. Using data from a large prospective cohort, we examined associations for height and body mass index (BMI) at ages 7 to 13 years with risk of thyroid cancer in later life. The study population included 321,085 children from the Copenhagen School Health Records Register, born between 1930 and 1989 in Copenhagen, Denmark, with measurements of height and weight from 7 to 13 years of age. These data were linked with the Danish Cancer Registry to identify incident thyroid cancer cases (1968-2010). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for age- and sex-specific height and BMI SD scores (SDS) using proportional hazards models stratified by birth cohort and sex. During follow-up (median = 38.6 years), 171 women and 64 men were diagnosed with thyroid cancer. Both height and BMI were positively associated with thyroid cancer risk, and these associations were similar by age at measurement. Using age 10 as an example, HRs per 1 unit increase in SDS for height (~6-7 cm) and BMI (~1.5-2 kg/m(2)) were 1.22 (95% CI, 1.07-1.40) and 1.15 (95% CI, 1.00-1.34), respectively. These results, together with the relatively young ages at which thyroid cancers are diagnosed compared with other malignancies, suggest a potential link between early-life factors related to growth and body weight and thyroid carcinogenesis.
Collapse
Affiliation(s)
- Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Michael Gamborg
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
| | - Amy Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Thorkild I.A. Sørensen
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jennifer L. Baker
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
22
|
Marcello MA, Sampaio AC, Geloneze B, Vasques ACJ, Assumpção LVM, Ward LS. Obesity and excess protein and carbohydrate consumption are risk factors for thyroid cancer. Nutr Cancer 2013; 64:1190-5. [PMID: 23163848 DOI: 10.1080/01635581.2012.721154] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Conflicting data concerning the association between obesity and differentiated thyroid cancer (DTC) may be attributed to the lack of records showing dietary intake and inadequate evaluation of nutrient composition. We evaluated 115 DTC patients carefully paired with 103 healthy control individuals by using a structured questionnaire, including a 24-h recordatory during 3 days, to investigate calorie intake and macronutrient (proteins, carbohydrates, and lipids) composition of the diet. We observed that excess weight (body mass index > 25 kg/m(2)) increased individual susceptibility to DTC [odds ratio (OR) = 3.787; 95% confidence interval (CI) = 1.115-6.814; P < 0.0001). This augmented risk was evident in women (OR = 1.925; 95% CI = 1.110-3.338; P = 0.0259) but not in men (P = 0.3498). Excess calorie intake was more frequent in patients with DTC than in controls (OR = 5.890; 95% CI = 3.124-11.103; P < 0.0001), and both excess protein (OR = 4.601; 95% CI = 1.634-12.954; P = 0.0039) and carbohydrate (OR = 4.905; 95% CI = 2.593-9.278; P < 0.0001) consumption were associated with an increased risk of DTC, contrarily to lipid/fiber intake and physical activity (P = 0.894 and 0.5932, respectively). In conclusion, our data indicate that overweight and risk of DTC are associated with higher protein and carbohydrate consumption than the rates recommended by the World Health Organization. The nutritional orientation should be part of preventive strategy targets designed to combat the increasing incidence of both obesity and DTC.
Collapse
Affiliation(s)
- Marjory Alana Marcello
- Laboratory of Cancer Molecular Genetics (Gemoca), Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
23
|
Recreational physical activity and risk of papillary thyroid cancer among women in the California Teachers Study. Cancer Epidemiol 2012; 37:46-53. [PMID: 23116823 DOI: 10.1016/j.canep.2012.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 09/22/2012] [Accepted: 09/29/2012] [Indexed: 12/11/2022]
Abstract
PURPOSE Little is known about the relationship between physical activity and thyroid cancer risk, and few cohort data on this association exist. Thus, the present study aimed to prospectively examine long-term activity and risk of papillary thyroid cancer among women. METHODS 116,939 women in the California Teachers Study, aged 22-79 years with no history of thyroid cancer at cohort entry, were followed from 1995-1996 through 2009; 275 were diagnosed with invasive papillary thyroid cancer. Cox proportional-hazards regression provided relative risk (RR) estimates and 95% confidence intervals (CI) for associations between thyroid cancer and combined strenuous and moderate recreational physical activity both in the long-term (high school through age 54 years or current age if younger than 54 years) and recently (during the three years prior to joining the cohort). RESULTS Overall, women whose long-term recreational physical activity averaged at least 5.5 MET-hours/week (i.e. were active) had a non-significant 23% lower risk of papillary thyroid cancer than inactive women (RR = 0.77, 95% CI: 0.57, 1.04). RR estimates were stronger among normal weight or underweight women (body mass index, BMI<25.0 kg/m(2), trend p = 0.03) than among overweight or obese women (trend p = 0.35; homogeneity-of-trends p = 0.03). A similar pattern of risk was observed for recent activity (BMI<25 kg/m(2), trend p = 0.11; BMI≥25 kg/m(2), trend p = 0.16; homogeneity-of-trends p = 0.04). Associations for long-term activity did not appear to be driven by activity in any particular life period (e.g. youth, adulthood). CONCLUSIONS Long-term physical activity may reduce papillary thyroid cancer risk among normal weight and underweight women.
Collapse
|
24
|
The insulin and igf-I pathway in endocrine glands carcinogenesis. JOURNAL OF ONCOLOGY 2012; 2012:635614. [PMID: 22927847 PMCID: PMC3423951 DOI: 10.1155/2012/635614] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 06/20/2012] [Indexed: 12/26/2022]
Abstract
Endocrine cancers are a heterogeneous group of diseases that may arise from endocrine cells in any gland of the endocrine system. These malignancies may show an aggressive behavior and resistance to the common anticancer therapies. The etiopathogenesis of these tumors remains mostly unknown. The normal embryological development and differentiation of several endocrine glands are regulated by specific pituitary tropins, which, in adult life, control the function and trophism of the endocrine gland. Pituitary tropins act in concert with peptide growth factors, including the insulin-like growth factors (IGFs), which are considered key regulators of cell growth, proliferation, and apoptosis. While pituitary TSH is regarded as tumor-promoting factor for metastatic thyroid cancer, the role of other pituitary hormones in endocrine cancers is uncertain. However, multiple molecular abnormalities of the IGF system frequently occur in endocrine cancers and may have a role in tumorigenesis as well as in tumor progression and resistance to therapies. Herein, we will review studies indicating a role of IGF system dysregulation in endocrine cancers and will discuss the possible implications of these findings for tumor prevention and treatment, with a major focus on cancers from the thyroid, adrenal, and ovary, which are the most extensively studied.
Collapse
|
25
|
Nakao M, Hosono S, Ito H, Watanabe M, Mizuno N, Sato S, Yatabe Y, Yamao K, Ueda R, Tajima K, Tanaka H, Matsuo K. Selected polymorphisms of base excision repair genes and pancreatic cancer risk in Japanese. J Epidemiol 2012; 22:477-83. [PMID: 22850545 PMCID: PMC3798558 DOI: 10.2188/jea.je20120010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Although several reports have described a possible association between DNA repair genes and pancreatic cancer (PC) in smokers, this association has not been fully evaluated in an Asian population. We assessed the impact of genetic polymorphisms in the base excision repair (BER) pathway on PC risk among Japanese. Methods This case-control study compared the frequency of 5 single-nucleotide polymorphisms (SNPs) of BER genes, namely rs1052133 in OGG1, rs1799782 and rs25487 in XRCC1, rs1130409 in APE1, and rs1136410 in PARP1. SNPs were investigated using the TaqMan assay in 185 PC cases and 1465 controls. Associations of PC risk with genetic polymorphisms and gene–environment interaction were examined with an unconditional logistic regression model. Exposure to risk factors was assessed from the results of a self-administered questionnaire. We also performed haplotype-based analysis. Results We observed that the minor allele of rs25487 in XRCC1 was significantly associated with PC risk in the per-allele model (odds ratio = 1.29, CI = 1.01–1.65; trend P = 0.043). Haplotype analysis of XRCC1 also showed a statistically significant association with PC risk. No statistically significant interaction between XRCC1 polymorphisms and smoking status was seen. Conclusions Our findings suggest that XRCC1 polymorphisms affect PC risk in Japanese.
Collapse
Affiliation(s)
- Makoto Nakao
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
OBJECTIVES This study was to assess the role of hepatitis B virus (HBV) infection in pancreatic ductal adenocarcinoma (PDAC) risk using a hospital-based case-control design. METHODS Patients with pathologically confirmed PDAC (943) and 1128 matched controls were recruited from 2 hospitals. We evaluated the associations between risk of PDAC and age, sex, history of diabetes mellitus (DM), etc. In addition, we examined the interactive effects of HBV status and known risk factors for pancreatic cancer. RESULTS Chronic hepatitis B and inactive hepatitis B surface antigen (HBsAg) carrier state (HBsAg positive) had a significantly increased risk of pancreatic cancer, with an adjusted odds ratio of 1.60 (95% confidence interval [CI], 1.15-2.24). Furthermore, significant interactions were detected between a history of DM and chronic hepatitis B and inactive HBsAg positive, but not with antibodies to hepatitis B core antigen (anti-HBc) positive/antibodies to HBsAg (anti-HBs) negative, with an adjusted odds ratio of 5.42 (95% CI, 2.76-10.64), compared with those who were HBsAg negative/anti-HBc negative without a history of DM. CONCLUSIONS These results suggest that HBsAg-positive or anti-HBc-positive/anti-HBs-negative patients have an increased risk for PDAC independent of other risk factors. Significant interactions were found between a history of DM and chronic HBV infection for PDAC risk.
Collapse
|
27
|
Kitahara CM, Platz EA, Park Y, Hollenbeck AR, Schatzkin A, Berrington de González A. Body fat distribution, weight change during adulthood, and thyroid cancer risk in the NIH-AARP Diet and Health Study. Int J Cancer 2012; 130:1411-9. [PMID: 21544808 PMCID: PMC3242922 DOI: 10.1002/ijc.26161] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 04/19/2011] [Indexed: 01/08/2023]
Abstract
Body mass index (BMI) has been positively associated with thyroid cancer risk in several studies, but the underlying mechanisms remain unclear. We examined the associations for waist and hip circumference and weight change during adulthood with thyroid cancer risk among 125,347 men and 72,363 women in the NIH-AARP Diet and Health Study who completed a second mailed questionnaire in 1996-1997. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated separately by sex and adjusted for race/ethnicity, education and smoking status. During follow-up (median = 10.1 years), 106 men and 105 women were diagnosed with a first primary thyroid cancer, as identified through linkage to state cancer registries. Having a large waist circumference (above the clinical cutpoint for normal: > 102 cm in men and > 88 cm in women) was associated with increased risk in both men (HR = 1.79, 95% CI: 1.21-2.63) and women (HR = 1.54, 95% CI: 1.05-2.26). Having both a large waist and BMI in the obese range (≥ 30 kg/m2) approximately doubled the risk of thyroid cancer (HR in men = 2.13, 95% CI: 1.18-3.85; HR in women = 1.91, 95% CI: 1.31-3.25) compared to having a normal waist circumference/normal BMI (18.5-24.9 kg/m2). We also observed positive association for weight gain between ages 18-35 in men (gained ≥ 10.0 kg vs. lost/gained < 5 kg, HR = 1.49, 95% CI: 0.93-2.39, p-trend = 0.03), but the association was less pronounced in women. No clear association for weight gain in later life was observed. These results support a potential role for hormonal and metabolic parameters common to central adiposity in thyroid carcinogenesis.
Collapse
Affiliation(s)
- Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, NCI, National Institutes of Health, Rockville, MD 20852, USA.
| | | | | | | | | | | |
Collapse
|
28
|
Kitahara CM, Platz EA, Beane Freeman LE, Black A, Hsing AW, Linet MS, Park Y, Schairer C, Berrington de González A. Physical activity, diabetes, and thyroid cancer risk: a pooled analysis of five prospective studies. Cancer Causes Control 2012; 23:463-471. [PMID: 22294499 DOI: 10.1007/s10552-012-9896-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 01/06/2012] [Indexed: 12/18/2022]
Abstract
PURPOSE: Although many studies have linked obesity with increased risk of thyroid cancer, few have investigated the role of obesity-related lifestyle characteristics and medical conditions in the etiology of this disease. We examined the associations of self-reported physical activity and diabetes history with thyroid cancer risk in a large pooled analysis of prospective cohort studies. METHODS: Data from five prospective studies in the U.S. (n = 362,342 men, 312,149 women) were coded using standardized exposure, covariate, and outcome definitions. Hazard ratios (HR) and 95% confidence intervals (CI) for thyroid cancer were estimated using age as the time metric and adjusting for sex, education, race, marital status, cigarette smoking, body mass index, alcohol intake, and cohort. Effect modification by other risk factors (e.g., age, sex, and body mass index) and differences by cancer subtype (e.g., papillary, follicular) were also examined. RESULTS: Over follow-up (median = 10.5 years), 308 men and 510 women were diagnosed with a first primary thyroid cancer. Overall, subjects reporting the greatest amount of physical activity had an increased risk of the disease (HR = 1.18, 95% CI:1.00-1.39); however, this association was restricted to participants who were overweight/obese (≥25 kg/m(2); HR = 1.34, 95% CI:1.09-1.64) as opposed to normal-weight (<25 kg/m(2); HR = 0.92, 95% CI:0.69-1.22; P-interaction = 0.03). We found no overall association between self-reported history of diabetes and thyroid cancer risk (HR = 1.08, 95% CI:0.83-1.40). CONCLUSION: Neither physical inactivity nor diabetes history was associated with increased risk of thyroid cancer. While it may have been a chance finding, the possible increased risk associated with greater physical activity warrants further investigation.
Collapse
Affiliation(s)
- Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, EPS 7056, 6120 Executive Blvd, Rockville, MD, 20852, USA,
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Peterson E, De P, Nuttall R. BMI, diet and female reproductive factors as risks for thyroid cancer: a systematic review. PLoS One 2012; 7:e29177. [PMID: 22276106 PMCID: PMC3261873 DOI: 10.1371/journal.pone.0029177] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 11/22/2011] [Indexed: 11/29/2022] Open
Abstract
Background Thyroid cancer incidence rates have been increasing worldwide but the reason behind this is unclear. Both the increasing use of diagnostic technologies allowing the detection of thyroid cancer and a true increase in thyroid cancer incidence have been proposed. This review assesses the role of body mass index (BMI), diet, and reproductive factors on the thyroid cancer trend. Methods Epidemiologic studies of the selected risk factors up to June 2010 were reviewed and critically assessed. Results Among the thirty-seven studies reviewed and despite variation in the risk estimates, most papers supported a small but positive association for BMI (risk estimate range: 1.1–2.3 in males and 1.0–7.4 in females.). Among specific dietary components, there was no consistent association of thyroid cancer risk with iodine intake through fortification (risk estimate range: 0.49–1.6) or fish consumption (risk estimate range 0.6–2.2), nor with diets high in cruciferous vegetables (risk estimate range 0.6–1.9). A small number of studies showed a consistent protective effect of diets high in non-cruciferous vegetable (risk estimate range: 0.71–0.92). Among reproductive factors (pregnancy, parity, number of live births, use of prescription hormones, menstrual cycle regularity, and menopausal status), none were consistently associated with higher thyroid cancer risk. Conclusions BMI had the strongest link to thyroid cancer risk among those examined. Detailed examinations of population-level risk factors can help identify and support prevention efforts to reduce the burden of thyroid cancer.
Collapse
Affiliation(s)
- Emily Peterson
- University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Ontario, Canada
| | - Prithwish De
- University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Ontario, Canada
- Canadian Cancer Society, Cancer Control Policy, Toronto, Ontario, Canada
- * E-mail:
| | - Robert Nuttall
- Canadian Cancer Society, Cancer Control Policy, Toronto, Ontario, Canada
| |
Collapse
|
30
|
Anthropometric factors and physical activity and risk of thyroid cancer in postmenopausal women. Cancer Causes Control 2012; 23:421-30. [DOI: 10.1007/s10552-011-9890-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 12/19/2011] [Indexed: 01/10/2023]
|
31
|
Kim JY, Jung EJ, Park ST, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK, Ha WS. Body size and thyroid nodules in healthy Korean population. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2011; 82:13-7. [PMID: 22324041 PMCID: PMC3268138 DOI: 10.4174/jkss.2012.82.1.13] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/19/2011] [Accepted: 09/23/2011] [Indexed: 01/22/2023]
Abstract
PURPOSE Excess weight and obesity have been associated with numerous diseases including thyroid cancer, but the relationship has been weak. The objective of this study was to evaluate the relationship of body sizes on thyroid nodules in healthy Korean population. METHODS A total of 7,763 persons who underwent a health examination in our health examination center were included in this study. The epidemiologic factors, body size and thyroid ultrasound results were reviewed. We investigated the effects of body size on the presence of thyroid nodules and malignancy. RESULTS The incidence of thyroid nodules was 20.6%. In the group who were found to have thyroid nodules, mean height, weight and body surface area (BSA) were significantly smaller compared to the others. Especially, in the women, smaller height (less than 160 cm) and overweight (≥ 60 kg) were identified as independent risk factors for the presence of thyroid nodules. The patients with body mass index (BMI) subgroups of normal or overweight had a tendency to have thyroid nodules more frequently. The detection rate of thyroid cancer was 0.47%. The patients with thyroid cancer tended to be smaller in height and BSA than the others. CONCLUSION A higher frequency of thyroid nodules was associated with women and, older age. In women, there were significant correlations in height, weight and BMI subgroups to the presence of thyroid nodules.
Collapse
Affiliation(s)
- Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Hosono S, Matsuo K, Hirose K, Ito H, Suzuki T, Kawase T, Watanabe M, Nakanishi T, Tajima K, Tanaka H. Weight gain during adulthood and body weight at age 20 are associated with the risk of endometrial cancer in Japanese women. J Epidemiol 2011; 21:466-73. [PMID: 21986192 PMCID: PMC3899463 DOI: 10.2188/jea.je20110020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Current obesity is an established risk factor for endometrial cancer; however, the roles of weight gain during adulthood and obesity in early adulthood on endometrial cancer have not been elucidated. Here, we conducted a case-control study comprising 222 histologically diagnosed incident endometrial cancer cases and 2162 age- and menstrual-status matched non-cancer controls. METHODS Information on current body weight, weight and height at age 20 years, and lifestyle/environmental factors was obtained from a self-administered questionnaire. Subjects were classified into 3 groups according to change in body mass index (BMI, kg/m(2)) from age 20 years to enrollment (≤0 [reference], 0-3, and >3 kg/m(2)). The effects of adult BMI change and obesity in early adulthood were evaluated using an unconditional logistic regression model adjusted for potential confounders. RESULTS A high BMI at age 20 (BMI ≥25, BMI <25 as reference) was significantly positively associated with endometrial cancer risk (P = 0.005), as was a BMI increase during adulthood (0-3 BMI change, multivariate odds ratio [OR] = 1.28, 95% confidence interval [CI] = 0.88-1.87; >3 BMI change, OR = 2.02, 95% CI = 1.38-2.96; P-trend < 0.001). Parity and BMI at age 20 appeared to modify the effect of weight gain on cancer risk, albeit without statistical significance. This positive association of weight gain with risk was observed only for endometrioid adenocarcinoma. CONCLUSIONS The results show that endometrial cancer is positively associated with obesity at age 20 and weight gain during adulthood among Japanese women.
Collapse
Affiliation(s)
- Satoyo Hosono
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Chihara D, Matsuo K, Kanda J, Hosono S, Ito H, Nakamura S, Seto M, Morishima Y, Tajima K, Tanaka H. Inverse association between soy intake and non-Hodgkin lymphoma risk among women: a case-control study in Japan. Ann Oncol 2011; 23:1061-6. [PMID: 21765045 DOI: 10.1093/annonc/mdr320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Non-Hodgkin lymphoma (NHL) is one of the common malignant tumors worldwide. Environmental factors, such as diet have an important association with the risk of cancer. Although soy intake has been associated with a reduced risk of several cancers, its association with NHL is not known. PATIENTS AND METHODS We evaluated the association between soy consumption and risk of NHL by conducting a hospital-based case-control study in 302 patients with NHL and 1510 age- and sex-matched control subjects. Odds ratio (OR) and 95% confidence intervals (CIs) for groups with moderate (27-51 g/day) to high (>51 g/day) relative to low (<27 g/day) intake were calculated using multivariate conditional logistic regression model. RESULTS Soy intake was significantly associated with a reduced risk of NHL in women but not in men (OR [95% CI] for moderate and high intake: women, 0.64 [0.42-1.00] and 0.66 [0.42-1.02], respectively; men, 1.40 [0.87-2.24] and 1.33 [0.82-2.15], respectively; P-interaction = 0.02). This finding appeared consistent across NHL subtypes. CONCLUSION These results indicate the potential importance of certain ingredients in soy for lymphomagenesis. Further studies to evaluate the mechanism behind the association between soy intake and lymphomagenesis are warranted.
Collapse
Affiliation(s)
- D Chihara
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Kitahara CM, Platz EA, Freeman LEB, Hsing AW, Linet MS, Park Y, Schairer C, Schatzkin A, Shikany JM, Berrington de González A. Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies. Cancer Epidemiol Biomarkers Prev 2011; 20:464-72. [PMID: 21266520 DOI: 10.1158/1055-9965.epi-10-1220] [Citation(s) in RCA: 185] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Thyroid cancer incidence has risen dramatically in the United States since the early 1980s. Although the prevalence of obesity has doubled during this time period, the relationship between obesity and thyroid cancer is uncertain. METHODS We examined the association between body mass index (BMI) and thyroid cancer risk in a pooled analysis of five prospective U.S. studies, including 413,979 women and 434,953 men. Proportional hazards models with attained age as the time metric were adjusted for education, race, marital status, smoking, alcohol intake, and (where appropriate) cohort and sex. RESULTS Over follow-up (mean=10.3 years), 768 women and 388 men were diagnosed with thyroid cancer. The risk of thyroid cancer was greater with increasing BMI [per 5 kg/m2: HR in women, 1.16 (95% CI, 1.08-1.24); HR in men, 1.21 (95% CI, 0.97-1.49)]. There was no significant heterogeneity between studies (both P>0.05). For women and men combined, the HRs for overweight (25.0-29.9 kg/m2) and obesity (≥30 kg/m2) compared with normal-weight (18.5-24.9 kg/m2) were 1.20 (95% CI, 1.04-1.38) and 1.53 (95% CI, 1.31-1.79), respectively. We found no significant effect modification by other factors, and the results did not differ significantly by histologic type. A significant positive association for BMI in young adulthood (ages 18-20) with thyroid cancer risk was also observed [per 5-kg/m2 increase: HR, 1.18 (95% CI, 1.03-1.35)]. CONCLUSION BMI was positively associated with thyroid cancer risk in both men and women. IMPACT Our study provides strong evidence that obesity is an independent risk factor for thyroid cancer.
Collapse
Affiliation(s)
- Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20852, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
|
36
|
Cléro E, Leux C, Brindel P, Truong T, Anger A, Teinturier C, Diallo I, Doyon F, Guénel P, de Vathaire F. Pooled analysis of two case-control studies in New Caledonia and French Polynesia of body mass index and differentiated thyroid cancer: the importance of body surface area. Thyroid 2010; 20:1285-93. [PMID: 20932181 DOI: 10.1089/thy.2009.0456] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND New Caledonia and French Polynesia have among of the world highest thyroid cancer incidence rates. Studies have demonstrated a relationship between anthropometric parameters and the prevalence of cancer. In this study we evaluated further the relationship between body mass index (BMI) and other anthropometric parameters on the incidence of thyroid cancer in the New Caledonia and French Polynesia populations. METHODS We performed a pooled analysis of two case-control studies in New Caledonia and French Polynesia. We included a total of 554 cases (65 men and 489 women) of differentiated thyroid cancers and 776 population control subjects matched on sex, age, and study. Anthropometric factors (height, weight, BMI, body fat percentage [BF%], and body surface area [BSA]), at age 18 and before diagnosis, were analyzed by conditional logistic regression, adjusting for other independent risk factors. RESULTS A high proportion of cases (73%) were overweight (25-29.9 kg/m(2)) or obese (≥30 kg/m(2)) before diagnosis of thyroid cancer (against 57% of control subjects). An increased risk of thyroid cancer was observed with greater height, weight, BMI, BF%, and BSA. The association of thyroid cancer risk with height, weight, BMI, and BF% did not remain when adjustment was made for BSA. By comparison, the odds ratios for the highest versus the lowest quartile of BSA at age 18 were 3.97 (95% confidence interval, 2.57-6.15; p < 0.001) for women and 4.06 (95% confidence interval, 1.03-16.06; p = 0.04) for men. The association between thyroid cancer risk and each of anthropometric factors did not depend on tumor size or menopausal status before diagnosis. CONCLUSION Among anthropometric factors, BSA plays a dominant role in thyroid cancer risk and explains the apparent role of BMI.
Collapse
Affiliation(s)
- Enora Cléro
- Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, U1018 INSERM, Villejuif, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Veres C, Garsi JP, Rubino C, Pouzoulet F, Bidault F, Chavaudra J, Bridier A, Ricard M, Ferreira I, Lefkopoulos D, de Vathaire F, Diallo I. Thyroid volume measurement in external beam radiotherapy patients using CT imaging: correlation with clinical and anthropometric characteristics. Phys Med Biol 2010; 55:N507-19. [PMID: 20952815 DOI: 10.1088/0031-9155/55/21/n02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study is to define criteria for accurate representation of the thyroid in human models used to represent external beam radiotherapy (EBRT) patients and evaluate the relationship between the volume of this organ and clinical and anthropometric characteristics. From CT images, we segmented the thyroid gland and calculated its volume for a population of 188 EBRT patients of both sexes, with ages ranging from 1 to 89 years. To evaluate uncertainties linked to measured volumes, experimental studies on the Livermore anthropomorphic phantom were performed. For our population of EBRT patients, we observed that in children, thyroid volume increased rapidly with age, from about 3 cm(3) at 2 years to about 16 cm(3) at 20. In adults, the mean thyroid gland volume was 23.5 ± 9 cm(3) for males and 17.5 ± 8 cm(3) for females. According to anthropometric parameters, the best fit for children was obtained by modeling the log of thyroid volume as a linear function of body surface area (BSA) (p < 0.0001) and age (p = 0.04) and for adults, as a linear function of BSA (p < 0.0001) and gender (p = 0.01). This work enabled us to demonstrate that BSA was the best indicator of thyroid volume for both males and females. These results should be taken into account when modeling the volume of the thyroid in human models used to represent EBRT patients for dosimetry in retrospective studies of the relationship between the estimated dose to the thyroid and long-term follow-up data on EBRT patients.
Collapse
Affiliation(s)
- C Veres
- Inserm, CESP Centre for research in Epidemiology and Population Health, U1018, Radiation Epidemiology Team, F 94807, Villejuif, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Clavel-Chapelon F, Guillas G, Tondeur L, Kernaleguen C, Boutron-Ruault MC. Risk of differentiated thyroid cancer in relation to adult weight, height and body shape over life: the French E3N cohort. Int J Cancer 2010; 126:2984-90. [PMID: 19950225 DOI: 10.1002/ijc.25066] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The increasing incidence rate of thyroid cancer warrants investigation of potentially modifiable factors, especially overweightness. Few prospective studies have investigated anthropometry from childhood to adulthood in relation to thyroid cancer. We analyzed data from 91,909 women of the E3N study, a cohort of French women insured by a national health scheme mostly covering teachers with the age of 40-65 years at inclusion in 1990. Risk estimates of first primary differentiated thyroid cancer (n = 317) were computed using Cox proportional hazards models. There was a significant dose-effect relationship between thyroid cancer risk and weight or body mass index (BMI) but not height. Compared with women whose BMI was 18.5-22 kg/m(2), women with BMI 22-25 and those with BMI over 30 had a 39% [95% confidence interval (CI) 7-81] and 76% (12-176) higher risk of thyroid cancer, respectively, with a 21% (5-39) increased risk per 5 kg/m(2) increase in BMI. A large body shape from age 35-40 was significantly associated with an increased risk of differentiated thyroid cancer when compared with a lean one, while earlier body shapes were not. The highest risk was observed in women whose body shape increased from lean to large between menarche and adulthood, with a HR of 2.17 (95% CI 1.04-4.53) when compared with women who were lean at both periods. Our study adds to the existing evidence in relation to excess weight to the risk of thyroid cancer, particularly in women whose body shape increased from menarche to adult age.
Collapse
Affiliation(s)
- Françoise Clavel-Chapelon
- Institut National de la Santé et de la Recherche Médicale (INSERM), ERI 20, EA 4045, Institut Gustave Roussy, 39 rue Camille Desmoulins, Villejuif Cedex, France
| | | | | | | | | |
Collapse
|
39
|
Kanda J, Matsuo K, Suzuki T, Hosono S, Ito H, Ichinohe T, Seto M, Morishima Y, Tajima K, Tanaka H. Association between obesity and the risk of malignant lymphoma in Japanese: a case-control study. Int J Cancer 2010; 126:2416-25. [PMID: 19821488 DOI: 10.1002/ijc.24955] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although marked differences in anthropometric characteristics and malignant lymphoma (ML) incidence suggest that the association between obesity and ML risk in Asian and non-Asian populations may differ, few studies have investigated this association in Asian populations. Here, we conducted a sex- and age-matched case-control study in a Japanese population using 782 cases and 3,910 noncancer controls in the hospital-based Epidemiological Research Program at Aichi Cancer Center Hospital. Odds ratios (ORs) and 95% confidence intervals (CIs) for anthropometric characteristics were estimated using a conditional logistic regression model that incorporated smoking and alcohol intake. Recent body weight and body mass index (BMI) showed marginally significant association with ML risk (ORs [95% CIs] per 5-unit increase in recent weight and BMI; 1.04 [0.99-1.09] and 1.11 [0.98-1.27], respectively). On the other hand, weight and BMI in early adulthood exhibited a strong association with ML risk (ORs [95% CIs] per 5-unit increase in early adulthood weight and BMI; 1.11 [1.05-1.18] and 1.33 [1.13-1.55], respectively). Further, in women, a BMI of 25.0-29.9 kg/m(2), defined as obesity in Asian populations, during early adulthood was significantly associated with ML risk compared to the normal range of 18.5-22.9 kg/m(2). By histological ML subtype, the point estimates of ORs for obesity relative to normal weight in early adulthood were over unity for non-Hodgkin lymphoma (NHL) as a whole and significant for diffuse large B-cell lymphoma (DLBCL). In conclusion, our study in Japanese subjects suggested that early adulthood obesity is associated with the risk of NHL, particularly DLBCL.
Collapse
Affiliation(s)
- Junya Kanda
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Thyroid cancer: current molecular perspectives. JOURNAL OF ONCOLOGY 2010; 2010:351679. [PMID: 20369062 PMCID: PMC2847382 DOI: 10.1155/2010/351679] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 01/21/2010] [Indexed: 11/28/2022]
Abstract
The thyroid cancer is a rare oncological entity, representing no more than 1% of all human malignant neoplasms. Recently, it has been demonstrated a sharp increase in incidence of differentiated thyroid carcinoma, equally occurring in both sexes. So far, multiple genetic alterations have been identified in differentiated thyroid carcinoma, leading to investigate the clinical utility of genetic studies. In particular, molecular genetic approaches searching for gene mutations in the material collected by fine needle ago-biopsy may have a particular utility in small nodules and in those specimens with an indeterminate cytology. The expansion of knowledge about genetic mutations occurring in different thyroid tumors has characterized recent years, allowing the identification of a correlation between specific mutations and phenotypic characteristics of thyroid cancers, essential for their prognosis. This review will briefly report on the histological features and the new entity represented by thyroid microcarcinoma and will focus on both environmental and genetic aspects associated with the occurrence of thyroid cancer.
Collapse
|
41
|
Meinhold CL, Ron E, Schonfeld SJ, Alexander BH, Freedman DM, Linet MS, Berrington de González A. Nonradiation risk factors for thyroid cancer in the US Radiologic Technologists Study. Am J Epidemiol 2010; 171:242-52. [PMID: 19951937 DOI: 10.1093/aje/kwp354] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The incidence of thyroid cancer has been rapidly increasing in the United States, but few risk factors have been established. The authors prospectively examined the associations of self-reported medical history, anthropometric factors, and behavioral factors with thyroid cancer risk among 90,713 US radiologic technologists (69,506 women and 21,207 men) followed from 1983 through 2006. Incident thyroid cancers in 242 women and 40 men were reported. Elevated risks were observed for women with benign thyroid conditions (hazard ratio (HR) = 2.35, 95% confidence interval (CI): 1.73, 3.20), benign breast disease (HR = 1.56, 95% CI: 1.08, 2.26), asthma (HR = 1.68, 95% CI: 1.00, 2.83), and body mass index > or =35.0 versus 18.5-24.9 kg/m(2) (HR = 1.74, 95% CI: 1.03, 2.94; P-trend = 0.04). Current smoking was inversely associated with thyroid cancer risk (HR = 0.54). No clear associations emerged for reproductive factors, other medical conditions, alcohol intake, or physical activity. Despite few thyroid cancers in men, men with benign thyroid conditions had a significantly increased risk of thyroid cancer (HR = 4.65, 95% CI: 1.62, 13.34), and results for other risk factors were similar to those for women. Consistent with prior studies, obesity and benign thyroid conditions increased and current smoking decreased the risk of thyroid cancer. The novel findings for benign breast disease and asthma warrant further investigation.
Collapse
Affiliation(s)
- Cari L Meinhold
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Rockville, MD 20852, USA.
| | | | | | | | | | | | | |
Collapse
|
42
|
Current World Literature. Curr Opin Oncol 2010; 22:70-5. [DOI: 10.1097/cco.0b013e328334b4d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Kidokoro K, Ino K, Hirose K, Kajiyama H, Hosono S, Suzuki T, Kawase T, Hiraki A, Hamajima N, Tanaka H, Tajima K, Kikkawa F, Matsuo K. Association between CYP19A1 polymorphisms and sex hormones in postmenopausal Japanese women. J Hum Genet 2009; 54:78-85. [PMID: 19158807 DOI: 10.1038/jhg.2008.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In postmenopausal women, extraovarian sex hormone production plays an important role in hormone-related diseases, such as breast and endometrial cancers. Aromatase, an enzyme encoded by CYP19A1, is a key enzyme involved in estrogen biosynthesis. The impact of CYP19A1 polymorphisms on serum sex hormone levels in the Japanese population has never been investigated. This study enrolled 100 postmenopausal Japanese women found to be without cancer. Twenty-five CYP19A1 loci were identified, and measurements were conducted on serum levels of sex hormones; lifestyle data were collected, namely estrone (E1), estradiol (E2), testosterone and sex hormone-binding globulin (SHBG). We conducted a cross-sectional analysis to evaluate the impact of CYP19A1 haplotype on serum sex hormone levels. We found that subjects with BMI>or=25 kg/m(2) showed a significant difference in circulating testosterone levels (0.29+/-0.19, P=0.050). Neither age nor the amount of physical exercise or drinking habits showed any effect on hormone levels. We identified seven haplotype blocks in CYP19A1 by LD analysis. Estrone levels differed in rs12148604 (SNP 1) and rs11632903 (SNP14). No significant locus for estradiol was observed. SHBG levels were associated with rs4441215 (SNP11). Testosterone levels were strongly associated with rs752760 (SNP24) and rs2445768 (SNP25) and weakly associated with SNP 1, SNP11 and SNP14 as well. We found that polymorphisms in CYP19A1 influence sex hormone levels in Japanese postmenopausal women.
Collapse
Affiliation(s)
- Kumiko Kidokoro
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|