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Kim HR, Son M, Huh SJ, Moon SY, Moon H, Kang YW, Koh M, Lee JY. Relationship between METS-IR and thyroid cancer incidence in Korea: a nationwide population-based study. Front Oncol 2024; 14:1383864. [PMID: 38665956 PMCID: PMC11044182 DOI: 10.3389/fonc.2024.1383864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Background Several previous studies found a positive relationship between metabolic syndrome (MetS) and thyroid cancer (TC) risk. However, there is no research that has studied the relationship between the metabolic score for insulin resistance (METS-IR), a novel surrogate marker for IR, and TC incidence. Thus, we designed this retrospective cohort study to evaluate the relationship between the incidence of TC and METS-IR. Method We analyzed a cohort of 314,321 Korean adults aged over 40 years who participated in the National Health Screening Program from 2009 to 2010. The individuals were divided into four groups based on METS-IR quartiles. Follow-up was until the diagnosis of TC or death, or until December 31, 2019, if neither. The relationship between METS-IR and TC incidence was analyzed using the Cox proportional-hazards model with multi-variable adjustments. Results A total of 4,137 participants (1.3%) were diagnosed with TC during a mean follow-up of 9.5 ± 1.5 years. The population with Q1 METS-IR scores showed higher disease-free probabilities than those with Q4 METS-IR scores (p <0.001). The hazard ratio (95% confidential interval) for TC incidence in Q2, Q3, and Q4 METS-IR value were 1.14 (1.05 to 1.25), 1.21 (1.11 to 1.33), and 1.30 (1.18 to 1.42) compared with Q1 of METS-IR, respectively. The incidence of TC tended to increase with increasing METS-IR values in the total population, especially the male population in the restricted cubic spline. In subgroup analysis, the TC risk was more pronounced in the subgroups under 65 and with a BMI < 25 kg/m2. Conclusion METS-IR was positively correlated with TC incidence in Korea.
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Affiliation(s)
- Hye Ryeon Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Minkook Son
- Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea
- Department of Data Sciences Convergence, Dong-A University Interdisciplinary Program, Busan, Republic of Korea
| | - Seok Jae Huh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Sang Yi Moon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Hyeyeon Moon
- Department of Internal Medicine, Yeongdo Hospital, Busan, Republic of Korea
| | - Yeo Wool Kang
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Myeongseok Koh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Jong Yoon Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
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O’Grady TJ, Rinaldi S, Michels KA, Adami HO, Buring JE, Chen Y, Clendenen TV, D’Aloisio A, DeHart JC, Franceschi S, Freedman ND, Gierach GL, Giles GG, Lacey JV, Lee IM, Liao LM, Linet MS, McCullough ML, Patel AV, Prizment A, Robien K, Sandler DP, Stolzenberg-Solomon R, Weiderpass E, White E, Wolk A, Zheng W, Berrington de Gonzalez A, Kitahara CM. Association of hormonal and reproductive factors with differentiated thyroid cancer risk in women: a pooled prospective cohort analysis. Int J Epidemiol 2024; 53:dyad172. [PMID: 38110618 PMCID: PMC10859160 DOI: 10.1093/ije/dyad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The incidence of differentiated thyroid cancer (DTC) is higher in women than in men but whether sex steroid hormones contribute to this difference remains unclear. Studies of reproductive and hormonal factors and thyroid cancer risk have provided inconsistent results. METHODS Original data from 1 252 907 women in 16 cohorts in North America, Europe, Australia and Asia were combined to evaluate associations of DTC risk with reproductive and hormonal factors. Multivariable-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS During follow-up, 2142 women were diagnosed with DTC. Factors associated with higher risk of DTC included younger age at menarche (<10 vs 10-11 years; HR, 1.28; 95% CI, 1.00-1.64), younger (<40; HR, 1.31; 95% CI, 1.05-1.62) and older (≥55; HR, 1.33; 95% CI, 1.05-1.68) ages at menopause (vs 40-44 years), ever use of menopausal hormone therapy (HR, 1.16; 95% CI, 1.02-1.33) and previous hysterectomy (HR, 1.25; 95% CI, 1.13-1.39) or bilateral oophorectomy (HR, 1.14; 95% CI, 1.00-1.29). Factors associated with lower risk included longer-term use (≥5 vs <5 years) of oral contraceptives (HR, 0.86; 95% CI, 0.76-0.96) among those who ever used oral contraception and baseline post-menopausal status (HR, 0.82; 95% CI, 0.70-0.96). No associations were observed for parity, duration of menopausal hormone therapy use or lifetime number of reproductive years or ovulatory cycles. CONCLUSIONS Our study provides some evidence linking reproductive and hormonal factors with risk of DTC. Results should be interpreted cautiously considering the modest strength of the associations and potential for exposure misclassification and detection bias. Prospective studies of pre-diagnostic circulating sex steroid hormone measurements and DTC risk may provide additional insight.
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Affiliation(s)
- Thomas J O’Grady
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY, USA
| | - Sabina Rinaldi
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Kara A Michels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health and NYU Cancer Institute, NYU School of Medicine, New York, NY, USA
| | - Tess V Clendenen
- Division of Epidemiology, Department of Population Health and NYU Cancer Institute, NYU School of Medicine, New York, NY, USA
| | - Aimee D’Aloisio
- Social & Scientific Systems, DLH Holdings Corporation, Durham, NC, USA
| | - Jessica Clague DeHart
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA
| | | | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - James V Lacey
- Division of Health Analytics Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope, Atlanta, GA, USA
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Anna Prizment
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Kim Robien
- Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | | | - Emily White
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amy Berrington de Gonzalez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- The Institute of Cancer Research, London, UK
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Huang Y, Wang Y, Liu S, Xu Z, Chen WX. An integrative analysis of the tumor suppressors and oncogenes from sexual dimorphism and gene expression alteration features in thyroid cancer. Cancer Biomark 2023; 38:1-16. [PMID: 37355885 DOI: 10.3233/cbm-230029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND The incidence of thyroid cancer has risen rapidly over the last decades. Although mortality rates are relatively low compared to other cancers, the rate of new cases started to increase in the early 2000s. While tumor suppressors and oncogenes were recently identified in thyroid cancer, the potential roles of these genes in thyroid cancer remain unclear. OBJECTIVE Analyze the roles and functions of tumor suppressors and oncogenes in thyroid cancer. METHODS Thyroid cancer data were collected from public databases, such as the UCSC Xena database of TCGA thyroid cancer, TISIDB, and UALCAN. The genes frequently associated with unfavorable thyroid cancer were examined and validated. The association of these target genes with thyroid tumorigenesis, stages, subtypes, and survival rates were analyzed. Additionally, the genes aberrantly expressed in thyroid cancer and significantly involved in thyroid tumorigenesis, stages, subtypes, and survival rates were identified. RESULTS Female sex was identified as a risk factor for thyroid cancer. The expression of PAPSS2, PDLIM3, COPZ2, ALDH1B1, ANTXR1, GUF1, and SENP6 negatively correlated with thyroid cancer prognosis. CONCLUSION Female sex was a risk factor for thyroid cancer. In addition, our analysis suggested that PAPSS2, PDLIM3, COPZ2, ALDH1B1, ANTXR1, GUF1, and SENP6 are negatively correlated with the prognosis of thyroid cancer. The expression of ANTXR1, GUF1, and PDLIM3 was weakly associated with thyroid cancer's immune and molecular subtypes.
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Affiliation(s)
- Yue Huang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Yaoxin Wang
- Department of Laboratory Medicine, Wu Song Branch, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Sining Liu
- Department of Otolaryngology-Head and Neck Surgery, Hainan Women and Children's Medical Center, Hainan, China
| | - Zhengmin Xu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Wen-Xia Chen
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
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Graceffa G, Salamone G, Contino S, Saputo F, Corigliano A, Melfa G, Proclamà MP, Richiusa P, Mazzola S, Tutino R, Orlando G, Scerrino G. Risk Factors for Anaplastic Thyroid Carcinoma: A Case Series From a Tertiary Referral Center for Thyroid Surgery and Literature Analysis. Front Oncol 2022; 12:948033. [PMID: 35875085 PMCID: PMC9303013 DOI: 10.3389/fonc.2022.948033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive disease with a very poor prognosis. Several risk factors have been hypothesized, but there is no clear-cut literature data on it. We reviewed the literature concerning risk factors for ATC and analyzed the institutional database from 2005 to 2022. In total, 15 papers were suitable for review, while the retrospective data collection search, conducted on our institutional database, provided 13 results. In our experience, in agreement with literature data, ATC seems to be a neoplasm peculiar to old age (in our database, mean age is 72 years), with a higher prevalence in subjects with a low level of education and a long history of multinodular goiter (MNG). The role of cigarette smoking and blood group, hypothesized on some literature data, was more uncertain, although the small sample size evaluated probably had a great influence on these results. The higher incidence of the disease in individuals with a history of MNG could suggest more aggressive choices in the treatment of a benign disease, in contrast to current practice. However, this may be a highly questionable point considering that ATC accounts for no more than 2% of all thyroid neoplasms in surgical departments, even those dedicated to endocrine neck surgery. Further studies are therefore necessary for a step forward in this direction.
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Affiliation(s)
- Giuseppa Graceffa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giuseppe Salamone
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Silvia Contino
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Federica Saputo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Alessandro Corigliano
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Giuseppina Melfa
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Maria Pia Proclamà
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Pierina Richiusa
- Section of Endocrinology-Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Sergio Mazzola
- Unit of Clinical Epidemiology and Tumor Registry, Department of Laboratory Diagnostics, Policlinico “P. Giaccone” University of Palermo, Palermo, Italy
| | - Roberta Tutino
- Department of General and Specialized Surgery, City of Health and Science Hospital of Turin, Turin, Italy
| | - Giuseppina Orlando
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
- *Correspondence: Giuseppina Orlando,
| | - Gregorio Scerrino
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
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Kitahara CM, Schneider AB. Epidemiology of Thyroid Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1284-1297. [PMID: 35775227 PMCID: PMC9473679 DOI: 10.1158/1055-9965.epi-21-1440] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 01/03/2023] Open
Affiliation(s)
- Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Arthur B Schneider
- University of Illinois at Chicago, College of Medicine, Department of Medicine, Chicago, Illinois
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Pizzato M, Li M, Vignat J, Laversanne M, Singh D, La Vecchia C, Vaccarella S. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 2022; 10:264-272. [PMID: 35271818 DOI: 10.1016/s2213-8587(22)00035-3] [Citation(s) in RCA: 187] [Impact Index Per Article: 93.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Thyroid cancer incidence rates have increased in many countries and settings; however, mortality rates have remained stable at lower rates. This epidemiological pattern has been largely attributed to an overdiagnosis effect. Timely evidence for the global epidemiological status is necessary to identify the magnitude of this problem and the areas mostly affected by it. We therefore aimed to provide an up-to-date assessment on the global distribution of thyroid cancer incidence and mortality rates in 2020. METHODS We extracted age-standardised incidence and mortality rates per 100 000 person-years of thyroid cancer as defined by the International Classification of Diseases for Oncology 10th Revision (code C73), for 185 countries or territories by sex and 18 age groups (ie, 0-4, 5-9, …, 80-84, and ≥85 years) from the GLOBOCAN database. Both incidence and mortality estimates were presented by country and aggregated across the 20 UN-defined world regions and according to the UN's four-tier Human Development Index (ie, low, medium, high, and very high) in 2020. FINDINGS Globally, in 2020, the age-standardised incidence rates of thyroid cancer were 10·1 per 100 000 women and 3·1 per 100 000 men, and age-standardised mortality rates were 0·5 per 100 000 women and 0·3 per 100 000 men. In both sexes, incidence rates were five times higher in high and very high Human Development Index countries than in low and medium Human Development Index countries, whereas mortality rates were relatively similar across different settings. Incidence rates in women differed by more than 15 times across world regions, with the highest incidence rates being in the Federated States of Micronesia and French Polynesia (18·5 per 100 000 women), North America (18·4 per 100 000), and east Asia (17·8 per 100 000, with South Korea reaching 45 per 100 000). Mortality rates were less than one per 100 000 in most countries and in both sexes. South Korea had the highest incidence-to-mortality rate ratio in both sexes, followed by Cyprus and Canada. INTERPRETATION The current thyroid cancer epidemiological landscape is strongly suggestive of a large effect of overdiagnosis in many countries and settings worldwide, confirming the relevance of thyroid cancer overdiagnosis as a global public health problem. FUNDING None.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; International Agency for Research on Cancer, Lyon, France.
| | - Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jerome Vignat
- International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Battistella E, Pomba L, Costantini A, Scapinello A, Toniato A. Hashimoto's Thyroiditis and Papillary Cancer Thyroid Coexistence Exerts a Protective Effect: a Single Centre Experience. Indian J Surg Oncol 2022; 13:164-168. [PMID: 35462652 PMCID: PMC8986954 DOI: 10.1007/s13193-022-01515-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common malignant tumour of the thyroid and it is often found in association with Hashimoto's thyroiditis (HT). This concomitance is still under debate. The aim of this study is to investigate the influence of Hashimoto's thyroiditis in patients with papillary thyroid carcinoma. Two thousand two hundred eighteen patients underwent thyroidectomy in our department between January 2015 and January 2020. Of these, 435 patients had surgery for papillary thyroid carcinoma and form the basis of our studies. The association between PTC and HT was found in 180 patients (41.4%), mostly represented in the female group (78.9%), with a lower median age than patients with PTC without HT. In comparison to patients with PTC alone, the PTC-HT group had less invasive and smaller tumours, as well as less lymph node involvement. Moreover, tumours of patients with PTC-HT were diagnosed earlier. Our data showed that Hashimoto's thyroiditis may be considered a protective factor when PTC develops. Furthermore, we concluded that patients with PTC and HT had a better prognosis and a lower risk of recurrence than those that did not have HT.
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Affiliation(s)
- Enrico Battistella
- Department of Surgery, Endocrine Surgery Unit, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Luca Pomba
- Department of Surgery, Endocrine Surgery Unit, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Andrea Costantini
- Department of Surgery, Endocrine Surgery Unit, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | | | - Antonio Toniato
- Department of Surgery, Endocrine Surgery Unit, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
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Jiskra J, Horáček J, Špitálníková S, Paleček J, Límanová Z, Krátký J, Springer D, Žabková K, Vítková H. Thyroid nodules and thyroid cancer in women with positive thyroid screening in pregnancy: a double-centric, retrospective, cohort study. Eur Thyroid J 2022; 11:e210011. [PMID: 35108218 PMCID: PMC8963173 DOI: 10.1530/etj-21-0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/02/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Thyroid nodules are a common finding in the general population. The primary aim of the study was to determine the prevalence of thyroid nodules and cancer found by ultrasound (US) in women who underwent screening for thyroid dysfunction during pregnancy. DESIGN A double-centric, retrospective, cohort study. PATIENTS AND METHODS We searched through medical records, including thyroid ultrasonography, of pregnant women who were positively screened for thyroid disorders (using thyroid-stimulating hormone and thyroid antibodies) from an unselected population ('universal screening group', n = 690) and of women who underwent the testing based on the presence of clinical risk factors defined by American Thyroid Association ('case-finding group', n = 249). RESULTS Prevalence of benign and malignant thyroid nodules was lower in the 'universal screening group' than in the 'case-finding group' (9.9% vs 17.7%, P= 0.002, and 0.9% vs 7.2%, P< 0.001, respectively). Consistently, the thyroid cancer rate was lower among the nodules in the 'universal screening group' than in the 'case-finding group' (8.1% vs 29.0%, P= 0.003). Ultrasound EU-TIRADS (European Thyroid Imaging and Reporting Data System) category ≥4 had a 95.8% sensitivity for thyroid cancer. In palpable nodules, the prevalence of cancer was significantly higher than in the non-palpable ones (44.0% vs 2.2%, P < 0.001). In a multivariate regression analysis, thyroid nodules were associated with a history of infertility and parity. CONCLUSIONS Compared to the data from cancer registries, universal screening allowed detecting thyroid cancer in pregnancy three to five times more frequently, but the cancer rate among nodules (8.1%) did not differ from the common population. US had very good sensitivity for thyroid cancer in pregnancy.
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Affiliation(s)
- Jan Jiskra
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
- Correspondence should be addressed to J Jiskra:
| | - Jiří Horáček
- 4th Department of Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Czech Republic
| | - Sylvie Špitálníková
- Department of Nuclear Medicine, District Hospital, Havlíčkův Brod, Czech Republic
| | - Jan Paleček
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Zdeňka Límanová
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Jan Krátký
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Drahomíra Springer
- Department of Clinical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Kristýna Žabková
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Hana Vítková
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
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9
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Sex Bias in Differentiated Thyroid Cancer. Int J Mol Sci 2021; 22:ijms222312992. [PMID: 34884794 PMCID: PMC8657786 DOI: 10.3390/ijms222312992] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 01/03/2023] Open
Abstract
Differentiated thyroid cancers are more frequent in women than in men. These different frequencies may depend on differences in patient's behavior and in thyroid investigations. However, an impact on sexual hormones is likely, although this has been insufficiently elucidated. Estrogens may increase the production of mutagenic molecules in the thyroid cell and favor the proliferation and invasion of tumoral cells by regulating both the thyrocyte enzymatic machinery and the inflammatory process associated with tumor growth. On the other hand, the worse prognosis of thyroid cancer associated with the male gender is poorly explained.
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10
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Baron JA, Nichols HB, Anderson C, Safe S. Cigarette Smoking and Estrogen-Related Cancer. Cancer Epidemiol Biomarkers Prev 2021; 30:1462-1471. [PMID: 33990391 DOI: 10.1158/1055-9965.epi-20-1803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/13/2021] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
Cigarette smoking is a known cause of many cancers, yet epidemiologic studies have found protective associations with the risk of four "estrogen-related" malignancies: endometrial cancer, endometrioid and clear cell ovarian cancers, and thyroid cancer. This review considers epidemiologic and biological aspects of these associations, focusing particularly on estrogen signaling, and contrasts them with those for breast cancer, another estrogen-related malignancy. The observational findings regarding the inverse associations are consistent and remain after adjustment for possible confounding factors. In general, women who smoke do not have lower circulating estrogen levels than nonsmokers, eliminating one possible explanation for reduced risks of these malignancies. For endometrial and endometrioid ovarian cancer, the negative associations could plausibly be explained by interference with signaling through the estrogen receptor α. However, this is unlikely to explain the lower risks of thyroid and clear cell ovarian cancers. For thyroid cancer, an anti-inflammatory effect of nicotine and reduced TSH levels from smoking have been proposed explanations for the inverse association, but both lack convincing evidence. While the overall impact of cigarette smoking is overwhelmingly negative, protective associations such as those discussed here can provide potential clues to disease etiology, treatment, and prevention.
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Affiliation(s)
- John A Baron
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina. .,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Chelsea Anderson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Stephen Safe
- Department of Veterinary Physiology & Pharmacology, Texas A&M University, College Station, Texas
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Schubart JR, Eliassen AH, Schilling A, Goldenberg D. Reproductive Factors and Risk of Thyroid Cancer in Women: An Analysis in the Nurses' Health Study II. Womens Health Issues 2021; 31:494-502. [PMID: 33941452 DOI: 10.1016/j.whi.2021.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 03/16/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The incidence of thyroid cancer in women is increasing at an alarming rate, with greatest risk in the reproductive years. Establishing relationships of hormonally related reproductive factors with thyroid cancer has been difficult. We aimed to elucidate potential risk factors for thyroid cancer in a large cohort of women. METHODS Among 116,228 women in the Nurses' Health Study II followed from 1989 to 2013, 620 cases of thyroid cancer were identified. We examined reproductive and hormone-related factors, including age at menarche, age at menopause, parity, oral contraceptive use, and postmenopausal hormone therapy use. Pregnancy, reproductive years, and months of breastfeeding were used as surrogate markers for exposure to endogenous reproductive hormones. We used multivariable Cox models to calculate relative risks and 95% confidence intervals for the associations between these factors and risk of thyroid cancer. RESULTS Number of reproductive years of 41 years or more was associated with more than double the risk of thyroid cancer compared with 30 years or fewer (relative risk, 2.20; 95% confidence interval, 1.19-4.06). The other variables analyzed (parity number, months of breastfeeding, age at menarche, menopausal status, and postmenopausal hormone therapy) were not associated with the risk of thyroid cancer. Women who entered menopause at age 45 years or older had a higher risk of thyroid cancer compared with women who entered menopause at a younger age. This result did not reach statistical significance; however, there was a linear trend between later age at menopause and increased risk of thyroid cancer (ptrend = .009). CONCLUSIONS This study used a unique large, longitudinal dataset to assess thyroid cancer risk factors and potential confounders over an extended time frame. Our key finding suggests increased risk of thyroid cancer may be associated with a variety of indicators of longer reproductive years. The Nurses' Health Study II has provided new insights into the hormonal risks associated with thyroid cancer.
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Affiliation(s)
- Jane R Schubart
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Amber Schilling
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - David Goldenberg
- Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
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Iqbal A, Azhar S, Ibrahim NA, Kharaba ZJ, Iqbal MM, Khan SA, Arfat Yameen M, Murtaza G. Thyroid cancer risk factors and Pakistani University students' awareness towards its preventive practice. J Oncol Pharm Pract 2020; 27:570-578. [PMID: 32437225 DOI: 10.1177/1078155220925166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Thyroid Cancer is one of the rarest cancers but its prevalence has been increasing worldwide for the last couple of decades. METHODS The data collection tool was designed to assess knowledge, awareness, perception, and attitude towards preventive practices of thyroid cancer in Pakistani university students. The data were collected over a duration of six months and a total number of 3722 students participated. RESULTS The knowledge of risk factors of thyroid cancer was an important parameter of this study. The students who knew all the early signs of thyroid cancer were 28.7%. In this study, the independent variables such as age, gender, demographic location, and financial status were found to be highly significant with knowledge, attitude towards warning signs of cancer, and the perception of students about developing thyroid cancer. CONCLUSIONS The participants were found to have poor knowledge about early signs of thyroid cancer. The study participants perception, behavior, and attitude towards preventive practices of thyroid cancer were found inadequate and appropriate measures on a National level should be taken to enhance the knowledge about preventive practices of thyroid cancer. Increasing knowledge and awareness shall help decrease the overall morbidity and mortality linked with thyroid carcinomas and thyroid diseases.
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Affiliation(s)
- Ayesha Iqbal
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan.,Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Saira Azhar
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Nihal A Ibrahim
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
| | - Zelal J Kharaba
- Department of Clinical Sciences, College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | | | - Shujaat A Khan
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan
| | | | - Ghulam Murtaza
- Department of Pharmacy, COMSATS University Islamabad, Lahore, Pakistan
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Lorenz K, Schneider R, Elwerr M. Thyroid Carcinoma: Do We Need to Treat Men and Women Differently? Visc Med 2020; 36:10-14. [PMID: 32110651 PMCID: PMC7036538 DOI: 10.1159/000505496] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/17/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND For differentiated thyroid carcinoma, gender-specific differences exist in regard to incidence, age at onset, tumor stage, and recurrence, but causative factors remain to be elucidated. Possible and likely contributors are genetic and hormonal differences. While some of these factors are known to be differently distributed between the sexes, like, for example, BRAF-mutation and estrogen levels, their role in thyroid cancer initiation or promotion awaits further investigation. SUMMARY Apart from generally accepted risk factors for differentiated thyroid carcinoma, an apparent gender disparity of thyroid cancer with a general female predominance, an age-dependent difference in growth acceleration during the reproductive years, and a peak at the time of entering menopause have been demonstrated. Hormonal status and hormonal receptor mediation seem to be most likely to contribute to the differences in thyroid cancer phenotypes of males and females. However, specific cause-and-effect pathways have not yet been determined. KEY MESSAGES Female gender is overrepresented in the incidence of differentiated thyroid carcinoma, as it is in the more favorable tumor stages. Besides the assumption of gender-specific differences in general health awareness and behavior, hormonal age-dependent and gender-specific factors appear to be contributory. In the advanced stage of thyroid cancer, males are overrepresented. Therefore, the real cause of gender differences in thyroid cancer is likely due to a mixed effect. Present knowledge does not favor different treatment modalities of thyroid carcinoma according to gender.
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Affiliation(s)
- Kerstin Lorenz
- Department of Visceral, Vascular, and Endocrine Surgery, Martin-Luther University of Halle-Wittenberg, Halle an der Saale, Germany
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Tcheandjieu C, Cordina-Duverger E, Mulot C, Baron-Dubourdieu D, Guizard AV, Schvartz C, Laurent-Puig P, Guénel P, Truong T. Role of GSTM1 and GSTT1 genotypes in differentiated thyroid cancer and interaction with lifestyle factors: Results from case-control studies in France and New Caledonia. PLoS One 2020; 15:e0228187. [PMID: 31999731 PMCID: PMC6992216 DOI: 10.1371/journal.pone.0228187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023] Open
Abstract
Background GSTM1 and GSTT1 are involved in detoxification of xenobiotics, products of oxidative stress and in steroid hormones metabolism. We investigated whether GSTM1 and GSTT1 gene deletion was associated with DTC risk and explored interaction with non-genetic risk factors of DTC. Methods The study included 661 DTC cases and 736 controls from two case-control studies conducted in France and New Caledonia. Odds ratios (OR) and their confidence interval (CI) for DTC associated with GST genotypes, alcohol drinking, tobacco smoking, body mass index and hormonal factors were calculated using logistic regression models. Results Results are presented for Europeans and Melanesians combined, as no heterogeneity between groups was detected. We found that DTC risk increased with obesity and decrease with alcohol drinking. After stratification by gene deletion status, the OR for obesity was 5.75, (95%CI 2.25–14.7) among individuals with GSTT1 and GSTM1-deleted genotype, and 1.26, (95%CI 0.89–1.77) in carriers of both genes (p-interaction = 0.02). The OR for drinking ≥1 glass/week was 0.33 (95%CI 0.15–0.74) in GSTT1-null individuals while it was 1.01 (95%CI 0.67–1.52) in non-null carriers of the gene (p-interaction = 0.01). No interaction between GST genotypes and other non-genetic risk factors was detected. Conclusion GSTM1 and GSTT1 genotypes may modulate the DTC risk associated with BMI and alcohol consumption.
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Affiliation(s)
| | | | - Claire Mulot
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | | | - Anne-Valérie Guizard
- Registre Général des Tumeurs du Calvados, Centre François Baclesse, Caen, France
- U1086 INSERM–UCN “ANTICIPE”, Caen, France
| | - Claire Schvartz
- Registre spécialisé des Cancers de la Thyroide Marne-Ardennes Institut GODINOT, Reims, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Pascal Guénel
- Université Paris-Saclay, UVSQ, INSERM, CESP, Villejuif, France
- * E-mail: (PG); (TT)
| | - Thérèse Truong
- Université Paris-Saclay, UVSQ, INSERM, CESP, Villejuif, France
- * E-mail: (PG); (TT)
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Mannathazhathu AS, George PS, Sudhakaran S, Vasudevan D, Krishna Km J, Booth C, Mathew A. Reproductive factors and thyroid cancer risk: Meta-analysis. Head Neck 2019; 41:4199-4208. [PMID: 31595581 DOI: 10.1002/hed.25945] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/02/2019] [Accepted: 08/15/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Assessed pooled risk on reproductive factors and oral contraceptives (OC) on thyroid cancer (TC) using published studies (1996-2017). METHODS Summary odds ratio (OR) for case-control studies (n = 10) and risk ratio (RR) for cohort studies (n = 9) was done. RESULTS OR was 1.43 (95% CI: 1.16-1.77) for age at menarche >14 years, 1.49 (95% CI: 1.19-1.86) for parity >2, 1.38 (95% CI: 1.18-1.61) for miscarriage/abortion, and 2.05 (95% CI: 1.39-3.01) for artificial menopause. A protective effect (ORs: 0.85; 95% CI: 0.72-0.99) on TC was observed for prolonged use of OCs. RR was 1.17 (95% CI: 0.90-1.57) for age at menarche >14 years, 1.10 (95% CI: 0.94-1.27) for parity >2, 1.20 (95% CI: 1.03-1.40) for miscarriage/abortion, and 2.16 (95% CI: 1.41-3.31) for artificial menopause and protective effect (RR: 0.78; 95% CI: 0.65-0.92) for prolonged use of OCs. CONCLUSIONS This meta-analysis supports an association due to changes in female hormones during menstrual cycle and pregnancy with the risk of TC and explains female preponderance.
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Affiliation(s)
- Arathy S Mannathazhathu
- Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Preethi S George
- Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Sreekala Sudhakaran
- Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Durga Vasudevan
- Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Jagathnath Krishna Km
- Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | | | - Aleyamma Mathew
- Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Other Primary Malignancies Among Women With Adult-Type Ovarian Granulosa Cell Tumors. Int J Gynecol Cancer 2019; 28:1529-1534. [PMID: 30036228 DOI: 10.1097/igc.0000000000001333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the incidence of new primary malignancies after adult-type granulosa cell tumor (AGCT) and the incidence of AGCT after breast and uterine cancer using nationwide population-based registry data. METHODS We used the Finnish Cancer Registry to identify all patients diagnosed with AGCT in 1968 to 2013 (n = 986). The number of subsequent primary malignancies among women with AGCT and the number of AGCTs in women with previous breast or uterine cancer were compared with the expected number of cases and expressed as standardized incidence ratios (SIRs). RESULTS There were 122 cases of subsequent cancers diagnosed at least 6 months after the primary diagnosis of AGCT (SIR, 1.09; 95% confidence interval [CI], 0.91-1.3). In particular, the observed number of cancers of the soft tissue (SIR, 4.13; 95% CI, 1.33-12.8), thyroid (SIR, 3.42; 95% CI, 1.54-7.62), and leukemia (SIR, 2.67; 95% CI, 0.98-5.82) exceeded the number of expected cases. The SIR for breast cancers after AGCT was 1.26 (95% CI, 0.92-1.73), and the SIR for AGCT after breast cancer was 1.59 (95% CI, 1.04-2.29). The risk for subsequent AGCT was more than 2-fold in breast cancer patients younger than 50 years, and over 15 years after primary diagnosis. CONCLUSIONS There is an increased risk for thyroid and soft tissue cancer as well as leukemia after AGCT, which may be associated with late effects of carcinogenic treatments and possibly shared risk factors. After breast cancer, the risk for AGCT was higher, which may indicate a shared hormonal etiology.
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Guenego A, Mesrine S, Dartois L, Leenhardt L, Clavel-Chapelon F, Kvaskoff M, Boutron-Ruault MC, Bonnet F. Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort. Clin Endocrinol (Oxf) 2019; 90:360-368. [PMID: 30390407 DOI: 10.1111/cen.13899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Thyroid cancers are threefold more frequent in women than in men. A role of reproductive or hormonal factors has been suggested but with contradictory results. We investigated potential associations between history of hysterectomy, with or without oophorectomy, and history of benign gynaecological disease (uterine fibroids, endometriosis) and the incidence of differentiated thyroid cancer, in a large French prospective cohort. METHODS A total of 89 340 women from the E3N cohort were followed up between 1990 and 2012. Gynaecological diseases treated by surgery were self-reported. Thyroid cancers were validated by histological reports. Time-dependent covariates included smoking status, BMI and history of benign thyroid disease. Cox proportional hazard models with age as timescale were used to estimate Hazard Ratios (HR) and 95% confidence intervals (CI). RESULTS A total of 412 cases of thyroid cancer were diagnosed during follow-up. A history of hysterectomy was associated with an increased risk of differentiated thyroid cancer (adjusted HR=2.05; 95%CI: 1.65-2.55). The association was not altered after further adjustment for reproductive factors. Endometriosis, uterine polyps, ovarian cysts and oophorectomy without hysterectomy were not associated with the risk of thyroid cancer. A history of fibroids was also significantly related to the risk of thyroid cancer over the follow-up period (adjusted HR=1.91; 95%CI: 1.50-2.44) and the increased risk persisted after adjustment for history of hysterectomy. CONCLUSIONS Women who had either a history of fibroids or hysterectomy had an increased risk of differentiated thyroid cancer. These findings suggest shared biological mechanisms between fibroids and thyroid cancer, which deserve to be further dissected.
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Affiliation(s)
- Agathe Guenego
- Service d'Endocrinologie, CHU de Rennes, Rennes, France
- Univ Rennes1, Rennes, France
| | - Sylvie Mesrine
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Laureen Dartois
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Institut of Endocrinology, Pitié Salpêtrière Hospital, Paris, France
| | - Françoise Clavel-Chapelon
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marina Kvaskoff
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Fabrice Bonnet
- Service d'Endocrinologie, CHU de Rennes, Rennes, France
- Univ Rennes1, Rennes, France
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
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Kim H, Kim KY, Baek JH, Jung J. Are pregnancy, parity, menstruation and breastfeeding risk factors for thyroid cancer? Results from the Korea National Health and Nutrition Examination Survey, 2010-2015. Clin Endocrinol (Oxf) 2018; 89:233-239. [PMID: 29808502 DOI: 10.1111/cen.13750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/20/2018] [Accepted: 05/25/2018] [Indexed: 01/24/2023]
Abstract
CONTEXT It is unclear whether reproductive factors such as pregnancy, parity, menstruation, and breastfeeding are risk factors for thyroid cancer. The aim of this study was to evaluate the association of reproductive factors with thyroid cancer risk. DESIGN/SETTING Large-scale nation-wide cross-sectional data were analysed from representative samples from the Korea National Health and Nutrition Examination Survey V-VI (2010-2015). RESULTS In this study, 38 086 people over the age of 18 years were enrolled, of which 241 had a diagnosis of thyroid cancer. Of 21 543 female subjects, 210 had thyroid cancer. In logistic regression analysis, pregnancy, parity and number of reproductive years (period between menarche and menopause, excluding breastfeeding period) were significantly associated with thyroid cancer after adjusting for age, body mass index and smoking. However, the number of pregnancies did not show a linear relationship with thyroid cancer. Among breastfeeding women, total duration of breastfeeding and number of babies breastfed significantly decreased the risk for thyroid cancer. CONCLUSION Our findings suggest that reproductive factors can be associated with the development of thyroid cancer. A large prospective cohort study is needed to clarify the causality.
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Affiliation(s)
- Hosu Kim
- Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University, Jinju, Korea
| | - Kyong Young Kim
- Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jong Ha Baek
- Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jaehoon Jung
- Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
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Zabuliene L, Jasilionis D, Miseikyte-Kaubriene E, Stukas R, Kaceniene A, Smailyte G. Parity and Risk of Thyroid Cancer: a Population-Based Study in Lithuania. Discov Oncol 2017; 8:325-329. [PMID: 28916994 DOI: 10.1007/s12672-017-0308-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/06/2017] [Indexed: 11/25/2022] Open
Abstract
An association between parity and thyroid cancer risk has been investigated in a number of independent studies but yielded contradictory findings. The aim of this study was to explore the association between parity and thyroid cancer risk. The population-based cohort study in Lithuanian was conducted. The study dataset based on the linkages between all records from the 2001 population census, all cancer incidence records from the Lithuanian Cancer Registry, and all death and emigration records from Statistics Lithuania for the period between 6 April 2001 and 31 December 2009. Cox's proportional hazards regression models were used to estimate the hazard ratios (HRs) for parity, age at first birth, number of children, place of residence, education, and age at census. The cohort of 868,105 women was followed for 8.6 years, and 1775 thyroid cancer cases were diagnosed during the study period. The significantly higher thyroid cancer risk was observed among parous women (HR = 1.45, 95% CI: 1.20, 1.75) and in women with 1, 2, and 3 children, after adjusting for the possible confounding effects of relevant demographic variables. The findings of this study are consistent with the hypothesis that parity might be associated with the risk of thyroid cancer in women.
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Affiliation(s)
- L Zabuliene
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D Jasilionis
- Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - E Miseikyte-Kaubriene
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- National Cancer Institute, P. Baublio g. 3B, LT-08406, Vilnius, Lithuania
| | - R Stukas
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Kaceniene
- National Cancer Institute, P. Baublio g. 3B, LT-08406, Vilnius, Lithuania
| | - G Smailyte
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
- National Cancer Institute, P. Baublio g. 3B, LT-08406, Vilnius, Lithuania.
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Hormonal and reproductive risk factors of papillary thyroid cancer: A population-based case-control study in France. Cancer Epidemiol 2017; 48:78-84. [PMID: 28426980 DOI: 10.1016/j.canep.2017.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/30/2017] [Accepted: 04/01/2017] [Indexed: 11/23/2022]
Abstract
The three times higher incidence of thyroid cancer in women compared to men points to a role of female sex hormones in its etiology. However the effects of these factors are poorly understood. We analyzed the association between thyroid cancer and hormonal and reproductive factors among women enrolled in CATHY, a population-based case-control study conducted in France. The study included 430 cases of papillary thyroid cancer and 505 controls frequency-matched on age and area of residence. The odds ratios for thyroid cancer increased with age at menarche (p trend 0.05). Postmenopausal women were at increased risk, as compared to premenopausal women, particularly if menopause followed an ovariectomy, and for women with age at menopause <55years. In addition, use of oral contraceptives and menopausal hormone therapy reduced the association with thyroid cancer by about one third, and breastfeeding by 27%. Overall, these findings provide evidence that the risk of thyroid cancer increases with later age at menarche and after menopause, and decreases with use of oral contraceptives and menopausal hormone therapy. These findings confirm an implication of hormonal factors in papillary thyroid cancer risk, whose mechanisms need to be elucidated.
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Huang TC, Cheng YK, Chen TW, Hsu YC, Liu EW, Chen HH. A 'silent' skull metastatic follicular thyroid carcinoma mimicking as a benign scalp tumor in a pregnant woman. Endocrinol Diabetes Metab Case Rep 2017; 2017:EDM160100. [PMID: 28203373 PMCID: PMC5292982 DOI: 10.1530/edm-16-0100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 11/28/2016] [Indexed: 12/30/2022] Open
Abstract
Thyroid cancer with cranial metastasis in a pregnant woman is very rare. In the
literature, most cases are diagnosed early from neurogenic signs or symptomatic
thyroid gland. Pregnancy also contributes to a hesitation toward early surgical and
medical treatments. We reported a scalp tumor in a physically healthy 37-year-old
pregnant female with a follicular thyroid carcinoma (FTC) with lung, bone and cranial
metastasis in initial presentation. Silent neurogenic and physical examinations make
an early diagnosis very challenging. Resection of scalp and intracranial tumor, a
thyroidectomy, post-operative radioactive iodine therapy and tyrosine kinase
inhibitors were employed as treatment. The scalp tumor was confirmed as a metastatic
follicular thyroid carcinoma via positive immunoreactivity for thyroglobulin and
thyroid transcription factor 1 in tumor cells. Blood examination revealed an elevated
thyroglobulin level (>5335 ng/mL). The patient was discharged without any
neurological deficit. An asymptomatic scalp tumor in a pregnant woman with a normal
thyroid disease history needs differential diagnosis from intracranial origin. Rapid
progression and an elevated thyroglobulin level are the indicators that further image
study is needed. Aggressive surgical excision of resectable thyroid gland and
metastatic tumor are essential for a longer survival rate. There is nothing to
indicate that a post-partum operation will worsen prognosis.
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Affiliation(s)
| | | | - Tsung-Wei Chen
- Departments of Pathology , China Medical University Hospital, China Medical University, Taichung , Taiwan
| | | | - En-Wei Liu
- Departments of Plastic and Reconstructive Surgery
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Moleti M, Sturniolo G, Di Mauro M, Russo M, Vermiglio F. Female Reproductive Factors and Differentiated Thyroid Cancer. Front Endocrinol (Lausanne) 2017; 8:111. [PMID: 28588554 PMCID: PMC5440523 DOI: 10.3389/fendo.2017.00111] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/08/2017] [Indexed: 01/14/2023] Open
Abstract
Differentiated thyroid cancer (DTC) is markedly more common in women than men, the highest female-to-male ratio being recorded during the reproductive period. This evidence has led to the suggestion that female hormonal and reproductive factors may account for the observed DTC gender disparity. This review focuses on current evidence on the risk of DTC in conjunction with major female reproductive factors, including the impact of pregnancy on DTC occurrence and progression/recurrence. Overall, studies exploring the link between the risk of DTC and menstrual and menopausal factors, oral contraceptives and/or hormone replacement therapy, showed these associations, if any, to be generally weak. Nonetheless, there is some evidence that higher levels of exposure to estrogens during reproductive years may confer an increased risk of DTC. As far as pregnancy is concerned, it is unclear whether a potential association between parity and risk of DTC actually exists, and whether it is enhanced in the short-term following delivery. A possible role for pregnancy-related factors in DTC progression has been recently suggested by some reports, the results of which are consistent with a worse outcome in the short-term of women diagnosed with DTC during gestation compared to non-pregnant control patients. Also, some progression of disease has been described in women with structural evidence of disease prior to pregnancy. However, there seems to be no impact from pregnancy in DTC-related death or overall survival. Several in vitro and animal studies have evaluated the influence of estrogens (E) and estrogen receptors (ERs) on thyroid cell proliferation. Presently available data are indicative of a role of E and ERs in thyroid cancer growth, although considerable discrepancies in respect to ER expression patterns in thyroid cancer tissues actually exist. Further studies providing more direct evidence on the possible role of E and of placental hormones and growth factors on thyroid growth may expand our knowledge on the mechanisms beyond the gender disparity of proliferative thyroid diseases.
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Affiliation(s)
- Mariacarla Moleti
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- *Correspondence: Mariacarla Moleti,
| | - Giacomo Sturniolo
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Di Mauro
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Marco Russo
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Vermiglio
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Grantzau T, Overgaard J. Risk of second non-breast cancer among patients treated with and without postoperative radiotherapy for primary breast cancer: A systematic review and meta-analysis of population-based studies including 522,739 patients. Radiother Oncol 2016; 121:402-413. [DOI: 10.1016/j.radonc.2016.08.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 08/28/2016] [Accepted: 08/28/2016] [Indexed: 12/20/2022]
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Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP. Systematic Review of Trends in the Incidence Rates of Thyroid Cancer. Thyroid 2016; 26:1541-1552. [PMID: 27571228 DOI: 10.1089/thy.2016.0100] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND A large proportion of global increase in thyroid cancer (TC) incidence has been attributed to increased detection of papillary thyroid cancer (PTC). Nonetheless, some reports support a real increase in incidence. This study aimed to perform a systematic review to evaluate the changing trends in TC incidence and summarize potential risk factors predisposing to this trend. METHODS Literature published in the English language between 1980 and August 2014 was searched via PubMed (MEDLINE) and OvidSP (EMBASE). Original studies on changes in TC incidence in defined geographic areas that described clear methods of case selection and population estimates were included. Data on incidence rates and risk factors were collected. RESULTS Of 4719 manuscripts, 60 studies were included, of which 31 were from Europe, 13 from North America, and the rest from Asia (n = 9), Oceania (n = 4), and South America (n = 3). Fifty-three articles reported a significant increase in incidence (highest was a 10-fold increase in South Korea), six reported stable rates, and one noted a decrease. PTC was the commonest type reported to have increased in incidence (in 10 studies with relevant data). Follicular TC increased in incidence (in four studies), albeit at a lower rate compared with PTC. Data on risk factors were sparse; factors discussed included ionizing radiation, iodine deficiency, and supplementation. CONCLUSION This systematic review strongly supports a widespread and persistent increase in TC incidence. Evidence for over-detection of PTC as the predominant influence includes increased numbers of smaller size tumors and improved or unchanged survival.
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Affiliation(s)
| | - Thomas M Drake
- 1 Medical School, University of Sheffield , Sheffield, United Kingdom
| | - Lesley Uttley
- 2 School of Health and Related Research, University of Sheffield , Sheffield, United Kingdom
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Sierra MS, Soerjomataram I, Forman D. Thyroid cancer burden in Central and South America. Cancer Epidemiol 2016; 44 Suppl 1:S150-S157. [PMID: 27678317 DOI: 10.1016/j.canep.2016.07.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 07/15/2016] [Accepted: 07/24/2016] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVE Incidence of thyroid cancer (TC) is rapidly increasing worldwide, but little is known about the TC burden in Central and South America (CSA). We describe the geographic patterns and trends of TC by sex in CSA. METHODS We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and nationwide cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) per 100,000 person-years. We calculated ASRs by histological subtype. We estimated the annual percentage change (EAPC) to describe time trends. RESULTS Between CSA countries, TC incidence and mortality rates varied from 8-fold to 12-fold and from 2-fold to 5-fold, respectively. In 2003-2007, the highest TC ASRs in females and males were in Ecuador (16.0 and 3.5, respectively), Brazil (14.4 and 3.4), Costa Rica (12.6 and 2.1) and Colombia (10.7 and 2.5). The highest ASMRs were in Ecuador, Colombia, Mexico, Peru and Panama (0.68-0.91 in females and 0.41-0.48 in males). Papillary TC was the most commonly diagnosed histological subtype, following the same incidence pattern as overall TC. In Argentinean, Brazilian, Chilean and Costa Rican females TC incidence increased by 2.2-17.9% annually, and papillary TC increased by 9.1-15.0% annually, while mortality remained stable between 1997 and 2008. In males, trends in TC were stable. CONCLUSION TC occurred more frequently in females than in males. The overall high incidence and low mortality of TC suggest identification of subclinical disease due to improved detection methods.
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Affiliation(s)
- Mónica S Sierra
- International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France.
| | - Isabelle Soerjomataram
- International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France
| | - David Forman
- International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France
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Xhaard C, Lence-Anta JJ, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Danzon A, Velten M, Clero E, Maillard S, Marrer E, Bailly L, Mariné Barjoan E, Schlumberger M, Orgiazzi J, Adjadj E, Pereda CM, Turcios S, Velasco M, Chappe M, Infante I, Bustillo M, García A, Salazar S, Rodriguez R, Benadjaoud MA, Ortiz RM, Rubino C, de Vathaire F. Recreational Physical Activity and Differentiated Thyroid Cancer Risk: A Pooled Analysis of Two Case-Control Studies. Eur Thyroid J 2016; 5:132-8. [PMID: 27493888 PMCID: PMC4949366 DOI: 10.1159/000445887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/02/2016] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Physical activity has been hypothesized to influence cancer occurrence through several mechanisms. To date, its relation with thyroid cancer risk has been examined in relatively few studies. We pooled 2 case-control studies conducted in Cuba and Eastern France to assess the relationship between self-reported practice of recreational physical activity since childhood and thyroid cancer risk. METHODS This pooled study included 1,008 cases of differentiated thyroid cancer (DTC) matched with 1,088 controls (age range 9-35 and 17-60 years in the French and Cuban studies, respectively). Risk factors associated with the practice of recreational physical activity were estimated using OR and 95% CI. Logistic regressions were stratified by age class, country, and gender and were adjusted for ethnic group, level of education, number of pregnancies for women, height, BMI, and smoking status. RESULTS Overall, the risk of thyroid cancer was slightly reduced among subjects who reported recreational physical activity (OR = 0.8; 95% CI 0.5-1.0). The weekly frequency (i.e. h/week) seems to be more relevant than the duration (years). CONCLUSION Long-term recreational physical activity, practiced since childhood, may reduce the DTC risk. However, the mechanisms whereby the DTC risk decreases are not yet entirely clear.
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Affiliation(s)
- Constance Xhaard
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | | | - Yan Ren
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Françoise Borson-Chazot
- Groupement Hospitalier Lyon-Est, Hospices Civils de Lyon, Fédération d'Endocrinologie, Bron, France
- Rhône-Alpes Thyroid Cancer Registry, Cancer Research Center of Lyon (UMR INSERM 1052, CNRS 5286), RTH Laennec Faculty of Medicine, University of Lyon, Lyon, France
| | - Geneviève Sassolas
- Rhône-Alpes Thyroid Cancer Registry, Cancer Research Center of Lyon (UMR INSERM 1052, CNRS 5286), RTH Laennec Faculty of Medicine, University of Lyon, Lyon, France
| | - Claire Schvartz
- Thyroid Cancer Registry of Champagne-Ardennes, Institut Jean Godinot, Reims, France
| | | | - Brigitte Lacour
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- French National Registry of Childhood Solid Tumours, CHU, Nancy, France
| | - Arlette Danzon
- Cancer Registry of Doubs, EA 3181, Université de Franche-Comté, Besançon, France
| | - Michel Velten
- Cancer Registry of Bas-Rhin, EA 3430, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Enora Clero
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Stéphane Maillard
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Emilie Marrer
- Cancer Registry of Haut-Rhin, Mulhouse Hospital, Mulhouse, France
| | - Laurent Bailly
- Public Health Department, University Hospital Nice, Nice, France
| | | | | | - Jacques Orgiazzi
- Department of Endocrinology, Hospices Civils de Lyon, Lyon, France
| | - Elisabeth Adjadj
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Celia M. Pereda
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | | | - Milagros Velasco
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Mae Chappe
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Idalmis Infante
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Marlene Bustillo
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Anabel García
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Sirced Salazar
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | | | - Mohamed Amine Benadjaoud
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Rosa M. Ortiz
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Carole Rubino
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Florent de Vathaire
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
- *Florent de Vathaire, Radiation Epidemiology Group, U1018, Institut Gustave Roussy, Rue Edouard Vaillant, FR–94805 Villejuif (France), E-Mail
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Khaled H, Al Lahloubi N, Rashad N. A review on thyroid cancer during pregnancy: Multitasking is required. J Adv Res 2016; 7:565-70. [PMID: 27408758 PMCID: PMC4921779 DOI: 10.1016/j.jare.2016.02.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 12/11/2022] Open
Abstract
Thyroid cancer is the second most common cancer diagnosed during pregnancy after breast cancer. The goal of management is to control malignancy and prevent maternal and fetal complications as a result of maternal hypothyroidism. The role of female sex hormones as an etiologic factor was investigated, with no clear association. Pregnancy can cause an increase in size of a previously existed thyroid nodule through the structural similarity between TSH and BHCG, and the normally expressed estrogen receptors on thyroid gland cells. Effect of pregnancy on development and prognosis of differentiated thyroid malignancies (papillary and follicular) has also been studied. The prognosis of thyroid cancer is not worse in patients diagnosed during pregnancy or those who got pregnant after curative treatment. Termination of pregnancy is not indicated at all, surgery can be delayed till after delivery except in rapidly growing aggressive tumors. While radioactive iodine ablation is absolutely contra-indicated, the new systemic therapies are not well studied during pregnancy. However, almost all these new agents are classified as FDA category C or D and are better to be avoided. The effect of pregnancy on other types of thyroid cancer (medullary and anaplastic thyroid tumors) is not well studied because of very low incidence with pregnancy. The endocrinological management of thyroid cancer during pregnancy is of utmost importance. The hypothyroidism after total thyroidectomy can cause fetal hypothyroidism. Therefore, the management of thyroid cancer related to pregnancy needs a multidisciplinary team.
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Affiliation(s)
- Hussein Khaled
- Department of Medical Oncology, National Cancer Institute, Cairo University, Egypt
- Corresponding author. Tel.: +20 122 215 1040; fax: +20 2 5252953.
| | - Nasr Al Lahloubi
- Department of Medical Oncology, National Cancer Institute, Cairo University, Egypt
| | - Noha Rashad
- Department of Medical Oncology, Military Armed Hospital Caner Center, Cairo, Egypt
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Kuo JH, Chabot JA, Lee JA. Increased incidence of thyroid cancer among breast cancer survivors: an analysis of the SEER-9 database (1973–2011). INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2016. [DOI: 10.2217/ije.15.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: We sought to re-examine the incidence of thyroid cancer among breast cancer survivors by performing a population-based, cohort analysis using the SEER-9 database. Methods: We identified 704,370 breast cancer patients, 49,663 thyroid cancer patients and 1526 patients who developed thyroid cancer after breast cancer (B1T). Results: Risk for developing thyroid cancer is greatest among survivors diagnosed with breast cancer at age less than 50 years. In general, B1T patients are younger with smaller tumors, and have a greater percentage of invasive ductal carcinoma. They develop thyroid cancer at an older age, and have a greater percentage of aggressive subtypes. Conclusion: Recognition of this association between thyroid and breast cancer should prompt increased awareness in these cancer patient populations.
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Affiliation(s)
- Jennifer H Kuo
- Division of GI/Endocrine Surgery, Columbia University, 161 Fort Washington Ave, 8th Floor, New York, NY 10032, USA
| | - John A Chabot
- Division of GI/Endocrine Surgery, Columbia University, 161 Fort Washington Ave, 8th Floor, New York, NY 10032, USA
| | - James A Lee
- Division of GI/Endocrine Surgery, Columbia University, 161 Fort Washington Ave, 8th Floor, New York, NY 10032, USA
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Zhu J, Zhu X, Tu C, Li YY, Qian KQ, Jiang C, Feng TB, Li C, Liu GJ, Wu L. Parity and thyroid cancer risk: a meta-analysis of epidemiological studies. Cancer Med 2015; 5:739-52. [PMID: 26714593 PMCID: PMC4831293 DOI: 10.1002/cam4.604] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/29/2015] [Accepted: 11/11/2015] [Indexed: 01/02/2023] Open
Abstract
Although observational studies have assessed the relationship between parity and thyroid cancer risk, the findings are inconsistent. To quantitatively assess the association, we conducted a systematic review and meta-analysis. PubMed and Embase were searched up to January 2015. Prospective or case-control studies that evaluated the association between parity and thyroid cancer risk were included. We used the fixed-effects model to pool risk estimates. After literature search, 10 prospective studies, 12 case-control studies and 1 pooled analysis of 14 case-control studies including 8860 patients were identified. The studies had fair methodological quality. Pooled analysis suggested that there was a significant association between parity and risk of thyroid cancer (RR for parous versus nulliparous: 1.09, 95% CI 1.03-1.15; I2=33.4%). The positive association persisted in almost all strata of subgroup analyses based on study design, location, study quality, type of controls, and confounder adjustment, although in some strata statistical significance was not detected. By evaluating the number of parity, we identified that both parity number of 2 versus nulliparous and parity number of 3 versus nulliparous demonstrated significant positive associations (RR=1.11, 95% CI 1.01-1.22; I2=31.1% and RR=1.16, 95% CI 1.01-1.33; I2=19.6% respectively). The dose-response analysis suggested neither a non-linear nor linear relationship between the number of parity and thyroid cancer risk. In conclusion, this meta-analysis suggests a potential association between parity and risk of thyroid cancer in females. However, the lack of detection of a dose-response relationship suggests that further studies are needed to better understand the relationship.
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Affiliation(s)
- Jingjing Zhu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203.,Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, 55455
| | - Xiao Zhu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, 523808, China
| | - Chao Tu
- Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, 213003, China
| | - Yuan-Yuan Li
- Department of Hematology, the Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, 221000, China
| | - Ke-Qing Qian
- Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, 213003, China
| | - Cheng Jiang
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China
| | - Tong-Bao Feng
- Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, 213003, China
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, 70112
| | - Guang Jian Liu
- Department of Neurology, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei, 442000, China
| | - Lang Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203
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Yi X, Zhu J, Zhu X, Liu GJ, Wu L. Breastfeeding and thyroid cancer risk in women: A dose-response meta-analysis of epidemiological studies. Clin Nutr 2015; 35:1039-46. [PMID: 26732028 DOI: 10.1016/j.clnu.2015.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 11/22/2015] [Accepted: 12/03/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND & AIMS The association between breastfeeding and thyroid cancer risk is not consistent from epidemiological studies. To better clarify the association including assessing a potential dose-response relationship, we conducted a comprehensive meta-analysis. METHODS We searched PubMed (MEDLINE) up to November 2015 for prospective studies or case-control studies that evaluated the association between breastfeeding and risk of thyroid cancer. Effect estimates were pooled using a fixed-effects model. RESULTS Nine reports (2 prospective studies, 6 case-control studies and 1 pooled analysis of 14 case-control studies) involving 2423 cases and 350,081 non-cases were identified. After pooling relevant studies, there was a significant inverse association between ever breastfeeding and risk of thyroid cancer (RR = 0.91, 95% CI 0.83-0.99), with minor heterogeneity (I(2) = 10.1%). The dose-response analysis revealed a significant linear relationship between the duration of breastfeeding and risk of thyroid cancer. The summary RR for an increment of 1 month of breastfeeding with risk of thyroid cancer was 0.983 (95% CI 0.98-0.99). When focusing on cohort studies, a more prominent linear dose-response relationship was detected, with the combined RR for every increment of 1 month of breastfeeding to be 0.965 (95% CI 0.96-0.97). CONCLUSIONS This meta-analysis suggests that breastfeeding is potentially inversely associated with thyroid cancer risk. Also longer duration of breastfeeding may further decreases thyroid cancer risk. If validated in large-scale prospective studies, our findings may have implications for impacting women's decision in breastfeeding.
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Affiliation(s)
- Xingyang Yi
- Department of Neurology, The People's Hospital of Deyang City, Deyang 618000, Sichuan, China
| | - Jingjing Zhu
- Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, MN, 55455, USA; Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Xiao Zhu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan 523808, China
| | - Guang Jian Liu
- Department of Neurology, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan City, Hubei Province 442000, China.
| | - Lang Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA; Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55905, USA.
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Kuo JH, Chabot JA, Lee JA. Breast cancer in thyroid cancer survivors: An analysis of the Surveillance, Epidemiology, and End Results-9 database. Surgery 2015; 159:23-9. [PMID: 26522696 DOI: 10.1016/j.surg.2015.10.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 09/18/2015] [Accepted: 10/03/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND We sought to further elucidate the increased risk for breast cancer among survivors of thyroid cancer. METHODS Using the Surveillance, Epidemiology, and End Results-9 database, we conducted a retrospective cohort analysis on women ≥ 18 years of age with breast and thyroid cancer from 1973 to 2011. RESULTS A total of 707,678 breast cancer patients and 53,853 thyroid cancer patients were included; 1,750 patients developed breast cancer after a preceding diagnosis of thyroid cancer (T1B). Age-specific risk for breast cancer was greater among thyroid cancer survivors. Incidence trends showed a significant age-time interaction and suggested a difference in thyroid cancer biology as well as a treatment effect. Compared with patients with thyroid cancer only, T1B patients were older with smaller cancers, had more follicular thyroid cancers, and fewer patients received radioactive iodine. T1B patients developed breast cancer earlier than the general population, had more estrogen receptor/progesterone receptor-positive and mixed invasive tumor histology, but smaller tumors, and there is no significant difference in the number of lymph nodes involved or radiation therapy. CONCLUSION Thyroid cancer survivors are at greater risk for developing breast cancer than the general population. These patients develop breast cancer early, have more estrogen receptor/progesterone receptor-positive tumors, and have a greater incidence of mixed invasive cancer. Recognition of this association between thyroid and breast cancer should prompt vigilant screening in thyroid cancer survivors and further investigation into the relationship of these 2 diseases.
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Affiliation(s)
- Jennifer H Kuo
- Division of GI/Endocrine Surgery, Columbia University, New York, NY.
| | - John A Chabot
- Division of GI/Endocrine Surgery, Columbia University, New York, NY
| | - James A Lee
- Division of GI/Endocrine Surgery, Columbia University, New York, NY
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Crump C, Sundquist J, Sieh W, Winkleby MA, Sundquist K. Fetal growth and subsequent maternal risk of thyroid cancer. Int J Cancer 2015; 138:1085-93. [PMID: 26379007 DOI: 10.1002/ijc.29857] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 08/23/2015] [Accepted: 09/11/2015] [Indexed: 12/31/2022]
Abstract
Thyroid cancer has peak incidence among women of reproductive age, and growth factors, which have procarcinogenic properties, may play an important etiologic role. However, the association between fetal growth rate during a woman's pregnancy and her subsequent risk of thyroid cancer has not been previously examined. We conducted a national cohort study of 1,837,634 mothers who had a total of 3,588,497 live-births in Sweden in 1973-2008, followed up for thyroid cancer incidence through 2009. There were 2,202 mothers subsequently diagnosed with thyroid cancer in 36.8 million person-years of follow-up. After adjusting for maternal age, height, weight, smoking, and sociodemographic factors, high fetal growth (birth weight standardized for gestational age and sex) was associated with a subsequent increased risk of thyroid cancer in the mother (incidence rate ratio [IRR] per additional 1 standard deviation, 1.05; 95% CI, 1.01-1.09; p = 0.02). Each 1,000 g increase in the infant's birth weight was associated with a 13% increase in the mother's subsequent risk of thyroid cancer (IRR, 1.13; 95% CI, 1.05-1.22; p = 0.001). These findings appeared to involve both papillary and follicular subtypes, and did not vary significantly by the mother's height, weight or smoking status. In this large national cohort study, high fetal growth during a woman's pregnancy was independently associated with a subsequent increased risk of her developing thyroid cancer. If confirmed, these findings suggest an important role of maternal growth factors in the development of thyroid cancer, and potentially may help facilitate the identification of high-risk subgroups of women.
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Affiliation(s)
- Casey Crump
- Department of Medicine, Stanford University, Stanford, CA
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Weiva Sieh
- Department of Health Research and Policy, Stanford University, Stanford, CA
| | - Marilyn A Winkleby
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
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Vaccarella S, Dal Maso L, Laversanne M, Bray F, Plummer M, Franceschi S. The Impact of Diagnostic Changes on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Selected High-Resource Countries. Thyroid 2015; 25:1127-36. [PMID: 26133012 DOI: 10.1089/thy.2015.0116] [Citation(s) in RCA: 222] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Thyroid cancer (TC) incidence is rising in many countries, but the corresponding mortality is constant or declining. Incidence increases appear largely restricted to small papillary TC in young/middle-age individuals. We compared age-specific incidence rates across countries and time periods in order to estimate the fraction of TC possibly attributable to increased surveillance of the thyroid gland (diagnostic changes) following the introduction of neck ultrasonography in the 1980s. METHODS We focused on high-resource countries, including four Nordic countries, England and Scotland, France, Italy, the United States, Australia, Japan, and the Republic of Korea. Before the 1970s, TC incidence in Nordic countries increased proportionally to the second power of age, consistent with the multistage model of carcinogenesis. Using this historical observation for reference, we attributed the progressive departure from linearity of the age curves in each country to an increased detection of asymptomatic disease in young/middle-age individuals. The proportion of cases attributable to diagnostic changes was estimated from the difference between observed rates and those expected using the Nordic countries as reference. RESULTS Diagnostic changes may account for ≥60% of TC cases diagnosed in 2003-2007 in women aged under 80 years in France, Italy, the United States, Australia, and the Republic of Korea, and approximately 50% in other assessed countries, except Japan (30%). The proportions attributable to diagnostic changes were higher in countries with largest incidence increases and were consistent across sexes, although increases were smaller and delayed in men. CONCLUSIONS A large proportion of TC cases diagnosed in high-resource countries in the last two decades are likely to be due to diagnostic changes. This proportion has progressively increased over time, and it is likely to grow further in the future. Since there is evidence of harm but no proof of benefit from the intense scrutiny of the thyroid, the dangers of overdiagnosis and overtreatment of TC should be urgently addressed.
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Affiliation(s)
| | - Luigino Dal Maso
- 2 Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | - Freddie Bray
- 1 International Agency for Research on Cancer , Lyon, France
| | - Martyn Plummer
- 1 International Agency for Research on Cancer , Lyon, France
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Corsten MJ, Hearn M, McDonald JT, Johnson-Obaseki S. Incidence of differentiated thyroid cancer in Canada by City of residence. J Otolaryngol Head Neck Surg 2015; 44:36. [PMID: 26374205 PMCID: PMC4570639 DOI: 10.1186/s40463-015-0088-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 08/31/2015] [Indexed: 12/02/2022] Open
Abstract
Background Thyroid cancer incidence in Canada is increased in high socioeconomic groups, and in urban compared with rural areas. The objective of this study was to analyze patterns in thyroid cancer incidence across Canada, particularly with respect to the major urban areas across the country, to identify whether there are any discrepancies in thyroid cancer incidence between Canadian cities. Methods Cases were drawn from the Canadian Cancer Registry. Demographic and socioeconomic information were extracted from the Canadian Census of Population data. We linked cases to income quintiles (InQs) by patients’ postal codes, and categorized residence by census metropolitan area ((CMA), population >100,000). Within the Toronto CMA we further classified by census subdivision (CSD). Results There were a total of 33 CMAs across the country. After controlling for demographic and socio-economic factors, we found that the Toronto CMA had an IRR of thyroid cancer that was significantly higher than all other CMAs across the country. For 70 % of CMAs and CAs across Canada, the IRR for thyroid cancer was less than half of the IRR for thyroid cancer in the Toronto CMA. As Toronto is one of the largest CMAs, we then subdivided the Toronto area into CSDs to examine how incidence of thyroid cancer varies within this large area. The Toronto City core was used as the reference category and all other areas were compared directly to it. In doing so, we found that a contiguous area of three CSDs North of Toronto had higher IRRs compared with the Toronto city core: Markham, Vaughan and Richmond Hill. Conclusions After controlling for demographic and socioeconomic factors, we found that the Toronto CMA has the highest incidence of thyroid cancer nationwide. Several explanations could account for this discrepancy including increased detection due to increased access to imaging, differences in ethnicity or environmental exposures.
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Affiliation(s)
- Martin J Corsten
- Department of Otolaryngology - Head and Neck Surgery, Aurora St. Luke's Hospital, Suite 630, 2801W Kinnickkinnik River Parkway, Milwaukee, WI, 53215, USA.
| | - Matthew Hearn
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, S3 - 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
| | - James Ted McDonald
- Department of Economics, University of New Brunswick, PO box 4400, Fredericton, NB, E3B6C4, Canada.
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, S3 - 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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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.
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Högnäs E, Kauppila A, Hinkula M, Tapanainen JS, Pukkala E. Incidence of cancer among grand multiparous women in Finland with special focus on non-gynaecological cancers: A population-based cohort study. Acta Oncol 2015. [PMID: 26217985 DOI: 10.3109/0284186x.2015.1063775] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Many studies have previously revealed evidence of an association between grand multiparity (five or more deliveries) and gynaecological cancer. Oestrogen has an impact on cancer formation and the amount of circulating oestrogen is significantly higher during pregnancy. Also the lifestyle of grand multiparous women differs somewhat from the average population. Considering these factors it is plausible that also non-gynaecological cancers are associated with multiparity. The aim of our study was to determine cancer incidence among grand multiparous women, with special attention to non-gynaecological cancers. MATERIAL AND METHODS All 102 541 women alive in 1974-2011 and having had at least five deliveries were identified in the Finnish Population Register and followed up for cancer incidence through the Finnish Cancer Registry to the end of 2011. Standardised incidence ratios (SIRs) were defined as ratios between observed and expected numbers of cases, the latter ones based on incidence in the entire Finnish female population. RESULTS The overall incidence of non-gynaecological cancers was the same as in the reference population (SIR 0.98, 95% confidence interval 0.90-1.06). The incidence of cancers of the gall-bladder (SIR 1.42, 1.26-1.58), biliary tract (1.19, 1.04-1.35) and kidney (1.22, 1.14-1.31) was increased. There were significantly fewer cases than expected of urinary bladder cancer (SIR 0.70, 0.61-0.78), lung cancer (0.87, 0.81-0.92), colon cancer (0.94, 0.89-0.99) and all types of skin cancers. As a consequence of the decreased incidence of gynaecological cancers (SIR 0.74, 0.71-0.77) and breast cancer (0.60, 0.58-0.61), the SIR for cancer overall was 0.84 (0.83-0.85). CONCLUSION The study demonstrated that grand multiparous women have a similar overall risk of non-gynaecological cancers as other women, despite significant differences in some specific forms of cancer.
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Affiliation(s)
- Emma Högnäs
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Antti Kauppila
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Marianne Hinkula
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Juha S. Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
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Hanley JP, Jackson E, Morrissey LA, Rizzo DM, Sprague BL, Sarkar IN, Carr FE. Geospatial and Temporal Analysis of Thyroid Cancer Incidence in a Rural Population. Thyroid 2015; 25:812-22. [PMID: 25936441 PMCID: PMC4507126 DOI: 10.1089/thy.2015.0039] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The increasing incidence of thyroid cancer has resulted in the rate tripling over the past 30 years. Reasons for this increase have not been established. Geostatistics and geographic information system (GIS) tools have emerged as powerful geospatial technologies to identify disease clusters, map patterns and trends, and assess the impact of ecological and socioeconomic factors (SES) on the spatial distribution of diseases. In this study, these tools were used to analyze thyroid cancer incidence in a rural population. METHODS Thyroid cancer incidence and socio-demographic factors in Vermont (VT), United States, between 1994 and 2007 were analyzed by logistic regression and geospatial and temporal analyses. RESULTS The thyroid cancer age-adjusted incidence in Vermont (8.0 per 100,000) was comparable to the national level (8.4 per 100,000), as were the ratio of the incidence of females to males (3.1:1) and the mortality rate (0.5 per 100,000). However, the estimated annual percentage change was higher (8.3 VT; 5.7 U.S.). Incidence among females peaked at 30-59 years of age, reflecting a significant rise from 1994 to 2007, while incidence trends for males did not vary significantly by age. For both females and males, the distribution of tumors by size did not vary over time; ≤1.0 cm, 1.1-2.0 cm, and >2.0 cm represented 38%, 22%, and 40%, respectively. In females, papillary thyroid cancer (PTC) accounted for 89% of cases, follicular (FTC) 8%, medullary (MTC) 2%, and anaplastic (ATC) 0.6%, while in males PTC accounted for 77% of cases, FTC 15%, MTC 1%, and ATC 3%. Geospatial analysis revealed locations and spatial patterns that, when combined with multivariate incidence analyses, indicated that factors other than increased surveillance and access to healthcare (physician density or insurance) contributed to the increased thyroid cancer incidence. Nine thyroid cancer incidence hot spots, areas with very high normalized incidence, were identified based on zip code data. Those locations did not correlate with urban areas or healthcare centers. CONCLUSIONS These data provide evidence of increased thyroid cancer incidence in a rural population likely due to environmental drivers and SES. Geospatial modeling can provide an important framework for evaluation of additional associative risk factors.
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Affiliation(s)
- John P. Hanley
- Department of Civil and Environmental Engineering, School of Engineering, University of Vermont, Burlington, Vermont
| | - Erin Jackson
- Department of Biology, College of Arts and Sciences, University of Vermont, Burlington, Vermont
| | - Leslie A. Morrissey
- Rubinstein School of Environment and Natural Resources, University of Vermont, Burlington, Vermont
| | - Donna M. Rizzo
- Department of Civil and Environmental Engineering, School of Engineering, University of Vermont, Burlington, Vermont
| | - Brian L. Sprague
- Department of Surgery, College of Medicine, University of Vermont, Burlington, Vermont
| | - Indra Neil Sarkar
- Center for Clinical and Translational Science and Department of Microbiology and Molecular Genetics, College of Medicine, University of Vermont, Burlington, Vermont
| | - Frances E. Carr
- Department of Pharmacology, College of Medicine, University of Vermont, Burlington, Vermont
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[Rising incidence of papillary thyroid carcinoma in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:84-92. [PMID: 24357177 DOI: 10.1007/s00103-013-1884-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The incidence of thyroid cancer (TC), a rare malignancy, has strongly risen in recent decades. Possible causes of this rise include increasing diagnostic activity, nuclear tests after World War II, and the Chernobyl disaster. AIM This article presents the time trends of TC incidence between 2003 and 2008 in Germany according to histological tumor type and sex, and provides a description of TC incidence according to districts (Kreise) and sex in Germany. METHODS Data on persons newly diagnosed with thyroid cancer (ICD-10 code, C73) between 2003 and 2008 were obtained from the Center of Cancer Registry Data at the Robert Koch Institute. Official population and mortality data were used. Age-specific and age-standardized incidence rates (ASIR) were calculated according to sex and tumor histology. RESULTS Between 2003 and 2008, the ASIR of TC rose from 2.7 to 3.4 (men) and from 6.5 to 8.9 (women) per 100,000 per year. This rise can be almost completely attributed to the rising incidence of papillary TC. The steepest rise in frequency was observed in TNM-T1 tumors. A positive north-south gradient of TC incidence was found. DISCUSSION The cause of the marked rise of TC incidence in recent decades is unknown. The positive north-south gradient of the TC incidence may possibly be attributed in part to long-standing differences of iodine intake between different German regions. CONCLUSION An epidemiological study of the possible causes of the rising TC incidence and of the regional differences of TC incidence in Germany is recommended.
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Caini S, Gibelli B, Palli D, Saieva C, Ruscica M, Gandini S. Menstrual and reproductive history and use of exogenous sex hormones and risk of thyroid cancer among women: a meta-analysis of prospective studies. Cancer Causes Control 2015; 26:511-8. [PMID: 25754110 DOI: 10.1007/s10552-015-0546-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/27/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE Thyroid cancer has a higher incidence in women than in men, and it has been hypothesized that hormonal factors may explain such disparity. We performed a meta-analysis of observational prospective studies to investigate the association between menstrual and reproductive variables and exogenous hormone use and the risk of thyroid cancer among women. METHODS We calculated summary relative risks and 95% confidence intervals (95% CI) using random effect models. RESULTS Overall, 5,434 thyroid cancer cases from twenty-four papers were included. Increasing age at first pregnancy/birth (SRR 1.56, 95% CI 1.01-2.42) and hysterectomy (SRR 1.43, 95% CI 1.15-1.78) were associated with thyroid cancer risk. Women that were in menopause at enrolment had a reduced thyroid cancer risk (SRR 0.79, 95% CI 0.62-1.01). No other menstrual, reproductive, and hormonal variable was associated with thyroid cancer risk. CONCLUSIONS Menstrual and reproductive factors may play a role in the etiology of thyroid cancer, possibly through the mediation of estrogen receptors.
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Affiliation(s)
- Saverio Caini
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention (ISPO), Via delle Oblate 2, 50139, Florence, Italy,
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Zamora-Ros R, Rinaldi S, Biessy C, Tjønneland A, Halkjaer J, Fournier A, Boutron-Ruault MC, Mesrine S, Tikk K, Fortner RT, Boeing H, Förster J, Trichopoulou A, Trichopoulos D, Papatesta EM, Masala G, Tagliabue G, Panico S, Tumino R, Polidoro S, Peeters PHM, Bueno-de-Mesquita HB, Weiderpass E, Lund E, Argüelles M, Agudo A, Molina-Montes E, Navarro C, Barricarte A, Larrañaga N, Manjer J, Almquist M, Sandström M, Hennings J, Tsilidis KK, Schmidt JA, Khaw KT, Wareham NJ, Romieu I, Byrnes G, Gunter MJ, Riboli E, Franceschi S. Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: the EPIC study. Int J Cancer 2015; 136:1218-27. [PMID: 25041790 DOI: 10.1002/ijc.29067] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/05/2014] [Accepted: 06/11/2014] [Indexed: 02/02/2023]
Abstract
Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for ≤ 5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for ≥ 9 vs. ≤ 1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR = 1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR = 1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.
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Affiliation(s)
- Raul Zamora-Ros
- International Agency for Research on Cancer (IARC), Lyon, France
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Zhou YQ, Zhou Z, Qian MF, Gong T, Wang JD. Association of thyroid carcinoma with pregnancy: A meta-analysis. Mol Clin Oncol 2014; 3:341-346. [PMID: 25798264 DOI: 10.3892/mco.2014.472] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 09/12/2014] [Indexed: 11/05/2022] Open
Abstract
A number of scholars reported that reproductive factors play a significant role in thyroid cancer and the correlation between the two may affect the diagnosis and treatment of thyroid carcinoma during pregnancy. To determine whether pregnancy reproductive factors affect thyroid carcinoma, we conducted a meta-analysis of studies that investigated the association between pregnancy factors and thyroid carcinoma. PubMed, OVID and the Cochrane Library were searched from their inception to April 1st, 2013. The searched publications mainly investigated reproductive factors and the morbidity or prognosis of female thyroid carcinoma. The studies were filtered by predetermined standards and the quality of the included studies was evaluated by the Newcastle-Ottawa scale inventory. Two researchers independently extracted information on first author, year of publication, study design (case-control or prospective cohort), compared populations, inclusion and exclusion criteria and total sample size. Other researchers assessed the studies for publication bias and performed statistical analyses. Discrepancies were resolved by consensus. A total of 21 studies were selected for the meta-analysis, including 406,329 cases in total. Compared to the control group, the risk of thyroid carcinoma in women with a history of pregnancy was not significantly discrepant, [odds ratio (OR)=1.00, 95% confidence interval (CI): 0.91-1.11]. However, the risk of thyroid carcinoma in women with a history of ≥ 3 pregnancies was significantly increased (OR=1.39, 95% CI: 1.21-1.59). Furthermore, an interval of ≤ 5 years since the last pregnancy was closely associated with thyroid carcinoma (OR=1.53, 95% CI: 1.29-1.81). The patients developed thyroid carcinoma during pregnancy did not exhibit an increased risk of lymphatic metastasis (OR=0.94, 95% CI: 0.53-1.67); the risk of distant metastasis also did not increase significantly (OR=1.03, 95% CI: 0.86-1.24). Therefore, multiple pregnancies and a ≤ 5-year interval between pregnancies were identified as high-risk factors for thyroid carcinoma, whereas thyroid carcinoma during pregnancy was not associated with a significant risk of lymphatic and distant metastasis.
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Affiliation(s)
- Y Q Zhou
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
| | - Z Zhou
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
| | - M F Qian
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
| | - T Gong
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
| | - J D Wang
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
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Xhaard C, Rubino C, Cléro E, Maillard S, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Danzon A, Velten M, Buemi A, Bailly L, Mariné Barjoan E, Schlumberger M, Orgiazzi J, Adjadj E, de Vathaire F. Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in young women in France: a population-based case-control study. Am J Epidemiol 2014; 180:1007-17. [PMID: 25269571 DOI: 10.1093/aje/kwu220] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The incidence of thyroid cancer has increased in eastern Europe since the Chernobyl nuclear power plant accident. Although the radioactive fallout was much less severe and the thyroid radiation dose was much lower in France, a case-control study was initiated in eastern France. The present study included 633 young women who were diagnosed with differentiated thyroid cancer before 35 years of age between 2002 and 2006 and matched with 677 controls. Face-to-face interviews were conducted from 2005 to 2010. Odds ratios were calculated using conditional logistic regressions and were reported in the total group and by histopathological type of cancer ("only papillary" and "excluding microcarcinomas"). The risk of thyroid cancer was higher in women who had a higher number of pregnancies, used a lactation suppressant, or had early menarche. Conversely, breastfeeding, oral contraceptive use, and late age at first pregnancy were associated with a lower risk of thyroid cancer. No association was observed between thyroid cancer and having irregular menstrual cycle, undergoing treatment for menstrual cycle regularity shortly after menarche, having a cessation of menstruation, use of another contraceptive, history of miscarriage or abortion for the first pregnancy, or having had gestational diabetes. This study confirms the role of hormonal and reproductive factors in thyroid cancer, and our results support the fact that exposure to estrogens increases thyroid cancer risk.
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Abstract
PURPOSE OF REVIEW Numerous staging and scoring systems exist for differentiated thyroid cancer (DTC), but all harbor limitations. This has prompted investigation for new factors with prognostic implications for DTC. RECENT FINDINGS Several new factors that may be involved in DTC risk stratification have emerged, such as thyroid stimulating hormone and molecular markers. In addition, others are controversial and being challenged, such as age, sex and lymph node involvement. SUMMARY The purpose of this review is to present recent updates in the literature on new potential risk stratification predictors for DTC.
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Braganza MZ, Berrington de González A, Schonfeld SJ, Wentzensen N, Brenner AV, Kitahara CM. Benign breast and gynecologic conditions, reproductive and hormonal factors, and risk of thyroid cancer. Cancer Prev Res (Phila) 2014; 7:418-25. [PMID: 24449056 PMCID: PMC3976437 DOI: 10.1158/1940-6207.capr-13-0367] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The higher incidence of thyroid cancer in women compared with men suggests an influence of sex steroid hormones in the etiology of this malignancy. We investigated a comprehensive set of potential indicators of lifetime sex steroid hormone exposure in relation to thyroid cancer risk. Using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which enrolled 70,047 women, 50 to 78 years old, we prospectively examined associations of self-reported history of benign breast and gynecologic conditions, reproductive factors, and exogenous sex hormone use with thyroid cancer risk. Multivariable-adjusted HRs and 95% confidence intervals (CI) were calculated in models using age as the time metric. During follow-up (median, 11 years), 127 women were diagnosed with first primary thyroid cancer. Older age at natural menopause (≥55 vs. <50 years; HR, 2.24; 95% CI, 1.20-4.18), greater estimated lifetime number of ovulatory cycles (≥490 vs. <415 cycles; HR, 2.40; 95% CI, 1.33-4.30), greater number of live births (≥5 vs. 1-2; HR, 1.72; 95% CI, 1.05-2.82), and history of uterine fibroids (HR, 1.72; 95% CI, 1.18-2.50) were associated with an increased risk of thyroid cancer. Earlier age at menarche, greater number of reproductive years, history of a tubal ligation, and history of ovarian cysts were nonsignificantly associated with increased thyroid cancer risk. No associations were observed for oral contraceptive use, menopausal hormone therapy, or history of benign breast disease or endometriosis. In general, we found that factors reflecting a greater length of exposure to endogenous hormones, particularly during the reproductive years, were associated with risk of postmenopausal thyroid cancer.
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Affiliation(s)
- Melissa Z Braganza
- National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD 20892.
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45
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Hall SF, Irish J, Groome P, Griffiths R. Access, excess, and overdiagnosis: the case for thyroid cancer. Cancer Med 2014; 3:154-61. [PMID: 24408145 PMCID: PMC3930400 DOI: 10.1002/cam4.184] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/06/2013] [Accepted: 11/23/2013] [Indexed: 11/16/2022] Open
Abstract
The incidence of thyroid cancer in women is increasing at an epidemic rate. Numerous studies have proposed that the cause is increasing detection due to availability and use of medical diagnostic ultrasound. Our objective was to compare rates of diagnosis across different health-care regions to rates of diagnostic tests and to features of both health and access of the regional populations. This is a population-based retrospective ecological observational study of 12,959 patients with thyroid cancer between January 1, 2000 and December 31, 2008 in Ontario Canada based on the health-care utilization regions (Local Health Integration Networks) of the province of Ontario Canada. We found that some regions of Ontario had four times the rates of diagnosis of thyroid cancer compared to other regions. The regions with the highest use of discretionary medical tests (pelvic ultrasound, abdominal ultrasound, neck ultrasound, echocardiogram, resting electrocardiogram, cardiac nuclear perfusion tests, and bone scan), highest population density, and better education had the highest rates of thyroid cancer diagnoses. Differences in the rates of the ordering of discretionary diagnostic medical tests, such as diagnostic ultrasound, in different geographic regions of Ontario lead to differences in the rates of diagnosis of thyroid cancer.
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Affiliation(s)
- Stephen F Hall
- Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
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Zivaljevic V, Slijepcevic N, Paunovic I, Diklic A, Kalezic N, Marinkovic J, Zivic R, Vekic B, Sipetic S. Risk factors for anaplastic thyroid cancer. Int J Endocrinol 2014; 2014:815070. [PMID: 24949009 PMCID: PMC4052185 DOI: 10.1155/2014/815070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/29/2014] [Indexed: 12/04/2022] Open
Abstract
Background. Anaplastic thyroid cancer (ATC) is a form of thyroid cancer with very poor prognosis, but is fortunately quite rare. Its aetiology is unknown and not well researched. Aim. The aim of this study was to identify potential risk factors for ATC. Material and Method. Case-control study of 126 ATC patients (77 females and 49 males) and 252 controls individually matched by gender, age, and place of abode. In statistical analysis we used a Cox regression model. Results. Univariate logistic regression showed that the risk factors for ATC are low education level, type B blood group, goitre, other nonthyroid malignancies, diabetes, late menarche, and an early first pregnancy. Multivariate logistic regression analysis showed that independent risk factors for ATC are low education level (OR = 1.42, 95% CI = 1.09-1.86), type B blood group (OR = 2.41, 95% CI = 1.03-5.66), and goitre (OR = 25-33, 95% CI = 5.66-126.65). Conclusion. Independent risk factors for ATC are: low education level, type B blood group, and goitre.
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Affiliation(s)
- V. Zivaljevic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
| | - N. Slijepcevic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia
- *N. Slijepcevic:
| | - I. Paunovic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
| | - A. Diklic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
| | - N. Kalezic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
| | - J. Marinkovic
- School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
- Institute of Medical Statistics and Informatics, School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
| | - R. Zivic
- Clinical Centre “Dr Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
| | - B. Vekic
- Clinical Centre “Dr Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
| | - S. Sipetic
- School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia
- Institute of Epidemiology, School of Medicine, University of Belgrade, Visegradska 26A, 11000 Belgrade, Serbia
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47
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Pazaitou-Panayiotou K, Polyzos SA, Mantzoros CS. Obesity and thyroid cancer: epidemiologic associations and underlying mechanisms. Obes Rev 2013; 14:1006-22. [PMID: 24034423 DOI: 10.1111/obr.12070] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 07/16/2013] [Accepted: 07/16/2013] [Indexed: 12/26/2022]
Abstract
The incidence of thyroid cancer has been rising over the past few decades along with a parallel increase in obesity. Observational studies have provided evidence for a potential association between the two. By contrast, clinical data for a link between type 2 diabetes mellitus, a condition strongly associated with obesity, and thyroid cancer are limited and largely not supportive of such an association. Obesity leads to hypoadiponectinemia, a pro-inflammatory state, and insulin resistance, which, in turn, leads to high circulating insulin and insulin-like growth factor-1 levels, thereby possibly increasing the risk for thyroid cancer. Thus, insulin resistance possibly plays a pivotal role in underlying the observed association between obesity and thyroid cancer, potentially leading to the development and/or progression of thyroid cancer, through its interconnections with other factors including insulin-like growth factor-1, adipocytokines/cytokines and thyroid-stimulating hormone. In this review, epidemiological and clinical evidence and potential mechanisms underlying the proposed association between obesity and thyroid cancer risk are reviewed. If the association between obesity and thyroid cancer demonstrated in observational studies proves to be causal, targeting obesity (and/or downstream mediators of risk) could be of importance in the prevention and management of thyroid cancer.
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Veiga LHS, Neta G, Aschebrook-Kilfoy B, Ron E, Devesa SS. Thyroid cancer incidence patterns in Sao Paulo, Brazil, and the U.S. SEER program, 1997-2008. Thyroid 2013; 23:748-57. [PMID: 23410185 PMCID: PMC3675840 DOI: 10.1089/thy.2012.0532] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Thyroid cancer incidence has risen steadily over the last few decades in most of the developed world, but information on incidence trends in developing countries is limited. Sao Paulo, Brazil, has one of the highest rates of thyroid cancer worldwide, higher than in the United States. We examined thyroid cancer incidence patterns using data from the Sao Paulo Cancer Registry (SPCR) in Brazil and the National Cancer Institute's Surveillance Epidemiology End Results (SEER) program in the United States. METHODS Data on thyroid cancer cases diagnosed during 1997-2008 were obtained from SPCR (n=15,892) and SEER (n=42,717). Age-adjusted and age-specific rates were calculated by sex and histology and temporal patterns were compared between the two populations. RESULTS Overall incidence rates increased over time in both populations and were higher in Sao Paulo than in the United States among females (SPCR/SEER incidence rate ratio [IRR]=1.65) and males (IRR=1.23). Papillary was the most common histology in both populations, followed by follicular and medullary carcinomas. Incidence rates by histology were consistently higher in Sao Paulo than in the United States, with the greatest differences for follicular (IRR=2.44) and medullary (IRR=3.29) carcinomas among females. The overall female/male IRR was higher in Sao Paulo (IRR=4.17) than in SEER (IRR=3.10) and did not change over time. Papillary rates rose over time more rapidly in Sao Paulo (annual percentage change=10.3% among females and 9.6% among males) than in the United States (6.9% and 5.7%, respectively). Regardless of sex, rates rose faster among younger people (<50 years) in Sao Paulo, but among older people (≥50 years) in the United States. The papillary to follicular carcinoma ratio rose from <3 to >8 among both Sao Paulo males and females, in contrast to increases from 9 to 12 and from 6 to 7 among U.S.males and females, respectively. CONCLUSIONS Increased diagnostic activity may be contributing to the notable rise in incidence, mainly for papillary type, in both populations, but it is not likely to be the only reason. Differences in iodine nutrition status between Sao Paulo and the U.S. SEER population might have affected the observed incidence patterns.
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Affiliation(s)
- Lene H S Veiga
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Rio de Janeiro, Brazil.
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49
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50
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Ito Y, Nikiforov YE, Schlumberger M, Vigneri R. Increasing incidence of thyroid cancer: controversies explored. Nat Rev Endocrinol 2013; 9:178-84. [PMID: 23358352 DOI: 10.1038/nrendo.2012.257] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Thyroid cancer is the most common endocrine malignancy and its incidence has been increasing considerably in the past few decades. Many studies have been published providing evidence for this increase; however, why thyroid cancer incidence keeps rising is still debated and there are conflicting reports of factors leading to the increase in its incidence. In this article, Nature Reviews Endocrinology asks four experts their opinions on some of the controversies surrounding the changing trends in thyroid cancer incidence.
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Affiliation(s)
- Yasuhiro Ito
- Department of Surgery, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan. ito01@kuma h.or.jp
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