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de Vathaire F, Zidane M, Xhaard C, Souchard V, Chevillard S, Ory C, Rachédi F, Nunez S, Leufroy A, Noël L, Guérin T, Shan L, Bost-Bezeaud F, Petitdier P, Soubiran G, Allodji R, Ren Y, Doyon F, Taquet M, Gardon J, Bouville A, Drozdovitch V. Assessment of Differentiated Thyroid Carcinomas in French Polynesia After Atmospheric Nuclear Tests Performed by France. JAMA Netw Open 2023; 6:e2311908. [PMID: 37145599 PMCID: PMC10163383 DOI: 10.1001/jamanetworkopen.2023.11908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Importance Due to the amount of iodine 131 released in nuclear tests and its active uptake by the thyroid, differentiated thyroid carcinoma (DTC) is the most serious health risk for the population living near sites of nuclear tests. Whether low doses to the thyroid from nuclear fallout are associated with increased risk of thyroid cancer remains a controversial issue in medicine and public health, and a misunderstanding of this issue may be associated with overdiagnosis of DTCs. Design, Setting, and Participants This case-control study was conducted by extending a case-control study published in 2010 that included DTCs diagnosed between 1984 and 2003 by adding DTCs diagnosed between 2004 and 2016 and improving the dose assessment methodology. Data on 41 atmospheric nuclear tests conducted by France between 1966 and 1974 in French Polynesia (FP) were assessed from original internal radiation-protection reports, which the French military declassified in 2013 and which included measurements in soil, air, water, milk, and food in all FP archipelagos. These original reports led to an upward reassessment of the nuclear fallout from the tests and a doubling of estimates of the mean thyroid radiation dose received by inhabitants from 2 mGy to nearly 5 mGy. Included patients were diagnosed from 1984 to 2016 with DTC at age 55 years or younger and were born in and resided in FP at diagnosis; 395 of 457 eligible cases were included, and up to 2 controls per case nearest by birthdate and matched on sex were identified from the FP birth registry. Data were analyzed from March 2019 through October 2021. Exposure The radiation dose to the thyroid gland was estimated using recently declassified original radiation-protection service reports, meteorological reports, self-reported lifestyle information, and group interviews of key informants and female individuals who had children at the time of these tests. Main Outcomes and Measures The lifetime risk of DTC based on Biological Effects of Ionizing Radiation (BEIR) VII models was estimated. Results A total of 395 DTC cases (336 females [85.1%]; mean [SD] age at end of follow-up, 43.6 [12.9] years) and 555 controls (473 females [85.2%]; mean [SD] age at end of follow-up, 42.3 [12.5] years) were included. No association was found between thyroid radiation dose received before age 15 years and risk of DTC (excess relative risk [ERR] per milligray, 0.04; 95% CI, -0.09 to 0.17; P = .27). When excluding unifocal noninvasive microcarcinomas, the dose response was significant (ERR per milligray, 0.09; 95% CI, -0.03 to 0.02; P = .02), but several incoherencies with the results of the initial study reduce the credibility of this result. The lifetime risk for the entire FP population was 29 cases of DTC (95% CI, 8-97 cases), or 2.3% (95% CI, 0.6%-7.7%) of 1524 sporadic DTC cases in this population. Conclusions and Relevance This case-control study found that French nuclear tests were associated with an increase in lifetime risk of PTC in FP residents of 29 cases of PTC. This finding suggests that the number of thyroid cancer cases and the true order of magnitude of health outcomes associated with these nuclear tests were small, which may reassure populations of this Pacific territory.
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Affiliation(s)
- Florent de Vathaire
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Monia Zidane
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Constance Xhaard
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
- Now with University of Lorraine, Institut National de la Santé et de la Recherche Médicale, CIC 1433, Nancy, Centre HospitalierRegional Universitaire, U1116, Nancy, France
| | - Vincent Souchard
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Sylvie Chevillard
- Laboratoire de recherche sur la Réparation et la Transcription dans les Cellules Souches Hématopoïétiques, Institut de Biologie François Jacob, Institut de Recherche en Cancérologie de Montpellier, Direction de la Recherche Fondamentale, Commissariat à l'Énergie Atomique, 92265 Fontenay-aux-Roses Cedex, France
| | - Catherine Ory
- Laboratoire de recherche sur la Réparation et la Transcription dans les Cellules Souches Hématopoïétiques, Institut de Biologie François Jacob, Institut de Recherche en Cancérologie de Montpellier, Direction de la Recherche Fondamentale, Commissariat à l'Énergie Atomique, 92265 Fontenay-aux-Roses Cedex, France
- University Paris-Saclay, 92265 Fontenay-aux-Roses Cedex, France
| | - Frédérique Rachédi
- Endocrinology Unit, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Sébastien Nunez
- Endocrinology Unit, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Axelle Leufroy
- Agence Nationale Sécurité Sanitaire Alimentaire Nationale, Laboratory for Food Safety, F94700 Maisons-Alfort, France
| | - Laurent Noël
- French Directorate General for Food, Ministry of Agriculture, Agro-16 Food and Forestry, Paris, France
| | - Thierry Guérin
- Agence Nationale Sécurité Sanitaire Alimentaire Nationale, Strategy and Programmes Department, Maisons-Alfort, France
| | - Larys Shan
- Private practice, Tahiti, French Polynesia
| | - Frédérique Bost-Bezeaud
- Laboratory of Anatomy and Cytopathology, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Patrice Petitdier
- Laboratory of Anatomy and Cytopathology, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Gilles Soubiran
- Endocrinology Unit, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Rodrigue Allodji
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Yan Ren
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Françoise Doyon
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
| | - Marc Taquet
- Research Institute for Development, Arue, Tahiti, French Polynesia
| | - Jacques Gardon
- HydroSciences Montpellier, Univ Montpellier, Research Institute for Development, Centre National de la Recherche Scientifique, Montpellier, France
| | - André Bouville
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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Shihabi AN, Hussein M, Toraih EA, Attia AS, Youssef MR, Elnahla A, Omar M, Shama M, Corsetti R, Kandil E. Accuracy of the 'CUT' Score for Assessing Malignancy in Bethesda 3 and 4 Thyroid Nodules in North American population: a retrospective study. Cancer Invest 2022; 40:693-699. [PMID: 35549502 DOI: 10.1080/07357907.2022.2077956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND The CUT score is a thyroid nodule malignancy risk assessment scoring system intended to guide surgeons in treating Bethesda 3 and 4 thyroid nodules. It is based on clinical (C) and ultrasonographic (U) features and a five-tiered (T) representing cytology. PURPOSE Our study aimed to assess the utility of the CUT score in predicting thyroid malignancy in the North American population. The main reason for creating this score is to reduce unnecessary surgeries on these challenging thyroid nodules. MATERIALS AND METHODS A retrospective record review study applied the CUT score to 219 Bethesda 3 and 4 thyroid nodules. A total of 203 Bethesda 3 and 16 Bethesda 4 nodules from patients treated between January 2015 and December 2019 at a single institution were assessed. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the CUT diagnostic test. Binary logistic regression analysis was performed. Iteration of analysis was performed after stratification according to body mass index to assess CUT score accuracy in obese and non-obese patients. RESULTS Of 219 nodules analyzed, 148 were characterized as benign and 71 as malignant. Prevalence rates of malignancy were 29.6% (n = 60) and 68.8% (n = 11) in Bethesda 3 and 4 nodules, respectively. The mean CU (clinical, ultrasonography) score was 5.35 ± 1.38 in benign nodules versus 4.96 ± 1.5 in malignant nodules (p = 0.08). The area under the curve (AUC =0.433) for the association of CUT scores with nodule malignancy was not significant (p = 0.13). The CUT score was insignificant as a diagnostic test for nodule malignancy in obese (AUC =0.45; p = 0.72) and non-obese patients (AUC =0.39; p = 0.08). CONCLUSION The CUT score did not correlate with preoperative malignancy risk estimates in Bethesda 3 thyroid nodules and, therefore, may have limited utility as a predictor of malignancy in these thyroid nodules.
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Affiliation(s)
- Areej N Shihabi
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Mohammad Hussein
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Eman A Toraih
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA.,Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Abdallah S Attia
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Mohanad R Youssef
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Ahmed Elnahla
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Mahmoud Omar
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Mohamed Shama
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Ralph Corsetti
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
| | - Emad Kandil
- Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, 70112, USA
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Truong T, Lesueur F, Sugier PE, Guibon J, Xhaard C, Karimi M, Kulkarni O, Lucotte EA, Bacq-Daian D, Boland-Auge A, Mulot C, Laurent-Puig P, Schvartz C, Guizard AV, Ren Y, Adjadj E, Rachédi F, Borson-Chazot F, Ortiz RM, Lence-Anta JJ, Pereda CM, Comiskey DF, He H, Liyanarachchi S, de la Chapelle A, Elisei R, Gemignani F, Thomsen H, Forsti A, Herzig AF, Leutenegger AL, Rubino C, Ostroumova E, Kesminiene A, Boutron-Ruault MC, Deleuze JF, Guénel P, de Vathaire F. Multiethnic genome-wide association study of differentiated thyroid cancer in the EPITHYR consortium. Int J Cancer 2021; 148:2935-2946. [PMID: 33527407 DOI: 10.1002/ijc.33488] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/17/2020] [Accepted: 01/11/2021] [Indexed: 02/05/2023]
Abstract
Incidence of differentiated thyroid carcinoma (DTC) varies considerably between ethnic groups, with particularly high incidence rates in Pacific Islanders. DTC is one of the cancers with the highest familial risk suggesting a major role of genetic risk factors, but only few susceptibility loci were identified so far. In order to assess the contribution of known DTC susceptibility loci and to identify new ones, we conducted a multiethnic genome-wide association study (GWAS) in individuals of European ancestry and of Oceanian ancestry from Pacific Islands. Our study included 1554 cases/1973 controls of European ancestry and 301 cases/348 controls of Oceanian ancestry from seven population-based case-control studies participating to the EPITHYR consortium. All participants were genotyped using the OncoArray-500K Beadchip (Illumina). We confirmed the association with the known DTC susceptibility loci at 2q35, 8p12, 9q22.33 and 14q13.3 in the European ancestry population and suggested two novel signals at 1p31.3 and 16q23.2, which were associated with thyroid-stimulating hormone levels in previous GWAS. We additionally replicated an association with 5p15.33 reported previously in Chinese and European populations. Except at 1p31.3, all associations were in the same direction in the population of Oceanian ancestry. We also observed that the frequencies of risk alleles at 2q35, 5p15.33 and 16q23.2 were significantly higher in Oceanians than in Europeans. However, additional GWAS and epidemiological studies in Oceanian populations are needed to fully understand the highest incidence observed in these populations.
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Affiliation(s)
- Thérèse Truong
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Fabienne Lesueur
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Pierre-Emmanuel Sugier
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Julie Guibon
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Constance Xhaard
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
- University of Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, FCRIN, INI-CRCT, Nancy, France
| | - Mojgan Karimi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Om Kulkarni
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Elise A Lucotte
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Delphine Bacq-Daian
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Anne Boland-Auge
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Claire Mulot
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Claire Schvartz
- Registre des Cancers Thyroïdiens, Institut GODINOT, Reims, France
| | - Anne-Valérie Guizard
- Registre Général des tumeurs du Calvados, Centre François Baclesse, Caen, France
- Inserm U1086 -UCN "ANTICIPE", Caen, France
| | - Yan Ren
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
| | - Elisabeth Adjadj
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
| | - Frédérique Rachédi
- Endocrinology Unit, Territorial Hospital Taaone, Papeete, Tahiti, French Polynesia
| | - Francoise Borson-Chazot
- Fédération d'endocrinologie, Hôpital Louis Pradel, Hospices Civils de Lyon, EA 7425, Université Lyon 1, Lyon, France
| | | | | | | | - Daniel F Comiskey
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Huiling He
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Sandya Liyanarachchi
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Albert de la Chapelle
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | | | | | - Hauke Thomsen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- GeneWerk GmbH, Heidelberg, Germany
| | - Asta Forsti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Anthony F Herzig
- Inserm, U1078, GGB, Université de Bretagne Occidentale, EFS, Brest, France
| | | | - Carole Rubino
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
| | | | | | | | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Pascal Guénel
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Florent de Vathaire
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
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Kulkarni O, Sugier PE, Guibon J, Boland-Augé A, Lonjou C, Bacq-Daian D, Olaso R, Rubino C, Souchard V, Rachedi F, Lence-Anta JJ, Ortiz RM, Xhaard C, Laurent-Puig P, Mulot C, Guizard AV, Schvartz C, Boutron-Ruault MC, Ostroumova E, Kesminiene A, Deleuze JF, Guénel P, De Vathaire F, Truong T, Lesueur F. Gene network and biological pathways associated with susceptibility to differentiated thyroid carcinoma. Sci Rep 2021; 11:8932. [PMID: 33903625 PMCID: PMC8076215 DOI: 10.1038/s41598-021-88253-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/09/2021] [Indexed: 12/11/2022] Open
Abstract
Variants identified in earlier genome-wide association studies (GWAS) on differentiated thyroid carcinoma (DTC) explain about 10% of the overall estimated genetic contribution and could not provide complete insights into biological mechanisms involved in DTC susceptibility. Integrating systems biology information from model organisms, genome-wide expression data from tumor and matched normal tissue and GWAS data could help identifying DTC-associated genes, and pathways or functional networks in which they are involved. We performed data mining of GWAS data of the EPITHYR consortium (1551 cases and 1957 controls) using various pathways and protein-protein interaction (PPI) annotation databases and gene expression data from The Cancer Genome Atlas. We identified eight DTC-associated genes at known loci 2q35 (DIRC3), 8p12 (NRG1), 9q22 (FOXE1, TRMO, HEMGN, ANP32B, NANS) and 14q13 (MBIP). Using the EW_dmGWAS approach we found that gene networks related to glycogenolysis, glycogen metabolism, insulin metabolism and signal transduction pathways associated with muscle contraction were overrepresented with association signals (false discovery rate adjusted p-value < 0.05). Additionally, suggestive association of 21 KEGG and 75 REACTOME pathways with DTC indicate a link between DTC susceptibility and functions related to metabolism of cholesterol, amino sugar and nucleotide sugar metabolism, steroid biosynthesis, and downregulation of ERBB2 signaling pathways. Together, our results provide novel insights into biological mechanisms contributing to DTC risk.
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Affiliation(s)
- Om Kulkarni
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, 75248, Paris, France
| | | | - Julie Guibon
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, 75248, Paris, France
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
| | - Anne Boland-Augé
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | - Christine Lonjou
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, 75248, Paris, France
| | - Delphine Bacq-Daian
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | - Robert Olaso
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | - Carole Rubino
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
| | - Vincent Souchard
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
| | - Frédérique Rachedi
- Centre Hospitalier Territorial de Polynésie Française, CHTPF, Pirae, Tahiti, 98713, Papeete, French Polynesia
| | | | - Rosa Maria Ortiz
- Instituto Nacional de Oncologia y de Radiobiologia, INOR, La Havana, Cuba
| | - Constance Xhaard
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
- University of Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, FCRIN, INI-CRCT, 54000, Nancy, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, 75006, Paris, France
| | - Claire Mulot
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, 75006, Paris, France
| | - Anne-Valérie Guizard
- Registre Général des Tumeurs du Calvados, Centre François Baclesse, 14000, Caen, France
- Inserm U1086-UCNB, Cancers and Prevention, 14000, Caen, France
| | - Claire Schvartz
- Registre des Cancers Thyroïdiens, Institut Jean Godinot, 51100, Reims, France
| | | | - Evgenia Ostroumova
- Environment and Radiation Section, International Agency for Research on Cancer, 69008, Lyon, France
| | - Ausrele Kesminiene
- Environment and Radiation Section, International Agency for Research on Cancer, 69008, Lyon, France
| | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | - Pascal Guénel
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
| | - Florent De Vathaire
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
| | - Thérèse Truong
- Université Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, 94807, Villejuif, France
| | - Fabienne Lesueur
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, 75248, Paris, France.
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Zhou Y, Yang Y, Zhou T, Li B, Wang Z. Adiponectin and Thyroid Cancer: Insight into the Association between Adiponectin and Obesity. Aging Dis 2021; 12:597-613. [PMID: 33815885 PMCID: PMC7990371 DOI: 10.14336/ad.2020.0919] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/13/2020] [Indexed: 12/14/2022] Open
Abstract
In recent decades, the incidence and diagnosis of thyroid cancer have risen dramatically, and thyroid cancer has now become the most common endocrine cancer in the world. The onset of thyroid cancer is insidious, and its progression is slow and difficult to detect. Therefore, early prevention and treatment have important strategic significance. Moreover, an in-depth exploration of the pathogenesis of thyroid cancer is key to early prevention and treatment. Substantial evidence supports obesity as an independent risk factor for thyroid cancer. Adipose tissue dysfunction in the obese state is accompanied by dysregulation of a variety of adipocytokines. Adiponectin (APN) is one of the most pivotal adipocytokines, and its connection with obesity and obesity-related disease has gradually become a hot topic in research. Recently, the association between APN and thyroid cancer has received increasing attention. The purpose of this review is to systematically review previous studies, give prominence to APN, focus on the relationship between APN, obesity and thyroid cancer, and uncover the underlying pathogenic mechanisms.
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Affiliation(s)
- Yuanyuan Zhou
- 1Department of Endocrinology and Metabolism, The Second People's Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, China.,2Department of Endocrinology and Metabolism, Sixth Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, China
| | - Ying Yang
- 1Department of Endocrinology and Metabolism, The Second People's Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Taicheng Zhou
- 1Department of Endocrinology and Metabolism, The Second People's Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bai Li
- 3School of Medicine, Yunnan University, Kunming, China
| | - Zhanjian Wang
- 4Department of Endocrinology and Metabolism, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Guibon J, Sugier PE, Kulkarni O, Karimi M, Bacq-Daian D, Besse C, Boland A, Adjadj E, Rachédi F, Rubino C, Xhaard C, Mulot C, Laurent-Puig P, Guizard AV, Schvartz C, Ortiz RM, Ren Y, Ostroumova E, Deleuze JF, Boutron-Ruault MC, Kesminiene A, De Vathaire F, Guénel P, Lesueur F, Truong T. Fine-mapping of two differentiated thyroid carcinoma susceptibility loci at 2q35 and 8p12 in Europeans, Melanesians and Polynesians. Oncotarget 2021; 12:493-506. [PMID: 33747362 PMCID: PMC7939525 DOI: 10.18632/oncotarget.27888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/26/2021] [Indexed: 01/06/2023] Open
Abstract
Differentiated thyroid carcinoma (DTC) incidence is characterized by wide ethnic and geographic variations, with high incidence rates observed in Oceanian populations. Genome-wide association studies (GWAS) identified mainly four DTC susceptibility loci at 9q22.33, 14q13.3, 2q35 and 8p12. Here we performed fine-mapping of the 2q35 and 8p12 loci in the population of the EPITHYR consortium that includes Europeans, Melanesians and Polynesians to identify likely causal variants for DTC risk. We conducted a colocalization analysis using eQTLs data to determine the SNPs with the highest probability of causality. At 2q35, we highlighted rs16857609 located in DIRC3. This SNP has a high probability of causality in the three populations, and a significant association in Europeans (OR = 1.4, p = 1.9 x 10-10). It is also associated with expression of DIRC3 and of the nearby gene IGFBP5 in thyroid tumour cells. At 8p12, we identified rs7844425 which was significantly associated with DTC in Europeans (OR = 1.32, p = 7.6 x 10-8) and rs2439304, which was highlighted by the colocalization analysis but only moderately associated with DTC in our dataset (OR = 1.2, p = 0.001). These SNPs are linked to the expression of NRG1 in thyroid tissue. Hence, our study identified novel variants at 2q35 and 8p12 to be prioritized for further functional studies.
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Affiliation(s)
- Julie Guibon
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Exposome and Heredity Team, Villejuif, France
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Pierre-Emmanuel Sugier
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Exposome and Heredity Team, Villejuif, France
| | - Om Kulkarni
- University Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Mojgan Karimi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Exposome and Heredity Team, Villejuif, France
| | - Delphine Bacq-Daian
- University Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Céline Besse
- University Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Anne Boland
- University Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Elisabeth Adjadj
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Epidemiology of Radiations Team, Villejuif, France
| | - Frédérique Rachédi
- Endocrinology Unit, Territorial Hospital Taaone, Papeete, French Polynesia
| | - Carole Rubino
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Epidemiology of Radiations Team, Villejuif, France
| | - Constance Xhaard
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Epidemiology of Radiations Team, Villejuif, France
- University of Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, FCRIN, INI-CRCT, Nancy, France
| | - Claire Mulot
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Pierre Laurent-Puig
- 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
- Inserm U1086 -UCN "ANTICIPE", Caen, France
| | - Claire Schvartz
- Registre des Cancers Thyroïdiens, Institut Godinot, Reims, France
| | | | - Yan Ren
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Epidemiology of Radiations Team, Villejuif, France
| | | | - Jean-François Deleuze
- University Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | | | | | - Florent De Vathaire
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Epidemiology of Radiations Team, Villejuif, France
| | - Pascal Guénel
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Exposome and Heredity Team, Villejuif, France
| | - Fabienne Lesueur
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
- These authors contributed equally to this work
| | - Thérèse Truong
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Exposome and Heredity Team, Villejuif, France
- These authors contributed equally to this work
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7
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Youssef MR, Reisner ASC, Attia AS, Hussein MH, Omar M, LaRussa A, Galvani CA, Aboueisha M, Abdelgawad M, Toraih EA, Randolph GW, Kandil E. Obesity and the prevention of thyroid cancer: Impact of body mass index and weight change on developing thyroid cancer - Pooled results of 24 million cohorts. Oral Oncol 2020; 112:105085. [PMID: 33171329 DOI: 10.1016/j.oraloncology.2020.105085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Body weight may be a modifiable risk factor predisposing to different cancers. To establish a potential impact of weight change on thyroid cancer risk, we conducted a meta-analysis to evaluate the effect of body mass index (BMI) and weight change over time as a risk of developing thyroid cancer (TC). METHODS A systematic search was performed up to February 25, 2020. Pooled relative risk (RR) were estimated using fixed and random models. Heterogeneity between articles was examined using Q-test and I2 index. Evaluation of publication bias was conducted with Egger's regression test. RESULTS A total of 31 studies including 24,489,477 cohorts were eligible. Pooled analysis revealed that normal and underweight cohorts were associated with a decreased risk of TC (RR = 0.68, 95%CI = 0.65-0.71, p < 0.001) and (RR = 0.92, 95%CI = 0.91-0.93, p < 0.001), respectively. In contrast, overweight and obese cohorts were more likely to develop TC (RR = 1.26, 95%CI = 1.24-1.28, p < 0.001 and RR = 1.50, 95%CI = 1.45-1.55, p < 0.001, respectively). Obesity was associated with higher risk of developing TC among women (RR = 1.29, 95%CI = 1.14-1.46, p < 0.001), but not men (RR = 1.25, 95%CI = 0.97-1.62, p = 0.08). Furthermore, weight gain increased the risk of developing TC (RR = 1.18, 95%CI = 1.14-1.22, p < 0.001), while weight loss decreased the risk (RR = 0.89, 95%CI = 0.85-0.93, p < 0.001). Results showed similar trends of weight change effect in both males and females. CONCLUSIONS Obesity is associated with higher risk of developing TC in women. However, maintaining a healthy weight is associated with reduced risk of TC in both women and men. Shifting our practice to include weight control strategies will help lead to cancer prevention.
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Affiliation(s)
- Mohanad R Youssef
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | | | - Abdallah S Attia
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | | | - Mahmoud Omar
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | - Anna LaRussa
- Tulane University, School of Medicine, New Orleans, LA, USA
| | - Carlos A Galvani
- Division of Minimally Invasive Surgery and Bariatric, Department of Surgery, Tulane University, New Orleans, LA 70112, USA
| | - Mohamed Aboueisha
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA
| | - Mohamed Abdelgawad
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA; Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Eman Ali Toraih
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA
| | - Emad Kandil
- Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
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8
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Barrea L, Gallo M, Ruggeri RM, Giacinto PD, Sesti F, Prinzi N, Adinolfi V, Barucca V, Renzelli V, Muscogiuri G, Colao A, Baldelli R. Nutritional status and follicular-derived thyroid cancer: An update. Crit Rev Food Sci Nutr 2020; 61:25-59. [PMID: 31997660 DOI: 10.1080/10408398.2020.1714542] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The incidence of differentiated thyroid cancer has been increasing in the last decades all over the world. Such a steady growth cannot be entirely attributable to more intensive thyroid nodule screening and more sensitive diagnostic procedures. Several environmental factors have changed with sufficient rapidity in the same time frame and may represent credible candidates for this increase. They include modified iodine intake, lifestyle-associated risk factors, exposure to various toxic compounds, pollutants and xenobiotics, nutritional deficiencies, eating habits and comorbidities. Foremost, nutritional patterns have gained high interest as possible promoters and modifiable risk factors for thyroid cancer in recent years. The aim of this narrative review is to focus on the relationship between thyroid cancer and nutritional factors, dietary habits and obesity. Low iodine intake has been associated to increased risk of thyroid cancer, favoring the development of more aggressive histotypes. Moreover, correction of iodine deficiency can shift thyroid cancer subtypes toward less aggressive forms, without affecting the overall risk for cancer. Actually, evidence regarding the association between selenium and vitamin D deficiency and thyroid cancer is very limited, despite their well-known anti-cancer potentials, and the clinical usefulness of their supplementation is still uncertain in this setting. Albeit the relationship between single foods and thyroid cancer is difficult to examine, fish and iodine-rich foods, vegetables, and fruits might exert protective effects on thyroid cancer risk. Conversely, no clear association has been found for other foods to date. Lastly, a clear association between obesity and the risk of thyroid cancer, with more aggressive behavior, seems to emerge from most studies, likely involving variations in thyroid function and chronic inflammation mediated by cytokines, insulin, leptin and adiponectins. Although no definite association between dietary factors and thyroid cancer has been firmly established so far, some nutritional patterns, together with excessive weight, seem to play a relevant role in thyroid cancer carcinogenesis as well as in its severity and aggressiveness. These effects may play an additive role to the well-established one exerted by environmental carcinogens, such as pollutants and radiation exposure.
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Affiliation(s)
- Luigi Barrea
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosaria Maddalena Ruggeri
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paola Di Giacinto
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo-Forlanini, Rome, Italy
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Natalie Prinzi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Valerio Adinolfi
- Endocrinology and Diabetology Unit, ASL Verbano Cusio Ossola, Domodossola, Italy
| | - Viola Barucca
- Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Valerio Renzelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanna Muscogiuri
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Roberto Baldelli
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo-Forlanini, Rome, Italy
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9
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Zupunski L, Ostroumova E, Drozdovitch V, Veyalkin I, Ivanov V, Yamashita S, Cardis E, Kesminiene A. Thyroid Cancer after Exposure to Radioiodine in Childhood and Adolescence: 131I-Related Risk and the Role of Selected Host and Environmental Factors. Cancers (Basel) 2019; 11:E1481. [PMID: 31581656 PMCID: PMC6826556 DOI: 10.3390/cancers11101481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/20/2019] [Accepted: 09/29/2019] [Indexed: 11/24/2022] Open
Abstract
In this study, we expanded on a previously published population-based case-control study on subjects exposed to iodine-131 (131I) from Chernobyl fallout at age ≤18 years using improved individual 131I absorbed thyroid doses. We further studied the impact of iodine deficiency and other selected host risk factors on 131I-related thyroid cancer risk after childhood exposure. We included 298 thyroid cancer cases and 1934 matched controls from the most contaminated regions of Belarus and the Russian Federation. We performed statistical analysis using conditional logistic regression models. We found a statistically significant linear quadratic dose-effect association between thyroid cancer and 131I thyroid dose in the range up to 5 grays (Gy). Self-reported personal history of benign nodules, any thyroid disease except thyroid cancer, family history of thyroid cancer, increased body mass index, and deficient stable iodine status at the time of the accident were statistically significant risk factors (p < 0.05 for each factor) for thyroid cancer after adjustment for thyroid 131I dose effect. Subjects who received stable iodine supplementation in the years after the accident had a significantly lower 131I-related risk of thyroid cancer. Our findings are important for thyroid cancer prevention, and for further improvement of medical surveillance in the affected populations.
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Affiliation(s)
- Ljubica Zupunski
- Section of Environment and Radiation, International Agency for Research on Cancer, WHO, 69372 Lyon, France; (E.O.); (A.K.)
| | - Evgenia Ostroumova
- Section of Environment and Radiation, International Agency for Research on Cancer, WHO, 69372 Lyon, France; (E.O.); (A.K.)
| | - Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, U.S. DHHS, Bethesda, MD 20892, USA;
| | - Ilya Veyalkin
- The Republican Research Centre for Radiation Medicine and Human Ecology, 246040 Gomel, Republic of Belarus;
| | - Viktor Ivanov
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk, 249036 Kaluga Region, Russia;
| | | | - Elisabeth Cardis
- ISGlobal-Barcelona Institute for Global Health, 08003 Barcelona, Spain;
| | - Ausrele Kesminiene
- Section of Environment and Radiation, International Agency for Research on Cancer, WHO, 69372 Lyon, France; (E.O.); (A.K.)
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10
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Bhattacharjee S, Khobrani M, Alrabiah Z, Bilal J, Riaz IB. Healthcare expenditures among community-dwelling adults with thyroid cancer in the United States: A propensity score matched analysis. Heliyon 2019; 5:e01995. [PMID: 31297464 PMCID: PMC6597889 DOI: 10.1016/j.heliyon.2019.e01995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 04/08/2019] [Accepted: 06/19/2019] [Indexed: 11/28/2022] Open
Abstract
Objective This study assessed the excess healthcare expenditures and factors associated with it among community-dwelling adults with thyroid cancer compared to non-cancer controls in the United States. Method A retrospective, cross-sectional, matched case-control study design was used by pooling multiple years of Medical Expenditure Panel Survey (MEPS) data (2002–2012). The eligible study sample comprised of adults (age ≥18 years), who were alive during the calendar year and reported positive healthcare expenditure. The case group consisted of adults with thyroid cancer only while the control group consisted of adults who did not have any form of cancer. Total and subtypes of mean annual healthcare expenditures comprised the main study outcome. We also calculated the total and subtypes of out-of-pocket (OOP) expenditures as well as OOP as a percentage of household income. Ordinary Least Square (OLS) regressions on log-transformed expenditures were conducted to elucidate the influence of different factors on healthcare expenditures among adults with thyroid cancer. Results The yearly average total healthcare expenditures among adults with thyroid cancer was significantly higher compared to propensity score matched controls ($9,585 vs. $5,830, p < 0.001). Similar observations were found in terms of inpatient, and outpatient expenditures. Functional status as well as comorbid conditions were significantly associated with excess expenditures. The yearly average total OOP expenditure for adults with thyroid cancer was significantly higher compared to matched controls ($1,425 vs. $974, p < 0.001), with major differences observed in inpatient OOP ($178 vs. $24, p = 0.003), outpatient OOP ($435vs. $256, p < 0.001), and prescription OOP ($554 vs. $423, p < 0.001) expenditures. There was a significant (p < 0.001) difference between the average OOP as a percentage of household income between adults with thyroid cancer (Mean: 7.54%, S.E: 1.52%) and matched controls (Mean: 5.80%, S.E: 0.47%). Conclusions Our findings suggest that holistic care approach could be helpful to significantly reduce the economic burden in this population. Viable strategies such as limits on OOP costs are required to minimize this high OOP burden among cancer survivors and their families.
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Affiliation(s)
- Sandipan Bhattacharjee
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA
| | - Moteb Khobrani
- Health Outcomes & PharmacoEconomic Research (HOPE) Center, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Ziyad Alrabiah
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Jawad Bilal
- Department of Internal Medicine, The University of Arizona, Tucson, AZ, USA
| | - Irbaz Bin Riaz
- Department of Internal Medicine, The University of Arizona, Tucson, AZ, USA
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11
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Hidayat K, Du X, Shi BM. Body fatness at a young age and risks of eight types of cancer: systematic review and meta-analysis of observational studies. Obes Rev 2018; 19:1385-1394. [PMID: 30047231 DOI: 10.1111/obr.12705] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/13/2018] [Accepted: 04/15/2018] [Indexed: 12/13/2022]
Abstract
The associations between body fatness at a young age (childhood, adolescence and young adulthood; age ≤ 30 years) and diffuse large B-cell lymphoma (DLBCL), oesophageal adenocarcinoma, gastric cardia cancer, hepatocellular carcinoma, multiple myeloma, pancreatic cancer, renal cell cancer and thyroid cancer remain inconclusive. We performed a comprehensive systematic literature review and meta-analysis of observational studies to clarify the associations between body fatness at a young age and the risks of these cancers. PubMed and Web of Science databases were searched for relevant observational studies. Fifty-six articles yielded data on 27,559 cancer cases, including 3,170 DLBCL, 1,491 oesophageal adenocarcinoma, 1,103 gastric cardia cancer, 1,067 hepatocellular carcinoma, 3,090 multiple myeloma, 7,220 pancreatic cancer, 6,212 renal cell cancer and 4,206 thyroid cancer cases. Each 5 kg m-2 increase in body mass index at a young age was positively associated with DLBCL (relative risk [RR] 1.21, 95% confidence interval [CI] 1.09, 1.35), oesophageal adenocarcinoma (RR 1.88, 95% CI 1.37, 2.57), gastric cardia cancer (RR 1.59, 95% CI 1.15, 2.21), hepatocellular carcinoma (RR 1.31, 95% CI 1.13, 1.51), multiple myeloma (RR 1.23, 95% CI 1.15, 1.30), pancreatic cancer (RR 1.17, 95% CI 1.11, 1.24), renal cell cancer (RR 1.22, 95% CI 1.16, 1.28) and thyroid cancer (RR 1.12, 95% CI 1.07, 1.17). In summary, higher body fatness at a young age increases the risks of developing various types of cancer later in life. Prevention of overweight and obesity in children, adolescents and young adults should therefore be emphasized to reverse the obesity epidemic and thereby avoid further increases in the burden of cancer attributed to excess body fatness.
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Affiliation(s)
- K Hidayat
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - X Du
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - B-M Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
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12
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Yin DT, He H, Yu K, Xie J, Lei M, Ma R, Li H, Wang Y, Liu Z. The association between thyroid cancer and insulin resistance, metabolic syndrome and its components: A systematic review and meta-analysis. Int J Surg 2018; 57:66-75. [PMID: 30081182 DOI: 10.1016/j.ijsu.2018.07.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/15/2018] [Accepted: 07/28/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Thyroid cancer is rapidly increasing in incidence worldwide in the past several decades, same as the incidence of metabolic syndrome. We performed a system review and meta-analysis of the association between metabolic syndrome, its components and insulin resistance and thyroid cancer incidence. METHODS We searched several computer-assisted databases PUBMED, EMBASE and ISI Web of Science to identify studies published before 31st January 2018. Every study must report either risk estimates of thyroid cancer incidence with 95% confidence interval (CI) or related data can speculate. Two investigators independently identified eligible studies and extracted data. Evaluating the summaries of relative risk estimates use both fixed and random effects methods. RESULTS We found 42 articles met the inclusion criteria of this review. There is an increased risk for thyroid cancer for patients with insulin resistance (relative risk [RR] = 1.59, 95%confidence interval [CI] = 1.12-2.27, P = 0.01), dysglycemia (RR = 1.40, 95%CI = 1.15-1.70,P < 0.001), high BMI (RR = 1.35,95%CI = 1.23-1.48,P < 0.001) and hypertension(RR = 1.34,95%CI = 1.22-1.47, p < 0.001). However, patients with dyslipidemia, both total cholesterol (RR = 1.09, 95%CI = 0.98-1.21, P = 0.13) and triglyceride (RR = 1.01, 95%CI = 0.91-1.12, P = 0.82) was not associated with thyroid cancer. CONCLUSIONS Our meta-analysis showed Insulin Resistance, dysglycemia, high BMI and hypertension significantly increased the thyroid cancer risk. These results may help identify people with high risk of thyroid cancer and change to healthy life style.
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Affiliation(s)
- De-Tao Yin
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China.
| | - Huanan He
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China; Department of General Surgery, the First People's Hospital of Pingdingshan, Pingdingshan, 467000, PR China
| | - Kun Yu
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Jing Xie
- Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Mengyuan Lei
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Runsheng Ma
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Hongqiang Li
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Yongfei Wang
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
| | - Zhen Liu
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Key Discipline Laboratory of Clinical Medicine Henan, Zhengzhou, 450052, PR China
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13
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Son H, Lee H, Kang K, Lee I. The risk of thyroid cancer and obesity: A nationwide population-based study using the Korea National Health Insurance Corporation cohort database. Surg Oncol 2018; 27:166-171. [PMID: 29937167 DOI: 10.1016/j.suronc.2018.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/26/2018] [Accepted: 03/15/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In recent years, the incidence of thyroid cancer and obesity has increased rapidly worldwide. Many studies have been conducted on the relationship between thyroid cancer and obesity; however, the potential mechanisms are not well understood, and few studies have been performed in Asia. This study aimed to identify the relationship between the risk of thyroid cancer and obesity in the Korean population based on a large cohort of data. METHOD We analyzed clinical data from a total of 351,402 individuals (males: 181,709, females: 169,693) aged over 20 years who received medical examinations arranged by the national insurance program from 2003 to 2008. Newly diagnosed thyroid cancer was identified using insurance claims data. The median follow-up duration was 7.01 years. RESULTS The mean body mass index (BMI) of the subjects was 23.6 ± 3.2 kg/m2 (males, 24 ± 3; females, 23.1 ± 3.3). A total of 3308 individuals (0.94%) developed thyroid cancer during the study period. The risk of thyroid cancer was higher with increasing BMI in both men and women. Hazard ratios (95% confidence interval) for obese (25-29.9 kg/m2) and extremely obese (≥30 kg/m2) groups were 1.23 (1.13-1.34) and 1.26 (1.02-1.50), respectively, compared to the normal group (18.5-22.9 kg/m2). In particular, the association between the risk of thyroid cancer and BMI was more remarkable in the male group than female group. CONCLUSION Our findings show that higher BMI is positively associated with the risk of thyroid cancer. Furthermore, this study supports the positive association between obesity and the increased incidence of thyroid cancer.
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Affiliation(s)
- Haiyoung Son
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Republic of Korea; Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Hakmin Lee
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Republic of Korea.
| | - Keera Kang
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Republic of Korea.
| | - Ilkyun Lee
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Republic of Korea.
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Yu ST, Chen W, Cai Q, Liang F, Xu D, Han P, Yu J, Huang X. Pretreatment BMI Is Associated with Aggressive Clinicopathological Features of Papillary Thyroid Carcinoma: A Multicenter Study. Int J Endocrinol 2017; 2017:5841942. [PMID: 29085428 PMCID: PMC5632484 DOI: 10.1155/2017/5841942] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/21/2017] [Accepted: 08/10/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of the present study was to analyze the association between pretreatment body mass index (BMI) and the aggressiveness of papillary thyroid carcinoma (PTC) along with its clinical outcomes in a Chinese population with BMI classification for Asians. METHODS A retrospective, observational study was conducted on patients from two teaching hospitals in China. 1622 classical PTC patients were categorized into four groups according to BMI. RESULTS We found that increased BMI was associated with extrathyroidal extension, multifocality, the presence of lymph node (LN) metastasis, and advancing TNM stage in PTC patients. Furthermore, compared to patients with normal weight, those in the overweight and obese group exhibited a significantly increased risk of extrathyroidal extension, multifocality, cervical LN metastasis, and advanced TNM stage. 40 and 37 patients experienced persistent and recurrent disease, respectively. No differences regarding persistent disease or recurrence were observed among the BMI groups. CONCLUSION A higher pretreatment BMI has been strongly associated with aggressive features of PTC according to the BMI classification for Asians. Obesity was not found to be associated with a greater risk of recurrence.
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Affiliation(s)
- Shi-tong Yu
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Wanzhi Chen
- Department of Thyroid Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Qian Cai
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Faya Liang
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Debin Xu
- Department of Thyroid Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Ping Han
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Jichun Yu
- Department of Thyroid Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Xiaoming Huang
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China
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Malaguarnera R, Vella V, Nicolosi ML, Belfiore A. Insulin Resistance: Any Role in the Changing Epidemiology of Thyroid Cancer? Front Endocrinol (Lausanne) 2017; 8:314. [PMID: 29184536 PMCID: PMC5694441 DOI: 10.3389/fendo.2017.00314] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/30/2017] [Indexed: 12/13/2022] Open
Abstract
In the past few decades, the incidence of thyroid cancer (TC), namely of its papillary hystotype (PTC), has shown a steady increase worldwide, which has been attributed at least in part to the increasing diagnosis of early stage tumors. However, some evidence suggests that environmental and lifestyle factors can also play a role. Among the potential risk factors involved in the changing epidemiology of TC, particular attention has been drawn to insulin-resistance and related metabolic disorders, such as obesity, type 2 diabetes, and metabolic syndrome, which have been also rapidly increasing worldwide due to widespread dietary and lifestyle changes. In accordance with this possibility, various epidemiological studies have indeed gathered substantial evidence that insulin resistance-related metabolic disorders might be associated with an increased TC risk either through hyperinsulinemia or by affecting other TC risk factors including iodine deficiency, elevated thyroid stimulating hormone, estrogen-dependent signaling, chronic autoimmune thyroiditis, and others. This review summarizes the current literature evaluating the relationship between metabolic disorders characterized by insulin resistance and the risk for TC as well as the possible underlying mechanisms. The potential implications of such association in TC prevention and therapy are discussed.
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Affiliation(s)
- Roberta Malaguarnera
- Endocrinology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Veronica Vella
- School of Human and Social Sciences, “Kore” University of Enna, Enna, Italy
- *Correspondence: Veronica Vella, ; Antonino Belfiore,
| | - Maria Luisa Nicolosi
- Endocrinology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Antonino Belfiore
- Endocrinology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- *Correspondence: Veronica Vella, ; Antonino Belfiore,
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16
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Rotondi M, Castagna MG, Cappelli C, Ciuoli C, Coperchini F, Chiofalo F, Maino F, Palmitesta P, Chiovato L, Pacini F. Obesity Does Not Modify the Risk of Differentiated Thyroid Cancer in a Cytological Series of Thyroid Nodules. Eur Thyroid J 2016; 5:125-31. [PMID: 27493887 PMCID: PMC4949374 DOI: 10.1159/000445054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/05/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND A possible impact of obesity on the risk of thyroid cancer has been postulated in some studies, but it remains controversial. OBJECTIVE To investigate the association between obesity and differentiated thyroid carcinoma in a population of unselected patients subjected to fine-needle aspiration cytology (FNAC) for thyroid nodules. METHODS We retrospectively evaluated the results of FNAC of thyroid nodules in 4,849 patients (3,809 females and 1,040 males; mean age 55.9 ± 14.1 years). Patients were stratified according to their body mass index (BMI). There were 1,876 (38.7%) normal-weight patients (BMI 18-24.9), 1,758 (36.2%) overweight (BMI 25-29.9), 662 (13.7%) grade 1 obese (BMI 30-34.9), 310 (6.4%) grade 2 obese (BMI 35-39.9) and 243 (5.0%) grade 3 obese (BMI >40). RESULTS The prevalence of suspicious or malignant nodules (Thy4/Thy5) did not differ across the 5 BMI groups, i.e. it was 6.8% in normal-weight patients, 6.3% in overweight patients, 6.3% in grade 1 obese patients, 4.0% in grade 2 obese patients and 4.2% in grade 3 obese patients (p = 0.29). The prevalence of Thy4/Thy5 nodules did not differ when males and females were evaluated separately (p = 0.22 and p = 0.12, respectively). A significant, lower rate of Thy4/5 cytology was observed in female patients with grade 2-3 obesity (odds ratio 0.51; 95% confidence interval 0.284-0.920; p = 0.009). CONCLUSIONS The results of this study, in a retrospective series of patients with thyroid nodules, do not confirm previous findings reporting an association between obesity and differentiated thyroid carcinoma. Thus, obese patients with nodular thyroid disease should be managed the same as normal-weight patients.
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Affiliation(s)
- Mario Rotondi
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., ISPESL Laboratory for Endocrine Disruptors and Chair of Endocrinology, University of Pavia, Pavia, Italy
| | - Maria Grazia Castagna
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Carlo Cappelli
- Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
| | - Cristina Ciuoli
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Francesca Coperchini
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., ISPESL Laboratory for Endocrine Disruptors and Chair of Endocrinology, University of Pavia, Pavia, Italy
| | - Francesco Chiofalo
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Fabio Maino
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Paola Palmitesta
- Departments of Social, Political and Cognitive Sciences, University of Siena, Siena, Italy
| | - Luca Chiovato
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., ISPESL Laboratory for Endocrine Disruptors and Chair of Endocrinology, University of Pavia, Pavia, Italy
| | - Furio Pacini
- Departments of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- *Furio Pacini, MD, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, IT–53100 Siena (Italy), E-Mail
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17
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Kitahara CM, McCullough ML, Franceschi S, Rinaldi S, Wolk A, Neta G, Olov Adami H, Anderson K, Andreotti G, Beane Freeman LE, Bernstein L, Buring JE, Clavel-Chapelon F, De Roo LA, Gao YT, Gaziano JM, Giles GG, Håkansson N, Horn-Ross PL, Kirsh VA, Linet MS, MacInnis RJ, Orsini N, Park Y, Patel AV, Purdue MP, Riboli E, Robien K, Rohan T, Sandler DP, Schairer C, Schneider AB, Sesso HD, Shu XO, Singh PN, van den Brandt PA, Ward E, Weiderpass E, White E, Xiang YB, Zeleniuch-Jacquotte A, Zheng W, Hartge P, Berrington de González A. Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies. Thyroid 2016; 26:306-18. [PMID: 26756356 PMCID: PMC4754509 DOI: 10.1089/thy.2015.0319] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality. METHODS This large pooled analysis of 22 prospective studies (833,176 men and 1,260,871 women) investigated thyroid cancer incidence associated with greater height, BMI at baseline and young adulthood, and adulthood BMI gain (difference between young-adult and baseline BMI), overall and separately by sex and histological subtype using multivariable Cox proportional hazards regression models. Associations with thyroid cancer mortality were investigated in a subset of cohorts (578,922 men and 774,373 women) that contributed cause of death information. RESULTS During follow-up, 2996 incident thyroid cancers and 104 thyroid cancer deaths were identified. All anthropometric factors were positively associated with thyroid cancer incidence: hazard ratios (HR) [confidence intervals (CIs)] for height (per 5 cm) = 1.07 [1.04-1.10], BMI (per 5 kg/m2) = 1.06 [1.02-1.10], waist circumference (per 5 cm) = 1.03 [1.01-1.05], young-adult BMI (per 5 kg/m2) = 1.13 [1.02-1.25], and adulthood BMI gain (per 5 kg/m2) = 1.07 [1.00-1.15]. Associations for baseline BMI and waist circumference were attenuated after mutual adjustment. Baseline BMI was more strongly associated with risk in men compared with women (p = 0.04). Positive associations were observed for papillary, follicular, and anaplastic, but not medullary, thyroid carcinomas. Similar, but stronger, associations were observed for thyroid cancer mortality. CONCLUSION The results suggest that greater height and excess adiposity throughout adulthood are associated with higher incidence of most major types of thyroid cancer, including the least common but most aggressive form, anaplastic carcinoma, and higher thyroid cancer mortality. Potential underlying biological mechanisms should be explored in future studies.
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Affiliation(s)
- Cari M Kitahara
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | | | | | - Sabina Rinaldi
- 3 International Agency for Research on Cancer , Lyon, France
| | - Alicja Wolk
- 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden
| | - Gila Neta
- 5 Division of Cancer Control and Population Sciences; National Cancer Institute , Rockville, Maryland
| | - Hans Olov Adami
- 6 Department of Medical Epidemiology and Biostatistics; Karolinska Institutet , Stockholm, Sweden
- 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts
| | - Kristin Anderson
- 8 Division of Epidemiology and Community Health, School of Public Health; University of Minnesota , Minneapolis, Minnesota
- 9 Masonic Cancer Center; University of Minnesota , Minneapolis, Minnesota
| | - Gabriella Andreotti
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Laura E Beane Freeman
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Leslie Bernstein
- 10 Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute , City of Hope, Duarte, California
| | - Julie E Buring
- 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts
- 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts
| | - Francoise Clavel-Chapelon
- 12 Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France Paris South University , UMRS Inserm 1018 Team 9, Villejuif, France
| | - Lisa A De Roo
- 13 Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
- 14 Epidemiology Branch, National Institute of Environmental Health Sciences , Research Triangle Park, North Carolina
| | - Yu-Tang Gao
- 15 Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
| | - J Michael Gaziano
- 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts
- 16 Division of Aging; Brigham and Women's Hospital , Boston, Massachusetts
- 17 Massachusetts Veteran's Epidemiology, Research, and Information Center, Geriatric Research Education and Clinical Center , VA Boston Healthcare System, Boston, Massachusetts
| | - Graham G Giles
- 18 Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne, Australia
- 19 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Carlton, Australia
| | - Niclas Håkansson
- 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden
| | | | - Vicki A Kirsh
- 21 Prevention and Cancer Control, Cancer Care Ontario , Toronto, Canada
- 22 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada
| | - Martha S Linet
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Robert J MacInnis
- 18 Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne, Australia
- 19 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Carlton, Australia
| | - Nicola Orsini
- 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden
| | - Yikyung Park
- 23 Division of Public Health Sciences, Washington University School of Medicine in St. Louis , St. Louis, Missouri
| | - Alpa V Patel
- 2 Epidemiology Research Program, American Cancer Society , Atlanta, Georgia
| | - Mark P Purdue
- 24 Ontario Institute for Cancer Research , Toronto, Canada
| | - Elio Riboli
- 25 Imperial School of Public Health, Imperial College London , London, United Kingdom
| | - Kimberly Robien
- 26 Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University , Washington, DC
| | - Thomas Rohan
- 27 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, New York
| | - Dale P Sandler
- 14 Epidemiology Branch, National Institute of Environmental Health Sciences , Research Triangle Park, North Carolina
| | - Catherine Schairer
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
| | - Arthur B Schneider
- 28 Section of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago , Chicago, Illinois
| | - Howard D Sesso
- 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts
- 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts
- 16 Division of Aging; Brigham and Women's Hospital , Boston, Massachusetts
| | - Xiao-Ou Shu
- 29 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine , Nashville, Tennessee
| | - Pramil N Singh
- 30 Center for Health Research, School of Public Health, Loma Linda University , Loma Linda, California
| | - Piet A van den Brandt
- 31 Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University , Maastricht, Netherlands
| | - Elizabeth Ward
- 32 Intramural Research, American Cancer Society , Atlanta, Georgia
| | - Elisabete Weiderpass
- 6 Department of Medical Epidemiology and Biostatistics; Karolinska Institutet , Stockholm, Sweden
- 33 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway , Tromsø, Norway
- 34 Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research , Oslo, Norway
- 35 Genetic Epidemiology Group, Folkälsan Research Center , Helsinki, Finland
| | - Emily White
- 36 Public Health Services Division, Fred Hutchinson Cancer Research Center , Seattle, Washington
- 37 Department of Epidemiology, University of Washington , Seattle, Washington
| | - Yong-Bing Xiang
- 15 Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
| | - Anne Zeleniuch-Jacquotte
- 38 Division of Epidemiology, Department of Population Health and NYU Cancer Institute, NYU School of Medicine , New York, New York
| | - Wei Zheng
- 29 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine , Nashville, Tennessee
| | - Patricia Hartge
- 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland
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18
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Xu W, Chen Z, Li N, Liu H, Huo L, Huang Y, Jin X, Deng J, Zhu S, Zhang S, Yu Y. Relationship of anthropometric measurements to thyroid nodules in a Chinese population. BMJ Open 2015; 5:e008452. [PMID: 26692553 PMCID: PMC4691709 DOI: 10.1136/bmjopen-2015-008452] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Previous studies have found that overweight and obesity are related to numerous diseases, including thyroid cancer and thyroid volume. This study evaluates the relationship between body size and the presence of thyroid nodules in a Chinese population. METHODS A total of 6793 adults and 2410 children who underwent thyroid ultrasonography were recruited in this cross-sectional study in Hangzhou, Zhejiang Province, China, from March to October, 2010. Sociodemographic characteristics and potential risk factors of thyroid nodules were collected by questionnaire. Height and weight were measured using standard protocols. Associations of height, weight, body mass index (BMI) and body surface area (BSA) with the presence of thyroid nodules were evaluated using multiple logistic regression models. RESULTS After adjustment for potential risk factors, an increased risk of thyroid nodule incidence was associated with height (OR 1.15, 95% CI 1.02 to 1.30), weight (OR 1.40, 95% CI 1.24 to 1.58), BMI (OR 1.26, 95% CI 1.11 to 1.42) and BSA (OR 1.43, 95% CI 1.27 to 1.62) in all adults, but most obviously in women. In children, similar associations were observed between risk of thyroid nodule incidence and weight, BMI and BSA, but not height. BSA was the measurement most significantly associated with thyroid nodules in both adults and children. CONCLUSIONS This study identified that the presence of thyroid nodules was positively associated with weight, height, BMI and BSA in both women and girls. It suggests that tall, obese individuals have increased susceptibility to thyroid nodules. TRIAL REGISTRATION NUMBER NCT01838629.
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Affiliation(s)
- Weimin Xu
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Zexin Chen
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Na Li
- Shangcheng Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Hui Liu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liangliang Huo
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yangmei Huang
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xingyi Jin
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jin Deng
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Sujuan Zhu
- Department of Endemic Diseases Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Shanchun Zhang
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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19
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Schmid D, Ricci C, Behrens G, Leitzmann MF. Adiposity and risk of thyroid cancer: a systematic review and meta-analysis. Obes Rev 2015; 16:1042-54. [PMID: 26365757 DOI: 10.1111/obr.12321] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/11/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Abstract
Thyroid cancer incidence has increased rapidly over time, as has obesity prevalence. A link between the two appears plausible, but the relation of adiposity to thyroid cancer remains incompletely understood. We performed a meta-analysis of adiposity measures and thyroid cancer using studies identified through October 2014. Twenty-one articles yielded data on 12,199 thyroid cancer cases. We found a statistically significant 25% greater risk of thyroid cancer in overweight individuals and a 55% greater thyroid cancer risk in obese individuals as compared with their normal-weight peers. Each 5-unit increase in body mass index (BMI), 5 kg increase in weight, 5 cm increase in waist or hip circumference and 0.1-unit increase in waist-to-hip ratio were associated with 30%, 5%, 5% and 14% greater risks of thyroid cancer, respectively. When evaluated by histologic type, obesity was significantly positively related to papillary, follicular and anaplastic thyroid cancers, whereas it revealed an inverse association with medullary thyroid cancer. Both general and abdominal adiposity are positively associated with thyroid cancer. However, relations with BMI vary importantly by tumour histologic type.
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Affiliation(s)
- D Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - C Ricci
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - G Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - M F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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20
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Choi JS, Lee HS, Kim EK, Moon HJ, Kwak JY. The influence of body mass index on the diagnostic performance of pre-operative staging ultrasound in papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2015; 83:550-5. [PMID: 25323560 DOI: 10.1111/cen.12638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 08/27/2014] [Accepted: 10/11/2014] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the diagnostic performance of pre-operative staging ultrasound (US) according to body mass index (BMI) in patients with papillary thyroid carcinoma (PTC) PATIENTS AND METHODS: This retrospective study included 625 patients with PTC who underwent pre-operative staging US and surgical excision at a referral centre between December 2012 and April 2013. Four experienced radiologists prospectively evaluated the extent of primary tumours, multifocality and the presence of lymph node metastasis. Patients were grouped according to BMI (normal <25; overweight 25 ≤ and <30; obese ≥30, or nonobese <30; obese ≥30 kg/m(2) ). Diagnostic performances of pre-operative staging US (sensitivity, specificity, positive predictive value, negative predictive value and accuracy) were compared according to BMI based on pathologic findings of surgical specimens. RESULTS Pre-operative staging US in the obese group (BMI ≥30 kg/m(2) ) showed a significantly lower negative predictive value and accuracy in the detection of central lymph node metastasis (P = 0·010 and P = 0·025, respectively) than in the nonobese (BMI <30 kg/m(2) ) group. However, there were no significant differences in the diagnostic performance of pre-operative staging US for extrathyroidal extension, bilateral multifocality and lateral lymph node metastasis in analyses using the two (nonobese vs obese) and three BMI (normal vs overweight vs obese) groups, respectively. CONCLUSION Obesity (BMI ≥30 kg/m(2) ) may affect the pre-operative US staging of central lymph node metastasis in patients with PTC.
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Affiliation(s)
- Ji Soo Choi
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
- Department of Radiology, Samsung Medical Center, Seoul, Korea
| | - Hye Sun Lee
- Biostastistics Collaboration Unit, Medical Research Center, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | - Eun-Kyung Kim
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Moon
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Young Kwak
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
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21
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Arduc A, Dogan BA, Tuna MM, Tutuncu Y, Isik S, Berker D, Guler S. Higher body mass index and larger waist circumference may be predictors of thyroid carcinoma in patients with Hürthle-cell lesion/neoplasm fine-needle aspiration diagnosis. Clin Endocrinol (Oxf) 2015; 83:405-11. [PMID: 25296952 DOI: 10.1111/cen.12628] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/10/2014] [Accepted: 10/02/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE High body mass index (BMI) has been found to be associated with raised thyroid cancer risk, particularly in women. We examined the associations for BMI and waist circumference (WC) with thyroid cancer risk among women with Hürthle-cell lesion/neoplasm (HLN) on fine-needle aspiration biopsy (FNAB) with the hypothesis that BMI and WC could guide the management of these challenging indeterminate lesions. METHODS This cross-sectional study included 224 women with HLN who underwent thyroidectomy. In all patients, TSH and thyroid auto-antibodies were evaluated, and thyroid nodule features were recorded. Patients were grouped according to BMI (<30 or ≥30 kg/m(2)) and WC (<88 or ≥88 cm). Relationships of thyroid cancer with BMI and WC were assessed using logistic regression analysis. RESULTS Mean weight, BMI (31·26 ± 5·1 vs 26·47 ± 5·9, P < 0·001), WC (98·23 ± 7·6 vs 86·18 ± 11, P = 0·001), and proportion of patients with high BMI (≥30 kg/m(2)) (65·9 vs 33·8%, P < 0·001) or large WC (≥88 cm) (84·1 vs 47·9%, P < 0·001) were significantly higher in malignant group compared to benign group. In regression analysis, BMI and WC significantly associated with existence of malignancy. Malignancy risk was 3·819-fold higher (95% CI: 2·068-7·054) in BMI≥30 kg/m(2) group compared to BMI<30 kg/m(2), which was independent of TSH and age. Large WC was also associated with increased risk (OR = 5·593, 95% CI: 2·736-11·434). Baseline tumour characteristics were similar according to BMI and WC groups. CONCLUSIONS A great BMI and large WC were associated with higher thyroid cancer risk in patients with FNAB diagnosis of HLN. Further studies are needed to use BMI or WC in the management of patients with HLN.
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Affiliation(s)
- Ayse Arduc
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes, Endocrine and Obesity Branch, Bethesda, MD, USA
| | - Bercem Aycicek Dogan
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Mazhar Muslum Tuna
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Yasemin Tutuncu
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Serhat Isik
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Dilek Berker
- Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Serdar Guler
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hitit University, Corum, Turkey
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22
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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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23
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Braganza MZ, Potischman N, Park Y, Thompson FE, Hollenbeck AR, Kitahara CM. Adolescent and mid-life diet and subsequent risk of thyroid cancer in the NIH-AARP diet and health study. Int J Cancer 2015; 137:2413-23. [PMID: 25974060 DOI: 10.1002/ijc.29600] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 04/20/2015] [Indexed: 01/11/2023]
Abstract
Although thyroid cancer is suspected to have a nutritional etiology, prospective studies examining the relationship between diet and thyroid cancer are lacking. During 1996-1997, NIH-AARP Diet and Health Study participants, ages 51-72 years, completed a 37-item food frequency questionnaire about diet at ages 12-13 years (adolescence) and 10 years before baseline (mid-life). Over a median 10 years of follow-up, 325 individuals (143 men and 182 women) were diagnosed with thyroid cancer. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for intakes of foods and food groups comparing the highest to the lowest quartiles. Adolescent intakes of chicken/turkey (HR = 1.59, 95% CI: 0.97-2.60; ptrend < 0.01) and sweet baked goods (HR = 1.59, 95% CI: 1.09-2.34; ptrend = 0.04) were positively associated with thyroid cancer risk, while intake of butter/margarine was inversely associated with risk (HR = 0.64, 95% CI: 0.44-0.91; ptrend < 0.02). Similar to adolescent diet, mid-life intake of sweet baked goods was nonsignificantly associated with an increased risk of thyroid cancer (HR = 1.39, 95% CI: 0.96-2.00; ptrend = 0.11), but intake of butter/margarine was inversely associated with risk (HR = 0.66, 95% CI: 0.46-0.95; ptrend = 0.03). Among men, higher adolescent consumption of canned tuna was positively associated with risk of thyroid cancer (HR = 1.69, 95% CI: 1.01-2.83; ptrend = 0.03), and greater mid-life intake of broccoli was associated with a twofold increased risk (HR = 2.13, 95% CI: 1.13-3.99; ptrend < 0.01). This large prospective study suggests that several components of the adolescent and mid-life diet, including iodine-rich foods and goitrogens, may influence thyroid cancer risk.
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Affiliation(s)
- Melissa Z Braganza
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, 20892
| | - Nancy Potischman
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, 20892
| | - Yikyung Park
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, 20892.,Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, 63110
| | - Frances E Thompson
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, 20892
| | | | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, 20892
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24
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Maillard S, Damiola F, Clero E, Pertesi M, Robinot N, Rachédi F, Boissin JL, Sebbag J, Shan L, Bost-Bezeaud F, Petitdidier P, Doyon F, Xhaard C, Rubino C, Blanché H, Drozdovitch V, Lesueur F, de Vathaire F. Common variants at 9q22.33, 14q13.3, and ATM loci, and risk of differentiated thyroid cancer in the French Polynesian population. PLoS One 2015; 10:e0123700. [PMID: 25849217 PMCID: PMC4388539 DOI: 10.1371/journal.pone.0123700] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 03/06/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND French Polynesia has one of the highest incidence rates of thyroid cancer worldwide. Relationships with the atmospheric nuclear weapons tests and other environmental, biological, or behavioral factors have already been reported, but genetic susceptibility has yet to be investigated. We assessed the contribution of polymorphisms at the 9q22.33 and 14q13.3 loci identified by GWAS, and within the DNA repair gene ATM, to the risk of differentiated thyroid cancer (DTC) in 177 cases and 275 matched controls from the native population. PRINCIPAL FINDINGS For the GWAS SNP rs965513 near FOXE1, an association was found between genotypes G/A and A/A, and risk of DTC. A multiplicative effect of allele A was even noted. An excess risk was also observed in individuals carrying two long alleles of the poly-alanine tract expansion in FOXE1, while no association was observed with rs1867277 falling in the promoter region of the gene. In contrast, the GWAS SNP rs944289 (NKX2-1) did not show any significant association. Although the missense substitution D1853N (rs1801516) in ATM was rare in the population, carriers of the minor allele (A) also showed an excess risk. The relationships between these five polymorphisms and the risk of DTC were not contingent on the body surface area, body mass index, ethnicity or dietary iodine intake. However, an interaction was evidenced between the thyroid radiation dose and rs944289. SIGNIFICANCE A clear link could not be established between the high incidence in French Polynesia and the studied polymorphisms, involved in susceptibility to DTC in other populations. Important variation in allele frequencies was observed in the Polynesian population as compared to the European populations. For FOXE1 rs965513, the direction of association and the effect size was similar to that observed in other populations, whereas for ATM rs1801516, the minor allele was associated to an increased risk in the Polynesian population and with a decreased risk in the European population.
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Affiliation(s)
- Stéphane Maillard
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France
- University Paris-Sud, UMRS 1018, F-94807, Villejuif, France
- IGR, F-94800, Villejuif, France
| | - Francesca Damiola
- Genetic Cancer Susceptibility, International Agency for Research on Cancer (IARC), F-69372, Lyon, France
- CRCL, CNRS UMR5286, INSERM U1052, Centre Leon Bérard, Lyon, France
| | - Enora Clero
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France
- University Paris-Sud, UMRS 1018, F-94807, Villejuif, France
- IGR, F-94800, Villejuif, France
| | - Maroulio Pertesi
- Genetic Cancer Susceptibility, International Agency for Research on Cancer (IARC), F-69372, Lyon, France
| | - Nivonirina Robinot
- Genetic Cancer Susceptibility, International Agency for Research on Cancer (IARC), F-69372, Lyon, France
| | | | | | | | | | | | | | - Françoise Doyon
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France
- University Paris-Sud, UMRS 1018, F-94807, Villejuif, France
- IGR, F-94800, Villejuif, France
| | - Constance Xhaard
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France
- University Paris-Sud, UMRS 1018, F-94807, Villejuif, France
- IGR, F-94800, Villejuif, France
| | - Carole Rubino
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France
- University Paris-Sud, UMRS 1018, F-94807, Villejuif, France
- IGR, F-94800, Villejuif, France
| | | | - Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, United States of America
| | - Fabienne Lesueur
- Genetic Cancer Susceptibility, International Agency for Research on Cancer (IARC), F-69372, Lyon, France
- Inserm, U900, Institut Curie, Mines ParisTech, F-75248, Paris, France
| | - Florent de Vathaire
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France
- University Paris-Sud, UMRS 1018, F-94807, Villejuif, France
- IGR, F-94800, Villejuif, France
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25
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Turcios S, Lence-Anta JJ, Santana JL, Pereda CM, Velasco M, Chappe M, Infante I, Bustillo M, García A, Clero E, Maillard S, Rodriguez R, Xhaard C, Ren Y, Rubino C, Ortiz RM, de Vathaire F. Thyroid volume and its relation to anthropometric measures in a healthy cuban population. Eur Thyroid J 2015; 4:55-61. [PMID: 25960963 PMCID: PMC4404892 DOI: 10.1159/000371346] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 12/02/2014] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The aim of this study was to describe the thyroid volume in healthy adults by ultrasound and to correlate this volume with some anthropometric measures and other differentiated thyroid cancer risk factors. STUDY DESIGN Thyroid volume and anthropometric measures were recorded in a sample of 100 healthy adults, including 21 men and 79 women aged 18-50 years, living in a non-iodine-deficient area of Havana city. RESULTS The average thyroid volume was 6.6 ± 0.26 ml; it was higher in men (7.3 ml) than in women (6.4 ml; p = 0.15). In the univariate analysis, thyroid volume was correlated with all anthropometric measures, but in the multivariate analysis, body surface area was found to be the only significant anthropometric parameter. Thyroid volume was also higher in current or former smokers and in persons with blood group AB or B. CONCLUSION Specific reference values of thyroid volume as a function of body surface area could be used for evaluating thyroid volume in clinical practice. The relation between body surface area and thyroid volume is coherent with what is known about the relation of thyroid volume to thyroid cancer risk, but the same is not true about the relation between thyroid volume and smoking habit.
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Affiliation(s)
| | | | | | | | | | - Mae Chappe
- Institute of Oncology and Radiobiology, Havana, Cuba
| | | | | | - Anabel García
- Institute of Oncology and Radiobiology, Havana, Cuba
| | - Enora Clero
- Radiation Epidemiology Group, Unit 1018-Inserm, Villejuif, France
- The Gustave Roussy Cancer Center, Villejuif, France
- Paris-Sud University, Villejuif, France
| | - Stephane Maillard
- Radiation Epidemiology Group, Unit 1018-Inserm, Villejuif, France
- The Gustave Roussy Cancer Center, Villejuif, France
- Paris-Sud University, Villejuif, France
| | | | - Constance Xhaard
- Radiation Epidemiology Group, Unit 1018-Inserm, Villejuif, France
- The Gustave Roussy Cancer Center, Villejuif, France
- Paris-Sud University, Villejuif, France
| | - Yan Ren
- Radiation Epidemiology Group, Unit 1018-Inserm, Villejuif, France
- The Gustave Roussy Cancer Center, Villejuif, France
- Paris-Sud University, Villejuif, France
| | - Carole Rubino
- Radiation Epidemiology Group, Unit 1018-Inserm, Villejuif, France
- The Gustave Roussy Cancer Center, Villejuif, France
- Paris-Sud University, Villejuif, France
| | - Rosa M. Ortiz
- Institute of Oncology and Radiobiology, Havana, Cuba
| | - Florent de Vathaire
- Radiation Epidemiology Group, Unit 1018-Inserm, Villejuif, France
- The Gustave Roussy Cancer Center, Villejuif, France
- Paris-Sud University, Villejuif, France
- *Florent de Vathaire, PhD, Radiation Epidemiology Group, 1018 INSERM Unit, Institut Gustave Roussy, Rue Edouard Vaillant, FR-94805 Villejuif (France), E-Mail
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26
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Choi JS, Kim EK, Moon HJ, Kwak JY. Higher body mass index may be a predictor of extrathyroidal extension in patients with papillary thyroid microcarcinoma. Endocrine 2015; 48:264-71. [PMID: 24858734 DOI: 10.1007/s12020-014-0293-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/08/2014] [Indexed: 01/01/2023]
Abstract
Recently, higher body mass index (BMI) has been associated with aggressive pathologic features of papillary thyroid carcinoma. The aim of this study was to clarify the relationship between BMI and aggressive pathologic features of papillary thyroid microcarcinoma (PTMC) and to evaluate whether the BMI can be a prognostic factor of PTMC. This retrospective study included 612 PTMC patients who underwent surgical excision at a referral center between April 2006 and December 2007. Patients were grouped according to BMI (<25 or ≥25 kg/m2). Multivariable logistic regression analysis was performed to determine independent predictors of aggressive pathologic features (advanced stage, extrathyroidal extension, and lymph node metastasis), with adjustment for age, gender, tumor size, multifocality, thyroid stimulating hormone (TSH) level, and BMI (value/group). PTMC patients with a BMI≥25 kg/m2 showed significantly higher prevalences of extrathyroidal extension, advanced pathologic TNM stage, and male gender, compared to those of patients with a BMI<25 kg/m2. Lymph node metastasis and mean TSH level were not significantly different between the two BMI subgroups. In multivariable analysis, the BMI≥25 kg/m2 group was positively associated with the presence of extrathyroidal extension (adjusted odds ratio 1.49, P=0.05). Higher BMI was associated with extrathyroidal extension in PTMC patients. This study suggests that the BMI could be considered as a prognostic factor for predicting the presence of extrathyroidal extension and it may help decide the appropriate surgical extent for PTMC patients.
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Affiliation(s)
- Ji Soo Choi
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
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27
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Ma J, Huang M, Wang L, Ye W, Tong Y, Wang H. Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies. Med Sci Monit 2015; 21:283-91. [PMID: 25612155 PMCID: PMC4315628 DOI: 10.12659/msm.892035] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Several studies have evaluated the association between obesity and thyroid cancer risk. However, the results remain uncertain. In this study, we conducted a meta-analysis to assess the association between obesity and thyroid cancer risk. MATERIAL/METHODS Published literature from PubMed, EMBASE, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) were retrieved before 10 August 2014. We included all studies that reported adjusted risk ratios (RRs), hazard ratios (HRs) or odds ratios (ORs), and 95% confidence intervals (CIs) of thyroid cancer risk. RESULTS Thirty-two studies (n=12 620 676) were included in this meta-analysis. Obesity was associated with a significantly increased risk of thyroid cancer (adjusted RR=1.33; 95% CI, 1.24-1.42; I2=25%). In the subgroup analysis by study type, increased risk of thyroid cancer was found in cohort studies and case-control studies. In subgroup analysis by sex, both obese men and women were at significantly greater risk of thyroid cancer than non-obese subjects. When stratified by ethnicity, significantly elevated risk was observed in Caucasians and in Asians. In the age subgroup analysis, both young and old populations showed increased thyroid cancer risk. Subgroup analysis on smoking status showed that increased thyroid cancer risks were found in smokers and in non-smokers. In the histology subgroup analyses, increased risks of papillary thyroid cancer, follicular thyroid cancer, and anaplastic thyroid cancer were observed. However, obesity was associated with decreased risk of medullary thyroid cancer. CONCLUSIONS Our results indicate that obesity is associated with an increased thyroid cancer risk, except medullary thyroid cancer.
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Affiliation(s)
- Jie Ma
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Min Huang
- Department of Scientific Research and Education, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Li Wang
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Wei Ye
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Yan Tong
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Hanmin Wang
- Department of Stomatology, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
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28
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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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29
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Morand GB, da Silva SD, Hier MP, Alaoui-Jamali MA. Insights into genetic and epigenetic determinants with impact on vitamin d signaling and cancer association studies: the case of thyroid cancer. Front Oncol 2014; 4:309. [PMID: 25414832 PMCID: PMC4220101 DOI: 10.3389/fonc.2014.00309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 10/17/2014] [Indexed: 12/12/2022] Open
Abstract
Vitamin D is a key regulator of calcium metabolism and has been implicated as a cancer preventive agent. However, clinical studies have revealed conflicting results on its cancer preventive properties, attributed in part to multiple metabolic and regulatory factors susceptible to affect individual responses to exogenous vitamin D. Vitamin D is obtained from dietary sources and sun exposure, which depends on numerous parameters such as skin type, latitude, and lifestyle factors. Focusing on thyroid cancer (TC), we document that genetic and epigenetic determinants can greatly impact individual response to vitamin D and may outweigh the classical clinical correlative studies that focus on sun exposure/dietary intake factors. In particular, genetic determinants innate to host intrinsic metabolic pathways such as highly polymorphic cytochromes P450s responsible for the metabolic activation of vitamin D are expressed in many organs, including the thyroid gland and can impact vitamin D interaction with its nuclear receptor (VDR) in thyroid tissue. Moreover, downstream regulatory pathways in vitamin D signaling as well as VDR are also subject to wide genetic variability among human populations as shown by genome-wide studies. These genetic variations in multiple components of vitamin D pathways are critical determinants for the revaluation of the potential preventive and anticancer properties of vitamin D in TC.
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Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada ; Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada
| | - Sabrina Daniela da Silva
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada ; Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada
| | - Michael P Hier
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada
| | - Moulay A Alaoui-Jamali
- Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada
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30
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Abstract
Many studies have provided observational data on the association of obesity and thyroid cancers, but only few of them propose mechanisms that would permit a better understanding of the causal molecular mechanisms of this association. Considering that there is an increasing incidence of both obesity and thyroid cancers, we need to summarize and link recent studies in order to characterize and understand the contribution of obesity-related factors that might affect thyroid cancer development and progression. Adipose tissue is involved in many vital processes, including insulin sensitivity, angiogenesis, regulation of energy balance, activation of the complement system, and responses such as inflammation. Although these processes have their own molecular pathways, they involve the same molecules through which obesity and adipose tissue might exert their roles in carcinogenesis, not only affecting MAPK and PI3K or even insulin pathways, but also recruiting local inflammatory responses that could result in disease formation and progression. This review describes five important issues that might explain the link between excessive weight and thyroid cancer: thyroid hormones, insulin resistance, adipokines, inflammation, and sexual hormones.
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Affiliation(s)
- Marjory Alana Marcello
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM- Unicamp), Rua Tessália Vieira de Camargo 126, Barão Geraldo, Campinas, São Paulo 13083-970, Brazil
| | - Lucas Leite Cunha
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM- Unicamp), Rua Tessália Vieira de Camargo 126, Barão Geraldo, Campinas, São Paulo 13083-970, Brazil
| | - Fernando Assis Batista
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM- Unicamp), Rua Tessália Vieira de Camargo 126, Barão Geraldo, Campinas, São Paulo 13083-970, Brazil
| | - Laura Sterian Ward
- Laboratory of Cancer Molecular Genetics (Gemoca)Faculty of Medical Sciences, University of Campinas (FCM- Unicamp), Rua Tessália Vieira de Camargo 126, Barão Geraldo, Campinas, São Paulo 13083-970, Brazil
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31
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Dieringer P, Klass EM, Caine B, Smith-Gagen J. Associations between body mass and papillary thyroid cancer stage and tumor size: a population-based study. J Cancer Res Clin Oncol 2014; 141:93-8. [DOI: 10.1007/s00432-014-1792-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 07/29/2014] [Indexed: 01/02/2023]
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Ren Y, Kitahara CM, de Gonzalez AB, Clero E, Brindel P, Maillard S, Cote S, Dewailly E, Rachedi F, Boissin JL, Sebbag J, Shan L, Bost-Bezeaud F, Petitdidier P, Xhaard C, Rubino C, de Vathaire F. Lack of Association between Fingernail Selenium and Thyroid Cancer Risk: A Case-Control Study in French Polynesia. Asian Pac J Cancer Prev 2014; 15:5187-94. [DOI: 10.7314/apjcp.2014.15.13.5187] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Xu L, Port M, Landi S, Gemignani F, Cipollini M, Elisei R, Goudeva L, Müller JA, Nerlich K, Pellegrini G, Reiners C, Romei C, Schwab R, Abend M, Sturgis EM. Obesity and the risk of papillary thyroid cancer: a pooled analysis of three case-control studies. Thyroid 2014; 24:966-74. [PMID: 24555500 PMCID: PMC4046192 DOI: 10.1089/thy.2013.0566] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is a correlation between temporal trends of obesity prevalence and papillary thyroid cancer (PTC) incidence in the United States. Obesity is a well-recognized risk factor for many cancers, but there are few studies on the association between obesity and PTC risk. We investigated the association between anthropometric measurements and PTC risk using pooled individual data from three case-control populations. METHODS Height and weight information were obtained from three independent case-control studies, including 1917 patients with PTC (1360 women and 557 men) and 2127 cancer-free controls from the United States, Italy, and Germany. Body mass index (BMI), body fat percentage, and body surface area (BSA) were calculated. An unconditional logistic regression model was used to calculate odds ratios (ORs) and confidence intervals (CIs) with respect to risk of PTC, adjusted by age, sex, race/ethnicity, and study site. RESULTS In the pooled population, for both men and women, an increased risk of PTC was found to be associated with greater weight, BMI, body fat percentage, and BSA, whereas a reduced risk of PTC was associated with greater height, in the pooled population for both men and women. Compared with normal-weight subjects (BMI 18.5-24.9 kg/m2), the ORs for overweight (BMI 25-29.9 kg/m2) and obese (BMI≥30 kg/m2) subjects were 1.72 [CI 1.48-2.00] and 4.17 [CI 3.41-5.10] respectively. Compared with the lowest quartile of body fat percentage, the ORs for the highest quartile were 3.83 [CI 2.85-5.15] in women and 4.05 [CI 2.67-6.15] in men. CONCLUSION Anthropometric factors, especially BMI and body fat percentage, were significantly associated with increased risk of PTC. Future studies of anthropometric factors and PTC that incorporate intermediate factors, including adiposity and hormone biomarkers, are essential to help clarify potential mechanisms of the relationship.
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Affiliation(s)
- Li Xu
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matthias Port
- Department for Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Stefano Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | | | | | - Rossella Elisei
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
- Department of Orthopedics and Traumatology, University of Pisa, Pisa, Italy
- Department of Occupational Medicine, University of Pisa, Pisa, Italy
| | - Lilia Goudeva
- Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | | | - Kai Nerlich
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Giovanni Pellegrini
- Operative Unit of Laboratory of Clinical Chemistry Analyses, University Hospital of Cisanello, Pisa, Italy
| | - Christoph Reiners
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Cristina Romei
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
- Department of Orthopedics and Traumatology, University of Pisa, Pisa, Italy
- Department of Occupational Medicine, University of Pisa, Pisa, Italy
| | - Robert Schwab
- Department of General, Visceral, and Thoracic Surgery, Armed Forces Hospital, Koblenz, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Erich M. Sturgis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Trésallet C, Seman M, Tissier F, Buffet C, Lupinacci RM, Vuarnesson H, Leenhardt L, Menegaux F. The incidence of papillary thyroid carcinoma and outcomes in operative patients according to their body mass indices. Surgery 2014; 156:1145-52. [PMID: 24878452 DOI: 10.1016/j.surg.2014.04.020] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 04/14/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The connection between high body mass index (BMI), risk of papillary thyroid carcinoma (PTC), and the aggressiveness of PTC is still debated. We aimed to establish the relationship between excess BMI and the risk of PTC in an operative population, and the impact of obesity on histopathologic aggressiveness of PTC and on the outcome of patients. METHODS All consecutive patients who underwent thyroid operation from June 2002 to December 2009 were reviewed in this retrospective study. BMI groupings were based on standardized categories: normal-weight, overweight, and obesity. We performed a total thyroidectomy with lymph node dissection in patients with preoperative or operative diagnosis of PTC. Radioiodine ablation was performed in every N1 patient, in case of tumor size greater than 10 mm, and if there was extrathyroidal invasion. During a median follow-up of 6.2 years, patients who were retreated by operation or (131)I were considered to have a persistent (<18 months of the initial operative treatment) or recurrent (≥ 18 months) disease. RESULTS Of 6,684 patients who had a thyroid gland resection, we identified 1,216 (18.2%) patients with PTC. Patients who were overweight or obese were not at greater risk of PTC than normal-weight subjects. Indications for operation or radioiodine therapy were similar in the three BMI groups. During follow-up, 86 patients (7.1%) experienced persistent (4.5%) or recurrent (2.5%) disease. When excluding micro-PTCs (≤ 10 mm), we found an association between recurrent or residual locoregional thyroid cancer and BMI: 18.7% in obese patients versus 8.5% if BMI <25 kg/m(2) and 9.8% if 25 ≥ BMI < 30 kg/m(2) (P = .03). This difference was clearly marked for persistence. When adjusted for other cofounder factors, we observed that BMI was an independent factor associated with the risk of postoperative locoregional event (odds ratio 3.8, 95% confidence interval 1.6-8.8), with sex, age, lymph node metastasis, and tumor bilaterality. CONCLUSION In macro-PTC, obese patients had an increased risk of developing a locoregional event during the follow-up, specifically a persistence of the disease. According to these results, overweight and obese patients with macro-PTC should be monitored more carefully for early detection of cancer persistence.
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Affiliation(s)
- Christophe Trésallet
- Department of General, Digestive and Endocrine Surgery, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.
| | - Marie Seman
- Department of General, Digestive and Endocrine Surgery, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Frédérique Tissier
- Department of Pathology, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Camille Buffet
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Renato Micelli Lupinacci
- Department of General, Digestive and Endocrine Surgery, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Hélène Vuarnesson
- Department of General, Digestive and Endocrine Surgery, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Laurence Leenhardt
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Fabrice Menegaux
- Department of General, Digestive and Endocrine Surgery, Pierre-et-Marie Curie University (Paris VI), Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
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Xhaard C, Ren Y, Clero E, Maillard S, Brindel P, Rachedi F, Boissin JL, Sebbag J, Shan L, Bost-Bezeaud F, Petitdidier P, Drozdovitch V, Doyon F, Rubino C, de Vathaire F. Differentiated Thyroid Carcinoma Risk Factors in French Polynesia. Asian Pac J Cancer Prev 2014; 15:2675-80. [DOI: 10.7314/apjcp.2014.15.6.2675] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
BACKGROUND In the last decade, significant contributions have been made to our knowledge on the connection between the thyroid and adipose tissue. Modern society is faced with climbing rates of obesity and metabolic syndrome, and there is accumulating evidence of an association between obesity and increased cancer risk. The aim of this review is to summarize clinical data on the association between thyroid cancer (TC) and obesity and briefly to present plausible hypotheses explaining this interplay. SUMMARY We performed a search on the PubMed database for studies published in English from 1980 to March 2013 using the terms "thyroid cancer," "obesity," and "body mass index." Although there is inconsistency among the clinical studies, it seems that overweight and obesity are related to a modestly increased TC risk. Various factors, such as sex, ethnicity, and body changes during certain life periods, for example adolescence, may influence the association between obesity and TC risk. There are preliminary data linking obesity with a less favorable clinicopathologic profile of TC. However, validation with larger multicenter studies is needed. The precise underlying mechanisms have not yet been elucidated, but the insulin-IGF axis and adipokines, such as leptin and adiponectin, might be implicated in the link between excess weight and TC. CONCLUSIONS Given the rising prevalence of TC and the development of obesity as an epidemic, it is important to clarify its connection with TC as well as the mediating pathways. However, unless this association is confirmed and causation proven, screening for TC in overweight and obese subjects-a rapidly increasing body of the general population-does not seem justified.
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Affiliation(s)
- Theodora Pappa
- 1 Endocrine Unit, Department of Medical Therapeutics, Alexandra Hospital, Athens University School of Medicine , Athens, Greece
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Kitahara CM, Gamborg M, de González AB, Sørensen TI, Baker JL. Childhood height and body mass index were associated with risk of adult thyroid cancer in a large cohort study. Cancer Res 2014; 74:235-42. [PMID: 24247722 PMCID: PMC3891884 DOI: 10.1158/0008-5472.can-13-2228] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Taller stature and obesity in adulthood have been consistently associated with an increased risk of thyroid cancer, but few studies have investigated the role of childhood body size. Using data from a large prospective cohort, we examined associations for height and body mass index (BMI) at ages 7 to 13 years with risk of thyroid cancer in later life. The study population included 321,085 children from the Copenhagen School Health Records Register, born between 1930 and 1989 in Copenhagen, Denmark, with measurements of height and weight from 7 to 13 years of age. These data were linked with the Danish Cancer Registry to identify incident thyroid cancer cases (1968-2010). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for age- and sex-specific height and BMI SD scores (SDS) using proportional hazards models stratified by birth cohort and sex. During follow-up (median = 38.6 years), 171 women and 64 men were diagnosed with thyroid cancer. Both height and BMI were positively associated with thyroid cancer risk, and these associations were similar by age at measurement. Using age 10 as an example, HRs per 1 unit increase in SDS for height (~6-7 cm) and BMI (~1.5-2 kg/m(2)) were 1.22 (95% CI, 1.07-1.40) and 1.15 (95% CI, 1.00-1.34), respectively. These results, together with the relatively young ages at which thyroid cancers are diagnosed compared with other malignancies, suggest a potential link between early-life factors related to growth and body weight and thyroid carcinogenesis.
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Affiliation(s)
- Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Michael Gamborg
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
| | - Amy Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Thorkild I.A. Sørensen
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jennifer L. Baker
- Institute of Preventive Medicine; Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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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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Zhao ZG, Guo XG, Ba CX, Wang W, Yang YY, Wang J, Cao HY. Overweight, obesity and thyroid cancer risk: a meta-analysis of cohort studies. J Int Med Res 2013; 40:2041-50. [PMID: 23321160 DOI: 10.1177/030006051204000601] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This meta-analysis examined the relationship between excess body weight or body mass index (BMI) and risk of thyroid cancer. METHODS PubMed(®), MEDLINE(®), EMBASE™ and Academic Search™ Premier databases were searched to identify cohort studies examining the effect of being overweight or obese on the risk of thyroid cancer. RESULTS The inclusion criteria were met by seven cohort studies (total number of thyroid cancer cases, 5154). The pooled relative risk (RR) of thyroid cancer was 1.13 (95% confidence interval [CI] 1.04, 1.22) for overweight. Obesity was also linked with increased thyroid cancer risk in males and females, the strength of the association increasing with increasing BMI. The combined RR of thyroid cancer was 1.18 (95% CI 1.11, 1.25) for excess body weight (overweight and obesity combined). Being overweight was associated with a significant increase in thyroid cancer risk among non-Asians, but not among Asians. Overweight, obesity and excess body weight were all associated with papillary thyroid carcinoma risk. CONCLUSIONS The association between overweight/obesity/excess body weight and thyroid cancer risk was confirmed.
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Affiliation(s)
- Z G Zhao
- Third Department of Surgery, Baotou Tumour Hospital, Baotou, Inner Mongolia Autonomous Region, China
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Marcello MA, Sampaio AC, Geloneze B, Vasques ACJ, Assumpção LVM, Ward LS. Obesity and excess protein and carbohydrate consumption are risk factors for thyroid cancer. Nutr Cancer 2013; 64:1190-5. [PMID: 23163848 DOI: 10.1080/01635581.2012.721154] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Conflicting data concerning the association between obesity and differentiated thyroid cancer (DTC) may be attributed to the lack of records showing dietary intake and inadequate evaluation of nutrient composition. We evaluated 115 DTC patients carefully paired with 103 healthy control individuals by using a structured questionnaire, including a 24-h recordatory during 3 days, to investigate calorie intake and macronutrient (proteins, carbohydrates, and lipids) composition of the diet. We observed that excess weight (body mass index > 25 kg/m(2)) increased individual susceptibility to DTC [odds ratio (OR) = 3.787; 95% confidence interval (CI) = 1.115-6.814; P < 0.0001). This augmented risk was evident in women (OR = 1.925; 95% CI = 1.110-3.338; P = 0.0259) but not in men (P = 0.3498). Excess calorie intake was more frequent in patients with DTC than in controls (OR = 5.890; 95% CI = 3.124-11.103; P < 0.0001), and both excess protein (OR = 4.601; 95% CI = 1.634-12.954; P = 0.0039) and carbohydrate (OR = 4.905; 95% CI = 2.593-9.278; P < 0.0001) consumption were associated with an increased risk of DTC, contrarily to lipid/fiber intake and physical activity (P = 0.894 and 0.5932, respectively). In conclusion, our data indicate that overweight and risk of DTC are associated with higher protein and carbohydrate consumption than the rates recommended by the World Health Organization. The nutritional orientation should be part of preventive strategy targets designed to combat the increasing incidence of both obesity and DTC.
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Affiliation(s)
- Marjory Alana Marcello
- Laboratory of Cancer Molecular Genetics (Gemoca), Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
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Kim HJ, Kim NK, Choi JH, Sohn SY, Kim SW, Jin SM, Jang HW, Suh S, Min YK, Chung JH, Kim SW. Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer. Clin Endocrinol (Oxf) 2013; 78:134-40. [PMID: 22812676 DOI: 10.1111/j.1365-2265.2012.04506.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 05/01/2012] [Accepted: 07/16/2012] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Epidemiological studies have demonstrated that excess weight increases the risk of thyroid cancer. However, the associations between excess weight and prognostic factors for thyroid cancer are uncertain. We evaluated the relationships between body mass index (BMI) and clinico-pathological features and outcomes of papillary thyroid cancer (PTC). PATIENTS AND METHODS Retrospective analysis of 2057 patients with PTC was performed. Patients were grouped according to BMI (underweight, normal weight, overweight and obesity)-based World Health Organization standardized categories. Logistic regression models were used to assess the relationships between BMI and clinico-pathological features of PTC. A Cox proportional hazards model was used to examine the association between BMI and disease recurrence. RESULTS A 5-kg/m(2) increase in BMI was associated with PTC tumours larger than 1 cm [odds ratio (OR) 1.31, P < 0.001], with microscopic extrathyroidal invasion (OR 1.23, P = 0.006), and with advanced tumour-node-metastasis (TNM) stage (OR, 1.30, P = 0.003), which is independent of confounding variables such as gender, age, serum TSH, total cholesterol and fasting glucose level. The multivariate-adjusted OR [95% confidence intervals (CI)] in the overweight (25.0-29.9 kg/m(2)) and obese (BMI ≥ 30) groups for tumours larger than 1 cm were 1.41 (1.10-1.81) and 2.17 (1.23-3.82), respectively, compared to the normal weight group (BMI 18.5-24.9). The multivariate-adjusted OR (95% CI) for microscopic extrathyroidal extension in the obesity group was 1.88 (1.06-3.32), and the OR for advanced TNM stage in the overweight group was 1.35 (1.02-1.79) compared to the normal weight group. During follow-up (median, 84 month; range, 1-185), 43 patients (2.1%) experienced recurrence. There were no significant differences in recurrence of PTCs among BMI groups. CONCLUSIONS Higher BMI was strongly associated with larger tumour size, extrathyroidal invasion and advanced TNM stage of PTCs. However, there was no difference in recurrence rate among BMI groups. This study suggests that excess weight is associated with aggressive features of PTCs. Further studies with long-term follow-up are needed to confirm this finding.
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Affiliation(s)
- Hye Jeong Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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Kim MR, Kim SS, Huh JE, Lee BJ, Lee JC, Jeon YK, Kim BH, Kim SJ, Wang SG, Kim YK, Kim IJ. Neck circumference correlates with tumor size and lateral lymph node metastasis in men with small papillary thyroid carcinoma. Korean J Intern Med 2013; 28:62-71. [PMID: 23345998 PMCID: PMC3543962 DOI: 10.3904/kjim.2013.28.1.62] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 03/23/2012] [Accepted: 04/18/2012] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Obesity is correlated with numerous diseases, including thyroid cancer, but the clinical significance of obesity with regard to the clinical characteristics of thyroid cancer remains unclear. Neck circumference is an index of upper-body adipose tissue distribution. METHODS In total, 401 patients with papillary thyroid carcinoma (PTC) measuring ≤ 2 cm were included. Neck circumference was measured horizontally at the level just below the thyroid cartilage on preoperative neck computed tomographic images. RESULTS Neck circumference correlated significantly with tumor size in men (p = 0.001) but not in women (p = 0.930). Body mass index (BMI) did not significantly correlate with tumor size in either sex. Neck circumference was significantly larger in men with lateral lymph node (LN) metastasis than in those without (p = 0.004). Neck circumference and BMI did not differ significantly in women according to other factors such as tumor size, multifocality, extrathyroid extension, and LN metastasis. Tumor size and the prevalence of lateral LN metastasis in men tended to increase in the middle/large neck circumference subgroup compared with those in the low neck circumference subgroup. Multivariate logistic regression analysis revealed that neck circumference (p = 0.009) was a predictor for the presence of lateral LN metastasis in men. BMI was not a predictive factor for lateral LN involvement in either sex. CONCLUSIONS Neck circumference, an indicator of central or visceral obesity but not BMI, may be associated with some prognostic factors in men with small PTC.
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Affiliation(s)
- Mi Ra Kim
- Kim Yong Ki Internal Medicine Clinic, Busan, Korea
| | - Sang Soo Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- BioMedical Research Institute, Pusan National University Hospital, Busan, Korea
| | | | - Byung Joo Lee
- Department of Otolaryngology, Pusan National University Hospital, Busan, Korea
| | - Jin Choon Lee
- Department of Otolaryngology, Pusan National University Hospital, Busan, Korea
| | - Yun Kyung Jeon
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Seong Jang Kim
- BioMedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Soo Geun Wang
- Department of Otolaryngology, Pusan National University Hospital, Busan, Korea
| | - Yong Ki Kim
- Kim Yong Ki Internal Medicine Clinic, Busan, Korea
| | - In Joo Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- BioMedical Research Institute, Pusan National University Hospital, Busan, Korea
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Cléro É, Doyon F, Chungue V, Rachédi F, Boissin JL, Sebbag J, Shan L, Rubino C, de Vathaire F. Dietary Patterns, Goitrogenic Food, and Thyroid Cancer: A Case-Control Study in French Polynesia. Nutr Cancer 2012; 64:929-36. [DOI: 10.1080/01635581.2012.713538] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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The insulin and igf-I pathway in endocrine glands carcinogenesis. JOURNAL OF ONCOLOGY 2012; 2012:635614. [PMID: 22927847 PMCID: PMC3423951 DOI: 10.1155/2012/635614] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 06/20/2012] [Indexed: 12/26/2022]
Abstract
Endocrine cancers are a heterogeneous group of diseases that may arise from endocrine cells in any gland of the endocrine system. These malignancies may show an aggressive behavior and resistance to the common anticancer therapies. The etiopathogenesis of these tumors remains mostly unknown. The normal embryological development and differentiation of several endocrine glands are regulated by specific pituitary tropins, which, in adult life, control the function and trophism of the endocrine gland. Pituitary tropins act in concert with peptide growth factors, including the insulin-like growth factors (IGFs), which are considered key regulators of cell growth, proliferation, and apoptosis. While pituitary TSH is regarded as tumor-promoting factor for metastatic thyroid cancer, the role of other pituitary hormones in endocrine cancers is uncertain. However, multiple molecular abnormalities of the IGF system frequently occur in endocrine cancers and may have a role in tumorigenesis as well as in tumor progression and resistance to therapies. Herein, we will review studies indicating a role of IGF system dysregulation in endocrine cancers and will discuss the possible implications of these findings for tumor prevention and treatment, with a major focus on cancers from the thyroid, adrenal, and ovary, which are the most extensively studied.
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Rinaldi S, Lise M, Clavel-Chapelon F, Boutron-Ruault MC, Guillas G, Overvad K, Tjønneland A, Halkjaer J, Lukanova A, Kaaks R, Bergmann MM, Boeing H, Trichopoulou A, Zylis D, Valanou E, Palli D, Agnoli C, Tumino R, Polidoro S, Mattiello A, Bas Bueno-de-Mesquita H, Peeters PH, Weiderpass E, Lund E, Skeie G, Rodríguez L, Travier N, Sánchez MJ, Amiano P, Huerta JM, Ardanaz E, Rasmuson T, Hallmans G, Almquist M, Manjer J, Tsilidis KK, Allen NE, Khaw KT, Wareham N, Byrnes G, Romieu I, Riboli E, Franceschi S. Body size and risk of differentiated thyroid carcinomas: Findings from the EPIC study. Int J Cancer 2012; 131:E1004-14. [DOI: 10.1002/ijc.27601] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 03/19/2012] [Indexed: 01/27/2023]
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Cléro É, Doyon F, Chungue V, Rachédi F, Boissin JL, Sebbag J, Shan L, Bost-Bezeaud F, Petitdidier P, Dewailly E, Rubino C, de Vathaire F. Dietary iodine and thyroid cancer risk in French Polynesia: a case-control study. Thyroid 2012; 22:422-9. [PMID: 22280227 DOI: 10.1089/thy.2011.0173] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND French Polynesia has one of the world's highest thyroid cancer incidence rates. Iodine is suspected to play a role in this high incidence. The objective of this study was to assess whether low dietary iodine is related to a higher risk of thyroid cancer in the French Polynesian population. METHODS A case-control study was performed among native residents of French Polynesia. It included 229 cases of differentiated thyroid cancer diagnosed between 1979 and 2004 (203 women, 26 men) matched with 371 population controls (324 women, 47 men) on the date of birth. The current study is focused on dietary iodine intake and fish consumption (food rich in iodine) and analyzed by conditional logistic regression. RESULTS Daily dietary iodine intake was insufficient (<150 μg/day) in 60% of both cases and controls. A decreased risk of thyroid cancer was observed with a higher consumption of fish (p(trend)=0.008) and shellfish (p(trend)=0.002), and also with a higher dietary iodine intake (p(trend)=0.03). There was no significant interaction between the effects of the thyroid radiation dose and the dietary iodine intake (p=0.2). CONCLUSION French Polynesia is a mild iodine deficiency area in which a higher consumption of food from the sea and a higher dietary iodine intake are significantly associated with a decreased risk of thyroid cancer. The quantification of this reduction requires specific investigation of iodine intake in traditional Polynesian food.
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Affiliation(s)
- Énora Cléro
- Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, U1018 INSERM, Villejuif, France
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Kitahara CM, Platz EA, Park Y, Hollenbeck AR, Schatzkin A, Berrington de González A. Body fat distribution, weight change during adulthood, and thyroid cancer risk in the NIH-AARP Diet and Health Study. Int J Cancer 2012; 130:1411-9. [PMID: 21544808 PMCID: PMC3242922 DOI: 10.1002/ijc.26161] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 04/19/2011] [Indexed: 01/08/2023]
Abstract
Body mass index (BMI) has been positively associated with thyroid cancer risk in several studies, but the underlying mechanisms remain unclear. We examined the associations for waist and hip circumference and weight change during adulthood with thyroid cancer risk among 125,347 men and 72,363 women in the NIH-AARP Diet and Health Study who completed a second mailed questionnaire in 1996-1997. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated separately by sex and adjusted for race/ethnicity, education and smoking status. During follow-up (median = 10.1 years), 106 men and 105 women were diagnosed with a first primary thyroid cancer, as identified through linkage to state cancer registries. Having a large waist circumference (above the clinical cutpoint for normal: > 102 cm in men and > 88 cm in women) was associated with increased risk in both men (HR = 1.79, 95% CI: 1.21-2.63) and women (HR = 1.54, 95% CI: 1.05-2.26). Having both a large waist and BMI in the obese range (≥ 30 kg/m2) approximately doubled the risk of thyroid cancer (HR in men = 2.13, 95% CI: 1.18-3.85; HR in women = 1.91, 95% CI: 1.31-3.25) compared to having a normal waist circumference/normal BMI (18.5-24.9 kg/m2). We also observed positive association for weight gain between ages 18-35 in men (gained ≥ 10.0 kg vs. lost/gained < 5 kg, HR = 1.49, 95% CI: 0.93-2.39, p-trend = 0.03), but the association was less pronounced in women. No clear association for weight gain in later life was observed. These results support a potential role for hormonal and metabolic parameters common to central adiposity in thyroid carcinogenesis.
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Affiliation(s)
- Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, NCI, National Institutes of Health, Rockville, MD 20852, USA.
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Kitahara CM, Platz EA, Beane Freeman LE, Black A, Hsing AW, Linet MS, Park Y, Schairer C, Berrington de González A. Physical activity, diabetes, and thyroid cancer risk: a pooled analysis of five prospective studies. Cancer Causes Control 2012; 23:463-471. [PMID: 22294499 DOI: 10.1007/s10552-012-9896-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 01/06/2012] [Indexed: 12/18/2022]
Abstract
PURPOSE: Although many studies have linked obesity with increased risk of thyroid cancer, few have investigated the role of obesity-related lifestyle characteristics and medical conditions in the etiology of this disease. We examined the associations of self-reported physical activity and diabetes history with thyroid cancer risk in a large pooled analysis of prospective cohort studies. METHODS: Data from five prospective studies in the U.S. (n = 362,342 men, 312,149 women) were coded using standardized exposure, covariate, and outcome definitions. Hazard ratios (HR) and 95% confidence intervals (CI) for thyroid cancer were estimated using age as the time metric and adjusting for sex, education, race, marital status, cigarette smoking, body mass index, alcohol intake, and cohort. Effect modification by other risk factors (e.g., age, sex, and body mass index) and differences by cancer subtype (e.g., papillary, follicular) were also examined. RESULTS: Over follow-up (median = 10.5 years), 308 men and 510 women were diagnosed with a first primary thyroid cancer. Overall, subjects reporting the greatest amount of physical activity had an increased risk of the disease (HR = 1.18, 95% CI:1.00-1.39); however, this association was restricted to participants who were overweight/obese (≥25 kg/m(2); HR = 1.34, 95% CI:1.09-1.64) as opposed to normal-weight (<25 kg/m(2); HR = 0.92, 95% CI:0.69-1.22; P-interaction = 0.03). We found no overall association between self-reported history of diabetes and thyroid cancer risk (HR = 1.08, 95% CI:0.83-1.40). CONCLUSION: Neither physical inactivity nor diabetes history was associated with increased risk of thyroid cancer. While it may have been a chance finding, the possible increased risk associated with greater physical activity warrants further investigation.
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Affiliation(s)
- Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, EPS 7056, 6120 Executive Blvd, Rockville, MD, 20852, USA,
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Peterson E, De P, Nuttall R. BMI, diet and female reproductive factors as risks for thyroid cancer: a systematic review. PLoS One 2012; 7:e29177. [PMID: 22276106 PMCID: PMC3261873 DOI: 10.1371/journal.pone.0029177] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 11/22/2011] [Indexed: 11/29/2022] Open
Abstract
Background Thyroid cancer incidence rates have been increasing worldwide but the reason behind this is unclear. Both the increasing use of diagnostic technologies allowing the detection of thyroid cancer and a true increase in thyroid cancer incidence have been proposed. This review assesses the role of body mass index (BMI), diet, and reproductive factors on the thyroid cancer trend. Methods Epidemiologic studies of the selected risk factors up to June 2010 were reviewed and critically assessed. Results Among the thirty-seven studies reviewed and despite variation in the risk estimates, most papers supported a small but positive association for BMI (risk estimate range: 1.1–2.3 in males and 1.0–7.4 in females.). Among specific dietary components, there was no consistent association of thyroid cancer risk with iodine intake through fortification (risk estimate range: 0.49–1.6) or fish consumption (risk estimate range 0.6–2.2), nor with diets high in cruciferous vegetables (risk estimate range 0.6–1.9). A small number of studies showed a consistent protective effect of diets high in non-cruciferous vegetable (risk estimate range: 0.71–0.92). Among reproductive factors (pregnancy, parity, number of live births, use of prescription hormones, menstrual cycle regularity, and menopausal status), none were consistently associated with higher thyroid cancer risk. Conclusions BMI had the strongest link to thyroid cancer risk among those examined. Detailed examinations of population-level risk factors can help identify and support prevention efforts to reduce the burden of thyroid cancer.
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Affiliation(s)
- Emily Peterson
- University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Ontario, Canada
| | - Prithwish De
- University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Ontario, Canada
- Canadian Cancer Society, Cancer Control Policy, Toronto, Ontario, Canada
- * E-mail:
| | - Robert Nuttall
- Canadian Cancer Society, Cancer Control Policy, Toronto, Ontario, Canada
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Anthropometric factors and physical activity and risk of thyroid cancer in postmenopausal women. Cancer Causes Control 2012; 23:421-30. [DOI: 10.1007/s10552-011-9890-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 12/19/2011] [Indexed: 01/10/2023]
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