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Abiri B, Ahmadi AR, Valizadeh A, Abbaspour F, Valizadeh M, Hedayati M. Obesity and thyroid cancer: unraveling the connection through a systematic review and meta-analysis of cohort studies. J Diabetes Metab Disord 2024; 23:461-474. [PMID: 38932807 PMCID: PMC11196530 DOI: 10.1007/s40200-024-01425-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/21/2024] [Indexed: 06/28/2024]
Abstract
Background The relationship between adiposity indicators and thyroid cancer (TC) risk has garnered increasing attention due to the rising prevalence of obesity and its potential impact on cancer incidence. We conducted a comprehensive meta-analysis to investigate this association across various effect measures. Method Until July 2022, a comprehensive search of databases was conducted to identify cohort studies that assessed the association between adiposity and the development of TC. Meta-analysis was performed using random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Begg's tests. Results A systematic literature search identified 27 eligible studies reporting odds ratios (OR), relative risks (RR), or hazard ratios (HR) as effect measures. Pooling the studies irrespective of the effect measure, a significant positive association between adiposity indicators and TC risk was observed, yielding an effect estimate of 1.16 (95% CI 1.12-1.21). The combined effect estimate for OR/RR studies was 1.10 (95%CI 1.04-1.17), while HR studies yielded an effect estimate of 1.20 (95%CI 1.13-1.26). Subgroup analyses revealed associations across different age groups, obesity indices, and regions, with some variations based on effect measure. Meta-regression identified follow-up duration as a confounding factor only in HR studies. Conclusion The synthesis of 27 studies with diverse designs and populations underscores a robust positive association between adiposity and TC risk, providing compelling evidence for the potential role of increased adiposity in TC development. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01425-3.
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Affiliation(s)
- Behnaz Abiri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Faeze Abbaspour
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jang Y, Kim T, Kim BHS, Park B. Association between Obesity Indexes and Thyroid Cancer Risk in Korean Women: Nested Case-Control Study. Cancers (Basel) 2022; 14:cancers14194712. [PMID: 36230635 PMCID: PMC9563606 DOI: 10.3390/cancers14194712] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This study aimed to identify the association between various obesity indexes, including waist circumference (WC), waist−hip ratio (WHR), waist−height ratio (WHTR), and BMI, and their combinations with body mass index (BMI) and thyroid cancer risk. Methods: Of the 65,639 participants who completed a follow-up survey of the Health Examinee Study (HEXA), a prospective cohort of the Korean Genome and Epidemiology Study, 412 female incident thyroid cancer cases, and 1648 birth year- and enrollment year-matched female controls were included. Multiple conditional logistic regression was used to estimate the association between obesity indexes and thyroid cancer risk. Results: The risk of developing thyroid cancer was increased by 1.37-fold (95% confidence interval (CI) = 1.03−1.81) higher in the obese BMI group (≥25.0 Kg/m2) compared to that in the normal BMI group (<23.0 Kg/m2). Obesity in terms of WC (≥85.0 cm) and WHTR (≥0.5) was associated with an increased risk of thyroid cancer (OR 1.55, 95% CI = 1.16−2.07; OR 1.37, 95% CI = 1.07−1.75, respectively). However, increased WHR levels did not show any significant association. Women with both obese levels of BMI (≥25.0 Kg/m2) and other obesity indexes (WC ≥ 85.0 cm, WHR ≥ 0.85, or WHTR ≥ 0.5) showed an increased risk of thyroid cancer with OR of 1.63 (95% CI = 1.14−2.31), 1.49 (95% CI = 1.05−2.12), and 1.42 (95% CI = 1.04−1.94), compared to those with normal levels of BMI and each obesity index. Conclusion: These results provide evidence of the contribution of both total and central adiposity across the lifespan of thyroid cancer incidence. Risk factor modifications must be considered to explain the current thyroid cancer epidemic.
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Affiliation(s)
- Yoonyoung Jang
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Program in Regional Information, Department of Agricultural Economics and Rural Development, Seoul National University, Seoul 08826, Korea
| | - Taehwa Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Department of Psychology, Sungkyunkwan University, Seoul 03063, Korea
| | - Brian H. S. Kim
- Program in Regional Information, Department of Agricultural Economics and Rural Development, Seoul National University, Seoul 08826, Korea
- Program in Agricultural and Forest Meteorology, Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Korea
- Correspondence: (B.H.S.K.); (B.P.); Tel.: +82-2-880-4717 (B.H.S.K.); +82-2-2220-0682 (B.P.); Fax: +82-2-873-5080 (B.H.S.K.); +82-31-2220-0699 (B.P.)
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Correspondence: (B.H.S.K.); (B.P.); Tel.: +82-2-880-4717 (B.H.S.K.); +82-2-2220-0682 (B.P.); Fax: +82-2-873-5080 (B.H.S.K.); +82-31-2220-0699 (B.P.)
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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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Lai X, Zhang B, Wang Y, Jiang Y, Li J, Gao L, Wang Y. Adiposity and the risk of thyroid nodules with a high-suspicion sonographic pattern: a large cross-sectional epidemiological study. J Thorac Dis 2020; 11:5014-5022. [PMID: 32030217 DOI: 10.21037/jtd.2019.11.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background To our knowledge, no previous studies have evaluated the association between obesity and the risk of thyroid nodules with a high-suspicion sonographic pattern defined by the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancers. In this large cross-sectional epidemiological study, we investigated whether a positive association existed between anthropometric measurements and the risk of thyroid nodules. Methods In total, 10,504 individuals from two towns in northern China were enrolled between May to September 2016. The height and weight were measured and the body mass index (BMI), body fat percentage (BFP), and body surface area (BSA) were calculated. A logistic regression model was used to estimate age-, sex-, and study site-adjusted odds ratios (ORs) and confidence intervals (CIs) for each of the anthropometric measurements with respect to the risk of thyroid nodules. Results The final analyses included 9,096 participants, among whom 3,614 (39.7%) had thyroid nodules and 365 (4.0%) had thyroid nodules with a high-suspicion sonographic pattern. An increased risk of any thyroid nodules was associated with greater height, weight, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 1.33 (95% CI: 1.09-1.62) in women and 1.89 (95% CI: 1.35-2.65) in men. An increased risk of thyroid nodules with a high-suspicion sonographic pattern was associated with greater weight, BMI, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 2.19 (95% CI: 1.32-3.64) in women and 3.10 (95% CI: 1.31-7.36) in men. Conclusions Our results demonstrated that BFP was the most pronounced anthropometric factor associated with an increased risk of any thyroid nodules and thyroid nodules with a high-suspicion sonographic pattern.
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Affiliation(s)
- Xingjian Lai
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yong Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuxin Jiang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Jianchu Li
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Luying Gao
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Ying Wang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
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Fiore M, Cristaldi A, Okatyeva V, Lo Bianco S, Oliveri Conti G, Zuccarello P, Copat C, Caltabiano R, Cannizzaro M, Ferrante M. Physical Activity and Thyroid Cancer Risk: A Case-Control Study in Catania (South Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081428. [PMID: 31013573 PMCID: PMC6517930 DOI: 10.3390/ijerph16081428] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/10/2019] [Accepted: 04/14/2019] [Indexed: 12/24/2022]
Abstract
Background: The health benefits of physical activity are well established, but the association between physical activity and thyroid cancer remains poorly understood. The aim of the study was to investigate the relationship between physical activity and thyroid cancer in order to determine type, frequency, and duration of exercise needed to maximize prevention. Method: Cases, diagnosed from January 2009 to July 2018, and controls were enrolled at the University Hospital “Policlinico-Vittorio Emanuele” of Catania (South Italy). Logistic regression models were used to estimate the crude and adjusted odds ratios (ORs) and their 95% confidence intervals. Results: A total of 106 cases (91.2% papillary type) and 217 controls were enrolled. Physical activity was rare in Catania (32.8%) and was not correlated to risk of total thyroid cancer (OR: 0.997; 95% CI: 0.515–1.929). Conversely, walking every day for at least 60 minutes reduced the risk of thyroid cancer (OR: 0.357; 95% CI: 0.157–0.673). Conclusions: Our study showed that daily walking duration was associated with lower risk of thyroid cancer using a case-control study. Unfortunately, the frequency of physical activity often declines with age, particularly among the elderly, thus more research on physical activity adherence is needed to determine which approaches are most effective in promoting sustained physical activity participation.
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Affiliation(s)
- Maria Fiore
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Antonio Cristaldi
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Valeriya Okatyeva
- General Surgery, Department of Medical and Surgical Sciences and Advanced Technologies, "G.F. Ingrassia", 95123 Catania, Italy.
| | - Salvatore Lo Bianco
- General Surgery, Department of Medical and Surgical Sciences and Advanced Technologies, "G.F. Ingrassia", 95123 Catania, Italy.
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Pietro Zuccarello
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Chiara Copat
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Rosario Caltabiano
- Department of Medical and Surgical Sciences and Advanced Technologies, "G.F. Ingrassia", Section of Anatomic Pathology, 95123 Catania, Italy.
| | - Matteo Cannizzaro
- General Surgery, Department of Medical and Surgical Sciences and Advanced Technologies, "G.F. Ingrassia", 95123 Catania, Italy.
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
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Kwon H, Han KD, Park CY. Weight change is significantly associated with risk of thyroid cancer: A nationwide population-based cohort study. Sci Rep 2019; 9:1546. [PMID: 30733504 PMCID: PMC6367378 DOI: 10.1038/s41598-018-38203-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022] Open
Abstract
Obesity is a risk factor for many cancers including breast, esophageal, colon, and thyroid cancer. We aimed to evaluate the association of thyroid cancer with body mass index (BMI), waist circumference (WC), and weight change. This nationwide population-based cohort study included 11,323,006 adults who joined the national health screening program. Weight change was defined as the difference between the weight of the subjects measured during the study period and the weight at the time of four years ago. For evaluating the association between the weight change and the risk of thyroid cancer, subjects without weight change for four years were defined as the reference group. Mean age was 50.1 ± 13.7 years and 44% were female. In total, 50,464 subjects (0.4%) had newly-diagnosed thyroid cancer. After multivariable analyses, the incidence of thyroid cancer increased significantly in subjects with larger WC as well as higher BMI (P < 0.001 and P < 0.001, respectively). In subjects who were lean and became obese, the incidence of thyroid cancers increased significantly (hazard ratio [HR] 1.15 [1.11-1.19]). In subjects who were obese and became lean, the incidence of thyroid cancers decreased significantly (HR 0.89 [0.86-0.93]). These results demonstrated that higher BMI and larger WC were significantly associated with an increased risk of thyroid cancer. Weight gain in lean subjects was associated with an increased risk of thyroid cancer, and weight reduction in subjects with obesity was associated with a decreased risk of thyroid cancer.
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Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Biostatics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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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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Zivaljevic V, Slijepcevic N, Sipetic S, Paunovic I, Diklic A, Zoric G, Kalezic N. Risk factors for well-differentiated thyroid cancer in men. TUMORI JOURNAL 2018; 99:458-62. [DOI: 10.1177/030089161309900403] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Aims and background Thyroid cancers are relatively rare tumors that appear more frequently in women than in men. Accordingly, most studies focus on studying risk factors for thyroid cancer in women and consequently on various hormonal or reproductive factors that are specific for women. The aim of our study was to examine risk factors for developing well-differentiated thyroid cancer in men. Heretofore, we did not encounter in the literature a study that was solely focused on studying risk factors for well-differentiated thyroid cancer in men. Methods A case-control study was performed from 2005 to 2010. The case group included 204 consecutive well-differentiated thyroid cancers in male patients (180 papillary and 24 follicular including Hürthle cell). The control group comprised the same number of cases. Patients were individually matched by gender, age and place of residence. Statistical analysis included conditional univariate and multivariate logistic regression Methods. Results According to univariate logistic regression, well-differentiated thyroid cancer in men was significantly related to smoking status, duration of smoking, number of cigarettes smoked per day, history of goiter or thyroid nodules, history of non-thyroid cancer, diabetes mellitus, radiotherapy of the head and neck, and history of malignant tumors. According to multivariate logistic regression, it was independently related to smoking status (OR = 0.36; 95% CI, 0.19–0.69), history of goiter or thyroid nodules (OR = 9.19; 95% CI, 1.25–64.58), and a history of malignant tumors (OR = 2.11; 95% CI, 1.19–7.33). Conclusions Risk factors for well-differentiated thyroid cancer in men were goiter or thyroid nodules and family history of malignant tumors. Cigarette smoking was negatively associated with the disease.
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Affiliation(s)
- Vladan Zivaljevic
- Center for Endocrine Surgery, Clinic for endocrinology, Clinical Centre of Serbia, Koste Todorovica 8, Belgrade
- School of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Nikola Slijepcevic
- Center for Endocrine Surgery, Clinic for endocrinology, Clinical Centre of Serbia, Koste Todorovica 8, Belgrade
| | - Sandra Sipetic
- Institute of Epidemiology, School of Medicine, University of Belgrade, Visegradska 26, Belgrade
- School of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Ivan Paunovic
- Center for Endocrine Surgery, Clinic for endocrinology, Clinical Centre of Serbia, Koste Todorovica 8, Belgrade
- School of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Aleksandar Diklic
- Center for Endocrine Surgery, Clinic for endocrinology, Clinical Centre of Serbia, Koste Todorovica 8, Belgrade
- School of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Goran Zoric
- Center for Endocrine Surgery, Clinic for endocrinology, Clinical Centre of Serbia, Koste Todorovica 8, Belgrade
| | - Nevena Kalezic
- Center for Endocrine Surgery, Clinic for endocrinology, Clinical Centre of Serbia, Koste Todorovica 8, Belgrade
- School of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
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9
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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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Xhaard C, Lence-Anta JJ, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Danzon A, Velten M, Clero E, Maillard S, Marrer E, Bailly L, Mariné Barjoan E, Schlumberger M, Orgiazzi J, Adjadj E, Pereda CM, Turcios S, Velasco M, Chappe M, Infante I, Bustillo M, García A, Salazar S, Rodriguez R, Benadjaoud MA, Ortiz RM, Rubino C, de Vathaire F. Recreational Physical Activity and Differentiated Thyroid Cancer Risk: A Pooled Analysis of Two Case-Control Studies. Eur Thyroid J 2016; 5:132-8. [PMID: 27493888 PMCID: PMC4949366 DOI: 10.1159/000445887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/02/2016] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Physical activity has been hypothesized to influence cancer occurrence through several mechanisms. To date, its relation with thyroid cancer risk has been examined in relatively few studies. We pooled 2 case-control studies conducted in Cuba and Eastern France to assess the relationship between self-reported practice of recreational physical activity since childhood and thyroid cancer risk. METHODS This pooled study included 1,008 cases of differentiated thyroid cancer (DTC) matched with 1,088 controls (age range 9-35 and 17-60 years in the French and Cuban studies, respectively). Risk factors associated with the practice of recreational physical activity were estimated using OR and 95% CI. Logistic regressions were stratified by age class, country, and gender and were adjusted for ethnic group, level of education, number of pregnancies for women, height, BMI, and smoking status. RESULTS Overall, the risk of thyroid cancer was slightly reduced among subjects who reported recreational physical activity (OR = 0.8; 95% CI 0.5-1.0). The weekly frequency (i.e. h/week) seems to be more relevant than the duration (years). CONCLUSION Long-term recreational physical activity, practiced since childhood, may reduce the DTC risk. However, the mechanisms whereby the DTC risk decreases are not yet entirely clear.
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Affiliation(s)
- Constance Xhaard
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | | | - Yan Ren
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Françoise Borson-Chazot
- Groupement Hospitalier Lyon-Est, Hospices Civils de Lyon, Fédération d'Endocrinologie, Bron, France
- Rhône-Alpes Thyroid Cancer Registry, Cancer Research Center of Lyon (UMR INSERM 1052, CNRS 5286), RTH Laennec Faculty of Medicine, University of Lyon, Lyon, France
| | - Geneviève Sassolas
- Rhône-Alpes Thyroid Cancer Registry, Cancer Research Center of Lyon (UMR INSERM 1052, CNRS 5286), RTH Laennec Faculty of Medicine, University of Lyon, Lyon, France
| | - Claire Schvartz
- Thyroid Cancer Registry of Champagne-Ardennes, Institut Jean Godinot, Reims, France
| | | | - Brigitte Lacour
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- French National Registry of Childhood Solid Tumours, CHU, Nancy, France
| | - Arlette Danzon
- Cancer Registry of Doubs, EA 3181, Université de Franche-Comté, Besançon, France
| | - Michel Velten
- Cancer Registry of Bas-Rhin, EA 3430, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Enora Clero
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Stéphane Maillard
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Emilie Marrer
- Cancer Registry of Haut-Rhin, Mulhouse Hospital, Mulhouse, France
| | - Laurent Bailly
- Public Health Department, University Hospital Nice, Nice, France
| | | | | | - Jacques Orgiazzi
- Department of Endocrinology, Hospices Civils de Lyon, Lyon, France
| | - Elisabeth Adjadj
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Celia M. Pereda
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | | | - Milagros Velasco
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Mae Chappe
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Idalmis Infante
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Marlene Bustillo
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Anabel García
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Sirced Salazar
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | | | - Mohamed Amine Benadjaoud
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Rosa M. Ortiz
- National Institute of Oncology and Radiobiology (INOR), Havana, Cuba
| | - Carole Rubino
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Florent de Vathaire
- U1018, Centre d'Epidémiologie et de Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
- *Florent de Vathaire, Radiation Epidemiology Group, U1018, Institut Gustave Roussy, Rue Edouard Vaillant, FR–94805 Villejuif (France), E-Mail
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11
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Hwang Y, Lee KE, Park YJ, Kim SJ, Kwon H, Park DJ, Cho B, Choi HC, Kang D, Park SK. Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study. Medicine (Baltimore) 2016; 95:e2893. [PMID: 26945379 PMCID: PMC4782863 DOI: 10.1097/md.0000000000002893] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We evaluated the association between weight change in middle-aged adults and papillary thyroid cancer (PTC) based on a large-scale case-control study. Our study included data from 1551 PTC patients (19.3% men and 80.7% women) who underwent thyroidectomy at the 3 general hospitals in Korea and 15,510 individually matched control subjects. The subjects' weight history, epidemiologic information, and tumor characteristics confirmed after thyroidectomy were analyzed. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined for the annual average changes in weight and obesity indicators (body mass index (BMI), body surface area, and body fat percentage (BF%) in subjects since the age of 35 years. Subjects with a total weight gain ≥10 kg after age 35 years were more likely to have PTC (men, OR, 5.39, 95% CI, 3.88-7.49; women, OR, 3.36, 95% CI, 2.87-3.93) compared with subjects with a stable weight (loss or gain <5 kg). A marked increase in BMI since age 35 years (annual average change of BMI ≥0.3 kg/m/yr) was related to an elevated PTC risk, and the association was more pronounced for large-sized PTC risks (<1 cm, OR, 2.34, 95% CI, 1.92-2.85; ≥1 cm, OR, 4.00, 95% CI, 2.91-5.49, P heterogeneity = 0.005) compared with low PTC risks. Weight gain and annual increases in obesity indicators in middle-aged adults may increase the risk of developing PTC.
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Affiliation(s)
- Yunji Hwang
- From the Department of Preventive Medicine (YH, DK, SKP), Seoul National University College of Medicine; Department of Biomedical Science (YH, DK, SKP), Seoul National University Graduate School; Cancer Research Institute (YH, KEL, DK, SKP), Seoul National University College of Medicine; Department of Surgery (KEL, S-JK, HK), Seoul National University Hospital and College of Medicine; Division of Surgery (KEL), Thyroid Center, Seoul National University Cancer Hospital; Department of Internal Medicine (YJP, DJP), Seoul National University College of Medicine; Department of Family Medicine (BC, H-CC), Health Promotion Center for Cancer Survivor, Seoul National University Hospital, Seoul; and Advanced Institutes of Convergence Technology (BC, H-CC), Seoul National University, Suwon-si, Gyeonggi-do, Korea
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12
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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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13
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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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14
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Liu L, Shi Y, Li T, Qin Q, Yin J, Pang S, Nie S, Wei S. Leisure time physical activity and cancer risk: evaluation of the WHO's recommendation based on 126 high-quality epidemiological studies. Br J Sports Med 2015; 50:372-8. [PMID: 26500336 DOI: 10.1136/bjsports-2015-094728] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The WHO has concluded that physical activity reduces the risk of numerous diseases. However, few systemic reviews have been performed to assess the role of leisure time physical activity (LTPA) in lowering the risk of cancer in a dose-dependent manner and furthermore the suitability of recommendation of physical activity by the WHO. METHODS A systematic review and meta-analysis was designed to estimate cancer risk by LTPA in binary comparison and in a dose-dependent manner. MEDLINE and Web of Science were searched up to 30 December 2014 without language restrictions. Reference lists were reviewed for potential articles. RESULTS A total of 126 studies were recruited into the meta-analysis. Overall, the total cancer risk was reduced by 10% in people who undertook the most LTPA as compared with those who did the least. Dose-response meta-analysis indicated that the current WHO recommendation (equal to an average of 10 metabolic equivalents of energy hours per week) induced a 7% (95% CI 5% to 9%) cancer reduction. Moreover, the protective role of LTPA against cancer becomes saturated at 20 metabolic equivalents of energy hours per week, with a relative risk of 0.91 (95% CI 0.88 to 0.93). Subanalyses results based on cancer types showed that LTPA only exhibited significant protection against breast cancer and colorectal cancer. CONCLUSIONS Our meta-analysis indicates that the current WHO recommendation of physical activity can result in a 7% reduction in cancer risk, which is mainly attributed to its protective role against breast cancer and colorectal cancer. Furthermore, two-fold of current recommendation level is considered to give its saturated protection against cancer.
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Affiliation(s)
- Li Liu
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yun Shi
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingting Li
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Qin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieyun Yin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuo Pang
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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15
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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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16
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Kato I, Young A, Liu J, Abrams J, Bock C, Simon M. Electric Blanket Use and Risk of Thyroid Cancer in the Women's Health Initiative Observational Cohort. Women Health 2015; 55:829-41. [PMID: 25996298 PMCID: PMC4743246 DOI: 10.1080/03630242.2015.1050545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 08/13/2014] [Accepted: 08/31/2014] [Indexed: 10/23/2022]
Abstract
Thyroid cancer disproportionally affects more women than men. The aim of this study was to assess whether exposure to extremely low frequency electric magnetic fields from electric blankets (EBs) was associated with the development of thyroid cancer. Data were analyzed from 89,527 women who participated in the Women's Health Initiative Observational Study and who responded to questions concerning prior use of EBs. During a mean follow-up of 12.2 years, 190 incident cases of thyroid cancer were identified. We estimated the hazard ratio (HR) and 95 percent confidence interval (CI) of incident thyroid cancer associated with EB use by Cox's proportional hazard model, adjusted for selected covariates. A majority, 57 percent, of the women in the cohort reported the use of EBs while sleeping and/or for warming the bed before sleep. No association was found between use of EBs and subsequent risk of thyroid cancer (HR = 0.98, 95 percent CI 0.72-1.32). Duration of EB use measured in years, months, or hours had no effect on risk. These results did not change when the cases were limited to papillary thyroid cancer, the most frequently occurring histologic type. The results of this study do not support possible health hazards of EBs in regards to thyroid cancer risk.
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Affiliation(s)
- Ikuko Kato
- a Department of Oncology and Pathology , Wayne State University School of Medicine , Detroit , Michigan , USA
| | - Alicia Young
- b Fred Hutchinson Cancer Research Center , Seattle , Washington , USA
| | - Jingmin Liu
- b Fred Hutchinson Cancer Research Center , Seattle , Washington , USA
| | - Judith Abrams
- c Department of Oncology , Karmanos Cancer Institute at Wayne State University , Detroit , Michigan , USA
| | - Cathryn Bock
- c Department of Oncology , Karmanos Cancer Institute at Wayne State University , Detroit , Michigan , USA
| | - Michael Simon
- c Department of Oncology , Karmanos Cancer Institute at Wayne State University , Detroit , Michigan , USA
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Keum N, Greenwood DC, Lee DH, Kim R, Aune D, Ju W, Hu FB, Giovannucci EL. Adult weight gain and adiposity-related cancers: a dose-response meta-analysis of prospective observational studies. J Natl Cancer Inst 2015; 107:djv088. [PMID: 25757865 DOI: 10.1093/jnci/djv088] [Citation(s) in RCA: 236] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adiposity, measured by body mass index, is implicated in carcinogenesis. While adult weight gain has diverse advantages over body mass index in measuring adiposity, systematic reviews on adult weight gain in relation to adiposity-related cancers are lacking. METHODS PubMed and Embase were searched through September 2014 for prospective observational studies investigating the relationship between adult weight gain and the risk of 10 adiposity-related cancers. Dose-response meta-analyses were performed using a random-effects model to estimate summary relative risk (RR) and 95% confidence interval (CI) for each cancer type. All statistical tests were two-sided. RESULTS A total of 50 studies were included. For each 5 kg increase in adult weight gain, the summary relative risk was 1.11 (95% CI = 1.08 to 1.13) for postmenopausal breast cancer among no- or low-hormone replacement therapy (HRT) users, 1.39 (95% CI = 1.29 to 1.49) and 1.09 (95% CI = 1.02 to 1.16) for postmenopausal endometrial cancer among HRT nonusers and users, respectively, 1.13 (95% CI = 1.03 to 1.23) for postmenopausal ovarian cancer among no or low HRT users, 1.09 (95% CI = 1.04 to 1.13) for colon cancer in men. The relative risk of kidney cancer comparing highest and lowest level of adult weight gain was 1.42 (95% CI = 1.11 to 1.81). Adult weight gain was unrelated to cancers of the breast (premenopausal women, postmenopausal HRT users), prostate, colon (women), pancreas, and thyroid. An increase in risk associated with adult weight gain for breast cancer was statistically significantly greater among postmenopausal women (P(heterogeneity) = .001) and HRT nonusers (P(heterogeneity) = .001); that for endometrial cancer was alike among HRT nonusers (P(heterogeneity) = .04). CONCLUSIONS Avoiding adult weight gain itself may confer protection against certain types of cancers, particularly among HRT nonusers.
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Affiliation(s)
- NaNa Keum
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG).
| | - Darren C Greenwood
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
| | - Dong Hoon Lee
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
| | - Rockli Kim
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
| | - Dagfinn Aune
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
| | - Woong Ju
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
| | - Frank B Hu
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG)
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Adult Weight Gain and Adiposity-Related Cancers: A Dose-Response Meta-Analysis of Prospective Observational Studies. ACTA ACUST UNITED AC 2015; 107:dju428. [DOI: 10.1093/jnci/dju428] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Jing Z, Hou X, Liu Y, Yan S, Wang R, Zhao S, Wang Y. Association between height and thyroid cancer risk: a meta-analysis of prospective cohort studies. Int J Cancer 2015; 137:1484-90. [PMID: 25693727 DOI: 10.1002/ijc.29487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/12/2015] [Indexed: 11/06/2022]
Abstract
While several epidemiological studies have investigated the relationship between height and risk for thyroid cancer, the results were inconsistent. In the present study, a systematic review and meta-analysis of prospective cohort studies was conducted to assess the impact of height on thyroid cancer risk. Online databases were searched up to December 30, 2014, for prospective cohort studies on the association between height and thyroid cancer risk. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model of meta-analysis. In all, 11 articles were included in this meta-analysis, including 15 prospective cohort studies, containing 6,695,593 participants and 7,062 cases of thyroid cancer. By comparing the highest versus the lowest categories of height, we reported that risk of thyroid cancer was increased with height in both men (summary RR = 1.40, 95%CI 1.09-1.78, p = 0.008) and women (summary RR = 1.54, 95%CI 1.30-1.83, p < 0.001). The summary RR of thyroid cancer per 5-cm increase in height was 1.16 (95%CI 1.09-1.23, p < 0.001). The results were similar among men (per 5-cm increase RR = 1.13, 95%CI 1.03-1.23, p = 0.011) and women (per 5-cm increase RR = 1.18, 95%CI 1.10-1.27, p < 0.001). No obvious risk of publication bias was observed. Our meta-analysis provides strong evidence for a dose-response relationship between height and risk of thyroid cancer in both men and women.
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Affiliation(s)
- Zhaohai Jing
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Xu Hou
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Ying Liu
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Shengli Yan
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Robin Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.,Department of Medicine, Second Military Medical University, Shanghai, 200433, China
| | - Shihua Zhao
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Yangang Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
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20
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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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21
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Jiang Y, Marshall RJ, Walpole SC, Prieto-Merino D, Liu DX, Perry JK. An international ecological study of adult height in relation to cancer incidence for 24 anatomical sites. Cancer Causes Control 2015; 26:493-9. [PMID: 25575587 DOI: 10.1007/s10552-014-0520-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/22/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Anthropometric indices associated with childhood growth and height attained in adulthood, have been associated with an increased incidence of certain malignancies. To evaluate the cancer-height relationship, we carried out a study using international data, comparing various cancer rates with average adult height of women and men in different countries. METHODS An ecological analysis of the relationship between country-specific cancer incidence rates and average adult height was conducted for twenty-four anatomical cancer sites. Age-standardized rates were obtained from GLOBOCAN 2008. Average female (112 countries) and male (65 countries) heights were sourced and compiled primarily from national health surveys. Graphical and weighted regression analysis was conducted, taking into account BMI and controlling for the random effect of global regions. RESULTS A significant positive association between a country's average adult height and the country's overall cancer rate was observed in both men and women. Site-specific cancer incidence for females was positively associated with height for most cancers: lung, kidney, colorectum, bladder, melanoma, brain and nervous system, breast, non-Hodgkin lymphoma, multiple myeloma, corpus uteri, ovary, and leukemia. A significant negative association was observed with cancer of the cervix uteri. In males, site-specific cancer incidence was positively associated with height for cancers of the brain and nervous system, kidney, colorectum, non-Hodgkin lymphoma, multiple myeloma, prostate, testicular, lip and oral cavity, and melanoma. CONCLUSION Incidence of cancer was associated with tallness in the majority of anatomical/cancer sites investigated. The underlying biological mechanisms are unclear, but may include nutrition and early-life exposure to hormones, and may differ by anatomical site.
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Affiliation(s)
- Yannan Jiang
- Department of Statistics, University of Auckland, Auckland, 1023, New Zealand
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Yeo Y, Ma SH, Hwang Y, Horn-Ross PL, Hsing A, Lee KE, Park YJ, Park DJ, Yoo KY, Park SK. Diabetes mellitus and risk of thyroid cancer: a meta-analysis. PLoS One 2014; 9:e98135. [PMID: 24927125 PMCID: PMC4057085 DOI: 10.1371/journal.pone.0098135] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) is an important risk factor for endocrine cancers; however, the association with thyroid cancer is not clear. We performed a systematic review and meta-analysis to clarify the association between thyroid cancer and DM. METHODS We searched MEDLINE, PUBMED and EMBASE databases through July 2012, using search terms related to diabetes mellitus, cancer, and thyroid cancer. We conducted a meta-analysis of the risk of incidence of thyroid cancer from pre-existing diabetes. Of 2,123 titles initially identified, sixteen articles met our inclusion criteria. An additional article was identified from a bibliography. Totally, 14 cohort and 3 case-control studies were selected for the meta-analysis. The risks were estimated using random-effects model and sensitivity test for the studies which reported risk estimates and used different definition of DM. RESULTS Compared with individuals without DM, the patients with DM were at 1.34-fold higher risk for thyroid cancer (95% CI 1.11-1.63). However, there was heterogeneity in the results (p<0.0001). Sensitivity tests and studies judged to be high quality did not show heterogeneity and DM was associated with higher risk for thyroid cancer in these sub-analyses (both of RRs = 1.18, 95% CIs 1.08-1.28). DM was associated with a 1.38-fold increased risk of thyroid cancer in women (95% CI 1.13-1.67) after sensitivity test. Risk of thyroid cancer in men did not remain significant (RR 1.11, 95% CI 0.80-1.53). CONCLUSIONS Compared with their non-diabetic counterparts, women with pre-existing DM have an increased risk of thyroid cancer.
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Affiliation(s)
- Yohwan Yeo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Hyun Ma
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Yunji Hwang
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
| | - Pamela L. Horn-Ross
- Cancer Prevention Institute of California, Fremont, California, United States of America
| | - Ann Hsing
- Cancer Prevention Institute of California, Fremont, California, United States of America
| | - Kyu-Eun Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Do-Joon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
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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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Physical activity, diabetes, and risk of thyroid cancer: a systematic review and meta-analysis. Eur J Epidemiol 2013; 28:945-58. [PMID: 24243033 DOI: 10.1007/s10654-013-9865-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 11/08/2013] [Indexed: 12/11/2022]
Abstract
Thyroid cancer incidence has been increasing more rapidly over time than the occurrence of cancers of other sites, and interest in potential adverse relations of diabetes and lack of physical activity to thyroid cancer risk is accumulating. We conducted a systematic review and meta-analysis of published epidemiologic studies on the relations of physical activity and diabetes to thyroid cancer according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Published studies were identified through a search in MEDLINE and EMBASE. Random-effects models were used to summarize thyroid cancer risk estimates comparing high versus low levels of physical activity, and separately, comparing individuals with diabetes versus those without diabetes. Meta-regression analyses were performed to evaluate potential effect modification by study design and thyroid cancer risk factors. Information was extracted from seven studies of physical activity and thyroid cancer and from six studies of diabetes and thyroid cancer. The number of individuals from studies on physical activity was 939,305 (yielding 2,250 incident thyroid cancer cases) and from studies on diabetes it was 960,840 (yielding 1,230 cases). The summary relative risk (RR) estimate from cohort and case-control studies combined indicated no association between physical activity and thyroid cancer (summary RR 1.06, 95 % confidence interval (CI) 0.79-1.42). Subgroup-analyses revealed a significant positive association between physical activity and thyroid cancer in cohort studies (summary RR 1.28; 95 % CI 1.01-1.63), whereas the relation was suggestively inverse in case-control studies (summary RR 0.70; 95 % CI 0.48-1.03; p for heterogeneity = 0.005). Individuals with diabetes showed a borderline statistically significant increased risk of thyroid cancer compared with those without diabetes (summary RR 1.17; 95 % CI 0.99-1.39). The relations of physical activity and diabetes to thyroid cancer were not modified by sex, number of adjustment factors, and adjustments for adiposity, smoking, and study quality. In this comprehensive systematic review and meta-analysis, no significant association between physical activity and thyroid cancer was found. Diabetes showed a suggestive positive relation with risk of thyroid cancer.
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Kabat GC, Anderson ML, Heo M, Hosgood HD, Kamensky V, Bea JW, Hou L, Lane DS, Wactawski-Wende J, Manson JE, Rohan TE. Adult stature and risk of cancer at different anatomic sites in a cohort of postmenopausal women. Cancer Epidemiol Biomarkers Prev 2013; 22:1353-63. [PMID: 23887996 DOI: 10.1158/1055-9965.epi-13-0305] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Prospective studies in Western and Asian populations suggest that height is a risk factor for various cancers. However, few studies have explored potential confounding or effect modification of the association by other factors. METHODS We examined the association between height measured at enrollment in 144,701 women participating in the Women's Health Initiative and risk of all cancers combined and cancer at 19 specific sites. Over a median follow-up of 12.0 years, 20,928 incident cancers were identified. We used Cox proportional hazards models to estimate HR and 95% confidence intervals (CI) per 10 cm increase in height, with adjustment for established risk factors. We also examined potential effect modification of the association with all cancer and specific cancers. RESULTS Height was significantly positively associated with risk of all cancers (HR = 1.13; 95% CI, 1.11-1.16), as well as with cancers of the thyroid, rectum, kidney, endometrium, colorectum, colon, ovary, and breast, and with multiple myeloma and melanoma (range of HRs: 1.13 for breast cancer to 1.29 for multiple myeloma and thyroid cancer). These associations were generally insensitive to adjustment for confounders, and there was little evidence of effect modification. CONCLUSIONS This study confirms the positive association of height with risk of all cancers and a substantial number of cancer sites. IMPACT Identification of single-nucleotide polymorphisms associated both with height and with increased cancer risk may help elucidate the association.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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Walter RB, Brasky TM, Buckley SA, Potter JD, White E. Height as an explanatory factor for sex differences in human cancer. J Natl Cancer Inst 2013; 105:860-8. [PMID: 23708052 PMCID: PMC3687370 DOI: 10.1093/jnci/djt102] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 01/26/2013] [Accepted: 02/28/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Most cancers occur more frequently in men. Numerous explanations for this excess risk have been proposed, yet no study has quantified the degree to which height explains the sex difference even though greater height has been associated with increased risk for many cancers. METHODS During the period from 2000 to 2002, 65308 volunteers aged 50 to 76 years were recruited to the Vitamins And Lifestyle (VITAL) study. Cancers of shared anatomic sites (n = 3466) were prospectively identified through 2009 through the Surveillance, Epidemiology, and End Results cancer registry. Age- and race-adjusted hazard ratios (HRs) for the associations between sex and incident cancers were estimated using Cox proportional hazards models, with and without adjustment for height and height squared as measures of body size. RESULTS Men had a 55% increased risk of cancer at shared sites (HR = 1.55; 95% confidence interval [CI] = 1.45 to 1.66). When height was accounted for, 33.8% (95% CI = 10.2% to 57.3%) of the excess risk for men was explained by the height differences between sexes. The proportion mediated by height was 90.9%, 57.3%, and 49.6% for kidney, melanoma, and hematologic malignancies, respectively, with little evidence that height mediates the sex difference for gastrointestinal tract, lung, and bladder cancers. For comparison, more than 35 lifestyle and medical risk factors only explained 23.1% of the sex difference in cancer risk at shared sites. CONCLUSIONS Height is an important explanatory factor for the excess risk for men for many shared-site cancers. This suggests that some of the excess risk is due to factors associated with height (eg, number of susceptible cells in a specific organ or growth-influencing exposures in childhood).
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Affiliation(s)
- Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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Kabat GC, Heo M, Miller AB, Rohan TE. Scaling of weight for height in relation to risk of cancer at different sites in a cohort of Canadian women. Am J Epidemiol 2013; 177:93-101. [PMID: 23139246 DOI: 10.1093/aje/kws270] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Many studies have examined the associations of body mass index (weight (kg)/height (m)(2)) with risk of various cancers. However, optimal scaling of weight for height may depend on the population studied. The authors used data from a large cohort study of women (Canadian National Breast Cancer Screening Study, 1980-2000; n = 89,835) to examine how the scaling of weight for height (W/H(x)) influenced the association with risk of 19 different cancers. Cox proportional hazards models were used to estimate the hazard ratio for each cancer site with W/H(x), with x increasing from 0 to 3.0 by increments of 0.1. The correlation between weight and W/H(x) decreased monotonically with increasing x, whereas W/H(x) was minimally correlated with height when x = 1.4. W/H(x) showed significant positive associations with postmenopausal breast cancer, endometrial cancer, kidney cancer, and lung cancer in never smokers. W/H(x) was inversely associated with lung cancer in ever smokers. The value of x for which W/H(x) produced the largest statistically significant hazard ratio ranged from 0.8 (endometrial cancer) to 1.7 (postmenopausal breast cancer). For lung cancer in ever smokers, the inverse association was statistically significant for all values of x. These findings suggest that the scaling of weight for height may vary depending on the cancer site and that optimal scaling may be considerably different from W/H(2) or, alternatively, that a range of scaling should be considered when examining the association of body weight with risk of disease.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
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Recreational physical activity and risk of papillary thyroid cancer among women in the California Teachers Study. Cancer Epidemiol 2012; 37:46-53. [PMID: 23116823 DOI: 10.1016/j.canep.2012.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 09/22/2012] [Accepted: 09/29/2012] [Indexed: 12/11/2022]
Abstract
PURPOSE Little is known about the relationship between physical activity and thyroid cancer risk, and few cohort data on this association exist. Thus, the present study aimed to prospectively examine long-term activity and risk of papillary thyroid cancer among women. METHODS 116,939 women in the California Teachers Study, aged 22-79 years with no history of thyroid cancer at cohort entry, were followed from 1995-1996 through 2009; 275 were diagnosed with invasive papillary thyroid cancer. Cox proportional-hazards regression provided relative risk (RR) estimates and 95% confidence intervals (CI) for associations between thyroid cancer and combined strenuous and moderate recreational physical activity both in the long-term (high school through age 54 years or current age if younger than 54 years) and recently (during the three years prior to joining the cohort). RESULTS Overall, women whose long-term recreational physical activity averaged at least 5.5 MET-hours/week (i.e. were active) had a non-significant 23% lower risk of papillary thyroid cancer than inactive women (RR = 0.77, 95% CI: 0.57, 1.04). RR estimates were stronger among normal weight or underweight women (body mass index, BMI<25.0 kg/m(2), trend p = 0.03) than among overweight or obese women (trend p = 0.35; homogeneity-of-trends p = 0.03). A similar pattern of risk was observed for recent activity (BMI<25 kg/m(2), trend p = 0.11; BMI≥25 kg/m(2), trend p = 0.16; homogeneity-of-trends p = 0.04). Associations for long-term activity did not appear to be driven by activity in any particular life period (e.g. youth, adulthood). CONCLUSIONS Long-term physical activity may reduce papillary thyroid cancer risk among normal weight and underweight women.
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2012; 19:429-34. [PMID: 22931856 DOI: 10.1097/med.0b013e328358c698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Golden SH, Brown A, Cauley JA, Chin MH, Gary-Webb TL, Kim C, Sosa JA, Sumner AE, Anton B. Health disparities in endocrine disorders: biological, clinical, and nonclinical factors--an Endocrine Society scientific statement. J Clin Endocrinol Metab 2012; 97:E1579-639. [PMID: 22730516 PMCID: PMC3431576 DOI: 10.1210/jc.2012-2043] [Citation(s) in RCA: 271] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to provide a scholarly review of the published literature on biological, clinical, and nonclinical contributors to race/ethnic and sex disparities in endocrine disorders and to identify current gaps in knowledge as a focus for future research needs. PARTICIPANTS IN DEVELOPMENT OF SCIENTIFIC STATEMENT: The Endocrine Society's Scientific Statement Task Force (SSTF) selected the leader of the statement development group (S.H.G.). She selected an eight-member writing group with expertise in endocrinology and health disparities, which was approved by the Society. All discussions regarding the scientific statement content occurred via teleconference or written correspondence. No funding was provided to any expert or peer reviewer, and all participants volunteered their time to prepare this Scientific Statement. EVIDENCE The primary sources of data on global disease prevalence are from the World Health Organization. A comprehensive literature search of PubMed identified U.S. population-based studies. Search strategies combining Medical Subject Headings terms and keyword terms and phrases defined two concepts: 1) racial, ethnic, and sex differences including specific populations; and 2) the specific endocrine disorder or condition. The search identified systematic reviews, meta-analyses, large cohort and population-based studies, and original studies focusing on the prevalence and determinants of disparities in endocrine disorders. consensus process: The writing group focused on population differences in the highly prevalent endocrine diseases of type 2 diabetes mellitus and related conditions (prediabetes and diabetic complications), gestational diabetes, metabolic syndrome with a focus on obesity and dyslipidemia, thyroid disorders, osteoporosis, and vitamin D deficiency. Authors reviewed and synthesized evidence in their areas of expertise. The final statement incorporated responses to several levels of review: 1) comments of the SSTF and the Advocacy and Public Outreach Core Committee; and 2) suggestions offered by the Council and members of The Endocrine Society. CONCLUSIONS Several themes emerged in the statement, including a need for basic science, population-based, translational and health services studies to explore underlying mechanisms contributing to endocrine health disparities. Compared to non-Hispanic whites, non-Hispanic blacks have worse outcomes and higher mortality from certain disorders despite having a lower (e.g. macrovascular complications of diabetes mellitus and osteoporotic fractures) or similar (e.g. thyroid cancer) incidence of these disorders. Obesity is an important contributor to diabetes risk in minority populations and to sex disparities in thyroid cancer, suggesting that population interventions targeting weight loss may favorably impact a number of endocrine disorders. There are important implications regarding the definition of obesity in different race/ethnic groups, including potential underestimation of disease risk in Asian-Americans and overestimation in non-Hispanic black women. Ethnic-specific cut-points for central obesity should be determined so that clinicians can adequately assess metabolic risk. There is little evidence that genetic differences contribute significantly to race/ethnic disparities in the endocrine disorders examined. Multilevel interventions have reduced disparities in diabetes care, and these successes can be modeled to design similar interventions for other endocrine diseases.
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Affiliation(s)
- Sherita Hill Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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Kabat GC, Heo M, Kamensky V, Miller AB, Rohan TE. Adult height in relation to risk of cancer in a cohort of Canadian women. Int J Cancer 2012; 132:1125-32. [PMID: 22753236 DOI: 10.1002/ijc.27704] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 06/11/2012] [Indexed: 11/09/2022]
Abstract
Although the influence of body mass index on cancer risk has been intensively investigated, few epidemiologic studies have examined the association of adult height with risk of cancer. We assessed the association of height with risk of all cancer and of 19 site-specific cancers in the Canadian National Breast Screening Study, a prospective cohort of nearly 90,000 women. Weight and height were measured at enrollment, and information on reproductive and medical history as well as lifestyle exposures was obtained by means of questionnaire. After exclusions, 5,679 incident invasive cancers were identified among 88,256 women. We used Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) per 10 cm increase in height. All tests of statistical significance were two sided. All cancers combined and ten specific sites (colorectum, colon, premenopausal breast, postmenopausal breast, endometrium, ovary, kidney, thyroid, melanoma and leukemia) showed statistically significant positive associations with height. The HR for all cancers combined was 1.13 (95% CI: 1.08-1.18), and the magnitude of the associations for specific sites ranged from HR 1.11 (95% CI: 1.03-1.20) for postmenopausal breast cancer to HR 1.51 (95% CI: 1.27-1.80) for melanoma. Our study provides strong support for a positive association of adult height with risk of certain cancers. The underlying biological mechanisms are not clear but may differ by anatomic site.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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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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