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Schlueter DJ, Sulieman L, Mo H, Keaton JM, Ferrara TM, Williams A, Qian J, Stubblefield O, Zeng C, Tran TC, Bastarache L, Dai J, Babbar A, Ramirez A, Goleva SB, Denny JC. Systematic replication of smoking disease associations using survey responses and EHR data in the All of Us Research Program. J Am Med Inform Assoc 2023; 31:139-153. [PMID: 37885303 PMCID: PMC10746325 DOI: 10.1093/jamia/ocad205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/04/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE The All of Us Research Program (All of Us) aims to recruit over a million participants to further precision medicine. Essential to the verification of biobanks is a replication of known associations to establish validity. Here, we evaluated how well All of Us data replicated known cigarette smoking associations. MATERIALS AND METHODS We defined smoking exposure as follows: (1) an EHR Smoking exposure that used International Classification of Disease codes; (2) participant provided information (PPI) Ever Smoking; and, (3) PPI Current Smoking, both from the lifestyle survey. We performed a phenome-wide association study (PheWAS) for each smoking exposure measurement type. For each, we compared the effect sizes derived from the PheWAS to published meta-analyses that studied cigarette smoking from PubMed. We defined two levels of replication of meta-analyses: (1) nominally replicated: which required agreement of direction of effect size, and (2) fully replicated: which required overlap of confidence intervals. RESULTS PheWASes with EHR Smoking, PPI Ever Smoking, and PPI Current Smoking revealed 736, 492, and 639 phenome-wide significant associations, respectively. We identified 165 meta-analyses representing 99 distinct phenotypes that could be matched to EHR phenotypes. At P < .05, 74 were nominally replicated and 55 were fully replicated. At P < 2.68 × 10-5 (Bonferroni threshold), 58 were nominally replicated and 40 were fully replicated. DISCUSSION Most phenotypes found in published meta-analyses associated with smoking were nominally replicated in All of Us. Both survey and EHR definitions for smoking produced similar results. CONCLUSION This study demonstrated the feasibility of studying common exposures using All of Us data.
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Affiliation(s)
- David J Schlueter
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- Department of Health and Society, University of Toronto, Scarborough, Toronto, ON, Canada
| | - Lina Sulieman
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Huan Mo
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- The Cohort Analytics Core (CAC), Center for Precision Health Research, National Human Genome Research Institute, Bethesda, MD, USA
| | - Jacob M Keaton
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Tracey M Ferrara
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Ariel Williams
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Jun Qian
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Onajia Stubblefield
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Chenjie Zeng
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Tam C Tran
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- The Cohort Analytics Core (CAC), Center for Precision Health Research, National Human Genome Research Institute, Bethesda, MD, USA
| | - Lisa Bastarache
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jian Dai
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Anav Babbar
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Andrea Ramirez
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Slavina B Goleva
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Joshua C Denny
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
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Rezaei F, Mazidimoradi A, Pasokh Z, Dehghani SP, Allahqoli L, Salehiniya H. Temporal trends of thyroid cancer between 2010 and 2019 in Asian countries by geographical region and SDI, comparison with global data. Aging Med (Milton) 2023; 6:386-426. [PMID: 38239716 PMCID: PMC10792336 DOI: 10.1002/agm2.12277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024] Open
Abstract
Objective This study aims to describe temporal trends of thyroid cancer (ThC) from 2010 to 2019, in Asian countries by geographical region and sociodemographic index, compared with global data. Method Annual case data and age-standardized rates (ASRs) of epidemiological indicators of ThC cancer data were collected from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied. The female/male ratio was calculated by dividing female ASRs by male ASRs. Also, these rates were compared between the age group ≥70 years old and younger age groups. Results In 2019, more than 50% of ThC cases and deaths occurred in Asian countries. A total of 53% of ThC patients lived in Asia and more than 60% of the global burden of ThC was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of ThC cancer increased over 1.28-, 1.26-, 1.3-, and 1.2-fold, in Asia, respectively. During this period, the age-standardized incidence rate (ASIR) and the age-standardized prevalence rate (ASPR) of ThC cancer increased by 5% and 8%, respectively, while the age-standardized death rate (ASDR) and the age-standardized DALYs rate (DALYs ASR) of ThC cancer decreased by 6% and 4%, respectively. These trends are different from what happens in other continents. In 2019, age-specific incidence, death, prevalence, and DALY cases of ThC cancer were peaking at 50-54, 75-79, 50-54, and 55-59 years, respectively. In 2019, the highest ASIR and ASPR of ThC cancer was observed in high-income Asia Pacific countries and the highest ASDR and DALYs ASR in Southeast Asia countries. Only high-income Asia Pacific countries experienced a decreasing trend in ASIR and ASPR from 2010 to 2019. ASDR and DALYs ASR have the highest decreasing trend in high-income Asia Pacific. In 2019, among high SDI Asian countries, the Republic of Korea had the highest ASIR and ASPR, and Brunei Darussalam had the highest ASDR and DALYs ASR. The highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer was found in Lebanon and Malaysia (high-middle SDIs), Vietnam (middle SDIs), and Cambodia and Palestine (low-middle SDIs). Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer. All indicators for most countries were higher in women than men. Conclusion More than half of the burden of thyroid cancer is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America, and Europe, the highest rate of death from thyroid cancer occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of thyroid cancer control in its residents.
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Affiliation(s)
- Fatemeh Rezaei
- Research Center for Social Determinants of HealthJahrom University of Medical SciencesJahromIran
| | | | - Zahra Pasokh
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | | | - Leila Allahqoli
- Midwifery DepartmentMinistry of Health and Medical EducationTehranIran
| | - Hamid Salehiniya
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research CenterBirjand University of Medical SciencesBirjandIran
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Molecular Testing Results for Indeterminate Thyroid Nodules and Social Habits. J Surg Res 2023; 284:245-250. [PMID: 36603517 DOI: 10.1016/j.jss.2022.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The effects of smoking and alcohol use on the risk of thyroid cancer remain unclear. We sought to investigate the association between these social habits, molecular testing results, and the risk of thyroid cancer. METHODS We conducted a retrospective chart review of patients with indeterminate thyroid nodules (Bethesda III and IV) who underwent molecular testing. The frequency of abnormal molecular testing results was compared among patients with varying smoking and alcohol consumption habits. RESULTS Of 460 patients, median age was 51.8 y, 78.3% were female, 60.7% were White, and 79.8% presented with Bethesda III nodules. The rate of malignancy was 42.6% overall; 73.4% of molecular testing was performed with Afirma, 20.1% with ThyroSeq, and 5.0% with ThyGeNEXT. For social habits, 72.2% never smoked and 40.9% never drank alcohol. Never/rare drinkers were less likely to have abnormal results compared to routine drinkers when considering all types of molecular testing together (83.2% versus 91.3%, P = 0.046), as were those who underwent ThyroSeq molecular testing (71.8% versus 94.4%, P = 0.045). Multivariable analysis revealed that being a routine drinker (adjusted OR 2.19, 95% CI 1.08-4.88), having a larger lesion (adjusted OR 0.65, 95% CI 0.54-0.77), being tested by ThyroSeq (adjusted OR 0.41, 95% CI 0.22-0.76), and other commercial panels (adjusted OR 0.12, 95% CI 0.02-0.64) were independent predictors of abnormal molecular testing results. CONCLUSIONS Our patients' social habits may be associated with the molecular testing results of their indeterminate thyroid nodules but not with their surgical pathology results.
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Nguyen LTD, Gunathilake M, Lee J, Kim J. Association between dietary habits and incident thyroid cancer: A prospective cohort study. Front Nutr 2023; 10:1104925. [PMID: 36875835 PMCID: PMC9975340 DOI: 10.3389/fnut.2023.1104925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
Background In addition to the thyroid cancer (TC) risk from lifestyle and environmental factors such as radiation exposure, some studies have indicated that diet may affect TC development; however, previous findings are inconsistent. The objective of our study was to investigate the association between dietary habits and TC risk in a Korean population. Materials and methods A total of 13,973 participants were selected after excluding ineligible subjects from the Cancer Screenee Cohort at National Cancer Center in Korea from October 2007 to December 2021. Participants were followed until May 2022 to identify incident TC cases. Information on dietary habits and general characteristics was collected using a self-report questionnaire administered at enrollment without keeping track of changes in eating habits during the follow-up period. A Cox proportional hazards model was used to determine the hazard ratio (HR) and 95% confidence interval (CI) of TC risk for each dietary factor. Results A total of 138 incident TC cases were identified during the median follow-up period of 7.6 years. Of the 12 dietary habits evaluated, only two habits showed significant associations with TC. A significantly decreased TC risk was found among participants who consumed milk and/or dairy products 5 or more days a week [adjusted HR (aHR), 0.58; 95% CI, 0.39-0.85]. Notably, a stronger protective effect of dairy consumption was observed in participants aged ≥ 50 years (aHR, 0.44; 95% CI, 0.26-0.75), in women (aHR, 0.53; 95% CI, 0.35-0.81), and in non-smokers (aHR, 0.60; 95% CI, 0.39-0.92). There was a reduced risk of TC in participants with meal durations longer than 10 min (aHR, 0.58; 95% CI, 0.41-0.83). However, this association was limited to individuals aged ≥ 50 years (aHR, 0.49; 95% CI, 0.31-0.79), women (aHR, 0.61; 95% CI, 0.41-0.90), and non-smokers (aHR, 0.62; 95% CI, 0.41-0.92). Conclusion Our findings suggest that consuming milk and/or dairy products 5 or more days a week and having a meal duration longer than 10 min could be protective factors against TC, especially in individuals aged ≥ 50 years, women and non-smokers. Further prospective studies are needed to investigate the association of dietary intake with specific types of TC.
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Affiliation(s)
- Linh Thi Dieu Nguyen
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Madhawa Gunathilake
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
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Zablotska LB, Richardson DB, Golden A, Pasqual E, Smith B, Rage E, Demers PA, Do M, Fenske N, Deffner V, Kreuzer M, Samet J, Bertke S, Kelly-Reif K, Schubauer-Berigan MK, Tomasek L, Wiggins C, Laurier D, Apostoaei I, Thomas BA, Simon SL, Hoffman FO, Boice JD, Dauer LT, Howard SC, Cohen SS, Mumma MT, Ellis ED, Eckerman KF, Leggett RW, Pawel DJ. The epidemiology of lung cancer following radiation exposure. Int J Radiat Biol 2022; 99:569-580. [PMID: 35947399 PMCID: PMC9943789 DOI: 10.1080/09553002.2022.2110321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Lydia B Zablotska
- Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
| | - David B. Richardson
- Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences University of California, Irvine, Irvine, CA, USA
| | - Ashley Golden
- Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA
| | - Elisa Pasqual
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA
| | | | - Estelle. Rage
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | | | - Minh Do
- Occupational Cancer Research Centre, Toronto, Canada
| | - Nora Fenske
- Federal Office for Radiation Protection (BfS), Munich (Neuherberg), Germany
| | - Veronika Deffner
- Federal Office for Radiation Protection (BfS), Munich (Neuherberg), Germany
| | - Michaela Kreuzer
- Federal Office for Radiation Protection (BfS), Munich (Neuherberg), Germany
| | | | - Stephen Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | | | | | - Charles Wiggins
- University of New Mexico, Albuquerque, NM, USA
- New Mexico Tumor Registry, Albuquerque, NM, USA
| | - Dominque Laurier
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | | | - Brian A. Thomas
- Oak Ridge Center for Risk Analysis, Inc., Oak Ridge, TN, USA
| | - Steven L. Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA
| | - F. Owen Hoffman
- Oak Ridge Center for Risk Analysis, Inc., Oak Ridge, TN, USA
| | - John D. Boice
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
- National Council on Radiation Protection and Measurements (NCRP), Bethesda, MD, USA
| | | | - Sara C. Howard
- Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA
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Pasqual E, Schonfeld S, Morton LM, Villoing D, Lee C, Berrington de Gonzalez A, Kitahara CM. Association Between Radioactive Iodine Treatment for Pediatric and Young Adulthood Differentiated Thyroid Cancer and Risk of Second Primary Malignancies. J Clin Oncol 2022; 40:1439-1449. [PMID: 35044839 PMCID: PMC9061144 DOI: 10.1200/jco.21.01841] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Since the 1980s, both the incidence of differentiated thyroid cancer (DTC) and use of radioactive iodine (RAI) treatment increased markedly. RAI has been associated with an increased risk of leukemia, but risks of second solid malignancies remain unclear. We aimed to quantify risks of second malignancies associated with RAI treatment for DTC in children and young adults, who are more susceptible than older adults to the late effects of radiation. METHODS Using nine US SEER cancer registries (1975-2017), we estimated relative risks (RRs) for solid and hematologic malignancies associated with RAI (yes v no or unknown) using Poisson regression among ≥ 5- and ≥ 2-year survivors of nonmetastatic DTC diagnosed before age 45 years, respectively. RESULTS Among 27,050 ≥ 5-year survivors (median follow-up = 15 years), RAI treatment (45%) was associated with increased risk of solid malignancies (RR = 1.23; 95% CI, 1.11 to 1.37). Risks were increased for uterine cancer (RR = 1.55; 95% CI, 1.03 to 2.32) and nonsignificantly for cancers of the salivary gland (RR = 2.15; 95% CI, 0.91 to 5.08), stomach (RR = 1.61; 95% CI, 0.70 to 3.69), lung (RR = 1.42; 95% CI, 0.97 to 2.08), and female breast (RR = 1.18; 95% CI, 0.99 to 1.40). Risks of total solid and female breast cancer, the most common cancer type, were highest among ≥ 20-year DTC survivors (RRsolid = 1.47; 95% CI, 1.24 to 1.74; RRbreast = 1.46; 95% CI, 1.10 to 1.95). Among 32,171 ≥ 2-year survivors, RAI was associated with increased risk of hematologic malignancies (RR = 1.51; 95% CI, 1.08 to 2.01), including leukemia (RR = 1.92; 95% CI, 1.04 to 3.56). We estimated that 6% of solid and 14% of hematologic malignancies in pediatric and young adult DTC survivors may be attributable to RAI. CONCLUSION In addition to leukemia, RAI treatment for childhood and young-adulthood DTC was associated with increased risks of several solid cancers, particularly more than 20 years after exposure, supporting the need for long-term surveillance of these patients.
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Affiliation(s)
- Elisa Pasqual
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Sara Schonfeld
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | | | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | | | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD,Cari M. Kitahara, PhD, MHS, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rm. 7E-456, Bethesda, MD 20892; e-mail:
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Yeo Y, Shin DW, Han K, Kim D, Kim TH, Chun S, Jeong SM, Song YM. Smoking, Alcohol Consumption, and the Risk of Thyroid Cancer: A Population-Based Korean Cohort Study of 10 Million People. Thyroid 2022; 32:440-448. [PMID: 35236095 DOI: 10.1089/thy.2021.0675] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: It is unclear if cigarette smoking and alcohol consumption are associated with thyroid cancer risk. Our aim was to explore for any associations between cigarette smoking and alcohol consumption with thyroid cancer, after adjusting for potential confounders. Methods: Using data from the Korean National Health Insurance database, we retrospectively identified individuals aged ≥20 years who participated in the 2009 health screening program and were followed until 2017. We estimated the adjusted hazard ratio (aHR) for the risk of thyroid cancer using a Cox proportional hazard model, adjusted for age, sex, regular exercise, monthly income, body mass index, diabetes mellitus, and dyslipidemia. Results: During a mean follow-up period of 8.33 ± 0.57 years, of 9,699,104 participants, 89,527 (0.9%) were diagnosed with thyroid cancer. Compared with those who never smoked, current smokers had a lower risk of thyroid cancer (aHR: 0.74, 95% confidence interval [CI]: 0.72-0.76), while ex-smokers did not (aHR: 0.98, 95% CI: 0.96-1.01). There was no significant dose-response relationship with regard to daily amount smoked, duration of smoking, or pack-years. A reduced risk of thyroid cancer was observed in subjects who reported the following categories of alcohol intake (compared with none): mild (aHR: 0.92, 95% CI: 0.90-0.93), moderate (aHR: 0.86, 95% CI: 0.84-0.89), and heavy (aHR: 0.86, 95% CI: 0.82-0.89). Inverse associations with thyroid cancer risk were observed regarding the number of drinking episodes per week and the number of drinks per occasion. A submultiplicative effect of smoking and alcohol consumption was observed (p-interaction <0.001). Conclusions: We observed that thyroid cancer risk was inversely associated with smoking and alcohol consumption, with a significant interaction between these variables.
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Affiliation(s)
- Yohwan Yeo
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute of Health Science and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sohyun Chun
- International Healthcare Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Su-Min Jeong
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yun-Mi Song
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute of Health Science and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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Franchini F, Palatucci G, Colao A, Ungaro P, Macchia PE, Nettore IC. Obesity and Thyroid Cancer Risk: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031116. [PMID: 35162142 PMCID: PMC8834607 DOI: 10.3390/ijerph19031116] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/07/2023]
Abstract
Thyroid cancer (TC) is the most common endocrine malignancy worldwide and its incidence has increased dramatically in recent years. In parallel, the prevalence of overweight and obesity has also increased, suggesting a possible link between these two diseases. Indeed, low-grade chronic inflammation, altered cytokine levels, insulin resistance, oxidative stress, and hormonal changes that occur in obese patients are all factors that contribute to the occurrence and growth of TC. In this review, the most recent evidence supporting the potential role of the mechanisms linking obesity to TC will be discussed.
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Affiliation(s)
- Fabiana Franchini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Giuseppe Palatucci
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Paola Ungaro
- National Research Council–Institute for Experimental Endocrinology & Oncology ‘Gaetano Salvatore’, 80145 Napoli, Italy;
| | - Paolo Emidio Macchia
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Immacolata Cristina Nettore
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
- Correspondence: ; Tel.: +39-081-7463848; Fax: +39-081-7462108
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Ambient particulate matter air pollution is associated with increased risk of papillary thyroid cancer. Surgery 2022; 171:212-219. [PMID: 34210530 PMCID: PMC8688174 DOI: 10.1016/j.surg.2021.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/27/2021] [Accepted: 05/01/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The association between exposure to air pollution and papillary thyroid carcinoma is unknown. We sought to estimate the relationship between long-term exposure to the fine (diameter ≤ 2.5 μm) particulate matter component of air pollution and the risk of papillary thyroid cancer. METHODS Adult (age ≥18) patients with newly diagnosed papillary thyroid carcinoma between January 1, 2013 and December 31, 2016 across a single health system were identified using electronic medical records. Data from 1,990 patients with papillary thyroid carcinoma were compared with 3,980 age- and sex-matched control subjects without any evidence of thyroid disease. Cumulative fine (diameter <2.5 μm) particulate matter exposure was estimated by incorporating patients' residential zip codes into a deep learning neural networks model, which uses both meteorological and satellite-based measurements. Conditional logistic regression was performed to assess for association between papillary thyroid carcinoma and increasing fine (diameter ≤2.5 μm) particulate matter concentrations over 1, 2, and 3 years of cumulative exposure preceding papillary thyroid carcinoma diagnosis. RESULTS Increased odds of developing papillary thyroid carcinoma was associated with a 5 μg/m3 increase of fine (diameter ≤2.5 μm) particulate matter concentrations over 2 years (adjusted odds ratio = 1.18, 95% confidence interval: 1.00-1.40) and 3 years (adjusted odds ratio = 1.23, 95% confidence interval: 1.05-1.44) of exposure. This risk differed by smoking status (pinteraction = 0.04). Among current smokers (n = 623), the risk of developing papillary thyroid carcinoma was highest (adjusted odds ratio = 1.35, 95% confidence interval: 1.12-1.63). CONCLUSION Increasing concentration of fine (diameter ≤2.5 μm) particulate matter in air pollution is significantly associated with the incidence of papillary thyroid carcinoma with 2 and 3 years of exposure. Our novel findings provide additional insight into the potential associations between risk factors and papillary thyroid carcinoma and warrant further investigation, specifically in areas with high levels of air pollution both nationally and internationally.
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Nguyen DN, Kim J, Kim MK. Association of Metabolic Health and Central Obesity With the Risk of Thyroid Cancer: Data from the Korean Genome and Epidemiology Study. Cancer Epidemiol Biomarkers Prev 2021; 31:543-553. [PMID: 34933959 DOI: 10.1158/1055-9965.epi-21-0255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/23/2021] [Accepted: 12/08/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND It is unknown whether the risk of thyroid cancer differs among metabolically healthy/unhealthy, normal-weight, or obese women. We aimed to assess the association of metabolic health and obesity with thyroid cancer risk. METHODS The Korean Genome and Epidemiology Study is a population-based prospective cohort study. Data were obtained from 173,343 participants (age {greater than or equal to}40 years) enrolled from 2004 to 2013. Obese participants were those with body mass index (BMI) {greater than or equal to}25 kg/m2. Participants with abnormalities in three of these indices were considered metabolically unhealthy: triglycerides, blood pressure, high-density lipoprotein cholesterol (HDL-cholesterol), waist circumference (WC), and fasting glucose levels. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for thyroid cancer risk associated with metabolic health and obesity. RESULTS Compared to non-obese women without metabolic abnormalities, metabolically unhealthy women, either normal-weight or obese, had an increased risk of thyroid cancer (HR [95% CI]=1.57[1.02-2.40] and 1.71[1.21-2.41], respectively). Significant association was not observed in men. Thyroid cancer risk was higher among non-obese women with high WC ({greater than or equal to}85 cm; HR [95% CI]=1.62[1.03-2.56]) than in non-obese women with low WC, and in obese women with low HDL-cholesterol (<50 mg/dL; HR[95% CI]=1.75[1.26-2.42]) compared to non-obese women with high HDL-cholesterol. CONCLUSIONS Metabolically unhealthy women or women with central adiposity may be at an increased thyroid cancer risk despite normal BMI. IMPACT This study suggests that women with central obesity and metabolically abnormality despite normal BMI may constitute a target group for thyroid cancer prevention and control programs.
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Affiliation(s)
- Dung Ngoc Nguyen
- Division of Cancer Epidemiology and Prevention, National Cancer Center
| | - Jinhee Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center
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11
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Rahman ST, Pandeya N, Neale RE, McLeod DSA, Baade PD, Youl PH, Allison R, Leonard S, Jordan SJ. Tobacco smoking and risk of thyroid cancer according to BRAF V600E mutational subtypes. Clin Endocrinol (Oxf) 2021; 95:891-900. [PMID: 34170568 DOI: 10.1111/cen.14545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Smoking has been associated with a reduced risk of thyroid cancer, but whether the association varies between higher- and lower-risk cancers remains unclear. We aimed to assess the association between smoking and risk of thyroid cancer overall as well as by tumour BRAF mutational status as a marker of potentially higher-risk cancer. DESIGN AND PATIENTS We recruited 1013 people diagnosed with thyroid cancer and 1057 population controls frequency-matched on age and sex. METHODS Multivariable logistic regression was used to assess the association overall and in analyses stratified by tumour characteristics. We used sensitivity analysis to assess the potential for selection bias. RESULTS We found little evidence of an association with current smoking (odds ratio [OR] = 0.93; 95% confidence interval [CI]: 0.69-1.26; current vs. never smoking), but a higher number of pack-years of smoking was associated with a lower risk of thyroid cancer (OR = 0.75; 95% CI: 0.57-0.99; ≥20 pack-years vs. never). However, after correcting for potential selection bias, we observed a statistically significant inverse association between current smoking and risk of thyroid cancer (bias-corrected OR = 0.65; 95% CI: 0.51-0.83). Those with BRAF-positive cancers were less likely to be current smokers than those with BRAF-negative cancers (prevalence ratio: 0.79; 95% CI: 0.62-0.99). CONCLUSION We found smoking was inversely related to thyroid cancer risk and, in particular, current smoking was associated with a reduced risk of potentially more aggressive BRAF-positive than the likely more indolent BRAF-negative papillary thyroid cancers.
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Affiliation(s)
- Sabbir T Rahman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Nirmala Pandeya
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Donald S A McLeod
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Peter D Baade
- Cancer Council Queensland, Brisbane, Queensland, Australia
- Menzies Health Institute, Griffith University, Southport, Queensland, Australia
| | - Philippa H Youl
- Cancer Alliance Queensland, Metro South Hospital and Health Service, Woolloongabba, Queensland, Australia
| | - Roger Allison
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Susan Leonard
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Susan J Jordan
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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12
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Spatial distribution and determinants of thyroid cancer incidence from 1999 to 2013 in Korea. Sci Rep 2021; 11:22474. [PMID: 34795315 PMCID: PMC8602462 DOI: 10.1038/s41598-021-00429-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 09/29/2021] [Indexed: 11/23/2022] Open
Abstract
We evaluated the spatial variation in thyroid cancer incidence and its determinants in Korea considering its importance in cancer prevention and control. This study was based on the ecological design with cancer incidence data by administrative district from the National Cancer Center and regional characteristics generated from the Korea Community Health Survey Data. We identified spatial clusters of thyroid cancer incidences based on spatial scan statistics. Determinants of regional variation in thyroid cancer incidence were assessed using the Besag-York-Mollie model with integrated nested Laplace approximations. Spatial clusters for low and high thyroid cancer incidences were detected in the northeastern and southwestern regions, respectively. Regional variations in thyroid cancer incidence can be attributed to the prevalence of recipients of basic livelihood security (coefficient, - 1.59; 95% credible interval [CI], - 2.51 to - 0.67), high household income (coefficient, 0.53; 95% CI, 0.31 to 0.76), heavy smoking (coefficient, - 0.91; 95% CI, - 1.59 to - 0.23), thyroid dysfunction (coefficient, 3.24; 95% CI, 1.47 to 5.00), and thyroid cancer screening (coefficient, 0.38; 95% CI, 0.09 to 0.67). This study presented the spatial variations in thyroid cancer incidence, which can be explained by the prevalence of socioeconomic factors, thyroid cancer screening, thyroid dysfunction, and smoking.
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13
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ÇETİN Z. Hypoechoic nodule structure increases non-diagnostic rate of thyroid fine needle aspiration biopsy. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.976299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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14
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Truong T, Lesueur F, Sugier PE, Guibon J, Xhaard C, Karimi M, Kulkarni O, Lucotte EA, Bacq-Daian D, Boland-Auge A, Mulot C, Laurent-Puig P, Schvartz C, Guizard AV, Ren Y, Adjadj E, Rachédi F, Borson-Chazot F, Ortiz RM, Lence-Anta JJ, Pereda CM, Comiskey DF, He H, Liyanarachchi S, de la Chapelle A, Elisei R, Gemignani F, Thomsen H, Forsti A, Herzig AF, Leutenegger AL, Rubino C, Ostroumova E, Kesminiene A, Boutron-Ruault MC, Deleuze JF, Guénel P, de Vathaire F. Multiethnic genome-wide association study of differentiated thyroid cancer in the EPITHYR consortium. Int J Cancer 2021; 148:2935-2946. [PMID: 33527407 DOI: 10.1002/ijc.33488] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/17/2020] [Accepted: 01/11/2021] [Indexed: 02/05/2023]
Abstract
Incidence of differentiated thyroid carcinoma (DTC) varies considerably between ethnic groups, with particularly high incidence rates in Pacific Islanders. DTC is one of the cancers with the highest familial risk suggesting a major role of genetic risk factors, but only few susceptibility loci were identified so far. In order to assess the contribution of known DTC susceptibility loci and to identify new ones, we conducted a multiethnic genome-wide association study (GWAS) in individuals of European ancestry and of Oceanian ancestry from Pacific Islands. Our study included 1554 cases/1973 controls of European ancestry and 301 cases/348 controls of Oceanian ancestry from seven population-based case-control studies participating to the EPITHYR consortium. All participants were genotyped using the OncoArray-500K Beadchip (Illumina). We confirmed the association with the known DTC susceptibility loci at 2q35, 8p12, 9q22.33 and 14q13.3 in the European ancestry population and suggested two novel signals at 1p31.3 and 16q23.2, which were associated with thyroid-stimulating hormone levels in previous GWAS. We additionally replicated an association with 5p15.33 reported previously in Chinese and European populations. Except at 1p31.3, all associations were in the same direction in the population of Oceanian ancestry. We also observed that the frequencies of risk alleles at 2q35, 5p15.33 and 16q23.2 were significantly higher in Oceanians than in Europeans. However, additional GWAS and epidemiological studies in Oceanian populations are needed to fully understand the highest incidence observed in these populations.
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Affiliation(s)
- Thérèse Truong
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Fabienne Lesueur
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Pierre-Emmanuel Sugier
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Julie Guibon
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Constance Xhaard
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
- University of Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, FCRIN, INI-CRCT, Nancy, France
| | - Mojgan Karimi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Om Kulkarni
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Elise A Lucotte
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Delphine Bacq-Daian
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Anne Boland-Auge
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Claire Mulot
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Claire Schvartz
- Registre des Cancers Thyroïdiens, Institut GODINOT, Reims, France
| | - Anne-Valérie Guizard
- Registre Général des tumeurs du Calvados, Centre François Baclesse, Caen, France
- Inserm U1086 -UCN "ANTICIPE", Caen, France
| | - Yan Ren
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
| | - Elisabeth Adjadj
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
| | - Frédérique Rachédi
- Endocrinology Unit, Territorial Hospital Taaone, Papeete, Tahiti, French Polynesia
| | - Francoise Borson-Chazot
- Fédération d'endocrinologie, Hôpital Louis Pradel, Hospices Civils de Lyon, EA 7425, Université Lyon 1, Lyon, France
| | | | | | | | - Daniel F Comiskey
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Huiling He
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Sandya Liyanarachchi
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Albert de la Chapelle
- Human Cancer Genetics Program and Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | | | | | - Hauke Thomsen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- GeneWerk GmbH, Heidelberg, Germany
| | - Asta Forsti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Anthony F Herzig
- Inserm, U1078, GGB, Université de Bretagne Occidentale, EFS, Brest, France
| | | | - Carole Rubino
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
| | | | | | | | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Pascal Guénel
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Florent de Vathaire
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France
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15
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Lee JH, Chai YJ, Yi KH. Effect of Cigarette Smoking on Thyroid Cancer: Meta-Analysis. Endocrinol Metab (Seoul) 2021; 36:590-598. [PMID: 34034364 PMCID: PMC8258339 DOI: 10.3803/enm.2021.954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/29/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Although smoking is generally carcinogenic, its effect on thyroid cancers is still subject to controversy. The purpose of this study was to summarize the role of smoking in relation to thyroid cancer occurrence. METHODS We performed a meta-analysis of 24 eligible studies: 21 case-control studies and three prospective cohort studies. The summary odds ratio (OR) and 95% confidence interval (CI) of all studies were acquired based on random effect model. Further subgroup analyses were conducted according to gender, histological type of thyroid cancer, and smoking status of patients for the case-control studies. RESULTS The summary effect size indicated a negative association of smoking for thyroid cancer (OR, 0.798; 95% CI, 0.681 to 0.935). From the subgroup analyses for the case-control studies, reduced risk of thyroid cancer was observed in both men (OR, 0.734; 95% CI, 0.553 to 0.974) and women (OR, 0.792; 95% CI, 0.700 to 0.897). The protective effect of smoking was observed in studies in which thyroid cancer was limited to differentiated thyroid cancers (DTCs) (OR, 0.798; 95% CI, 0.706 to 0.902). CONCLUSION Our results suggests that smoking may have a protective effect on thyroid cancer, especially on DTCs. Further studies with larger sample sizes should be conducted in elucidating the dose and time dependent effect of smoking on thyroid cancer with specific focus on the types of thyroid cancers.
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Affiliation(s)
- Joon-Hyop Lee
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Young Jun Chai
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul,
Korea
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul,
Korea
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16
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Baron JA, Nichols HB, Anderson C, Safe S. Cigarette Smoking and Estrogen-Related Cancer. Cancer Epidemiol Biomarkers Prev 2021; 30:1462-1471. [PMID: 33990391 DOI: 10.1158/1055-9965.epi-20-1803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/13/2021] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
Cigarette smoking is a known cause of many cancers, yet epidemiologic studies have found protective associations with the risk of four "estrogen-related" malignancies: endometrial cancer, endometrioid and clear cell ovarian cancers, and thyroid cancer. This review considers epidemiologic and biological aspects of these associations, focusing particularly on estrogen signaling, and contrasts them with those for breast cancer, another estrogen-related malignancy. The observational findings regarding the inverse associations are consistent and remain after adjustment for possible confounding factors. In general, women who smoke do not have lower circulating estrogen levels than nonsmokers, eliminating one possible explanation for reduced risks of these malignancies. For endometrial and endometrioid ovarian cancer, the negative associations could plausibly be explained by interference with signaling through the estrogen receptor α. However, this is unlikely to explain the lower risks of thyroid and clear cell ovarian cancers. For thyroid cancer, an anti-inflammatory effect of nicotine and reduced TSH levels from smoking have been proposed explanations for the inverse association, but both lack convincing evidence. While the overall impact of cigarette smoking is overwhelmingly negative, protective associations such as those discussed here can provide potential clues to disease etiology, treatment, and prevention.
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Affiliation(s)
- John A Baron
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina. .,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Chelsea Anderson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Stephen Safe
- Department of Veterinary Physiology & Pharmacology, Texas A&M University, College Station, Texas
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Yeo Y, Han K, Shin DW, Kim D, Jeong SM, Chun S, Choi IY, Jeon KH, Kim TH. Changes in Smoking, Alcohol Consumption, and the Risk of Thyroid Cancer: A Population-Based Korean Cohort Study. Cancers (Basel) 2021; 13:cancers13102343. [PMID: 34066228 PMCID: PMC8150527 DOI: 10.3390/cancers13102343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 01/23/2023] Open
Abstract
Simple Summary The inverse association between smoking, alcohol intake, and thyroid cancer has been suggested by observational studies. From the representative data in Korea, we identified the epidemiologic evidence to elucidate the true effect between smoking, alcohol intake, and thyroid cancer incidence by exploring the effect of changes in smoking and alcohol consumption habits. Abstract To elucidate potential causality between smoking and alcohol intake on thyroid cancer incidence, we explored the effect of changes in smoking and alcohol consumption habits. From the Korean National Health Insurance database, we identified 4,430,070 individuals who participated in the national health screening program in 2009 and 2011. The level of smoking and alcohol consumption was measured twice, once in 2009 and again in 2011. The risk of thyroid cancer according to their changes was estimated using the Cox proportional hazard model. During the mean follow-up period of 6.32 ± 0.72 years, 29,447 individuals were diagnosed with thyroid cancer. Compared to those who sustained not smoking, non-smokers who initiated smoking to light (adjusted hazard ratio (aHR) 0.96, 95% confidence interval (CI) 0.81–1.15), moderate (aHR 0.90, 95% CI 0.78–1.04), and heavy level (aHR 0.81, 95% CI 0.69–0.96) had a decreased risk of thyroid cancer. Heavy smokers who quit smoking had an increased risk of thyroid cancer (aHR 1.23, 95% CI 1.06–1.42) compared to those who sustained heavy smoking. Change in drinking status was not significantly associated with thyroid cancer risk compared to drinking at the same level, although a non-significant trend of increased risk was noted in quitters. Participants who initiated both smoking and drinking (HR 0.80, 95% CI 0.69–0.93) had a lower risk of thyroid cancer compared with those who continued not to smoke and drink. Our findings provide further evidence that smoking, and possibly alcohol consumption, would have true protective effects on the development of thyroid cancer.
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Affiliation(s)
- Yohwan Yeo
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea
- Correspondence: (K.H.); (D.-W.S.)
| | - Dong-Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea
- Department of Digital Health (SAIHST), Sungkyunkwan University, Seoul 06351, Korea
- Correspondence: (K.H.); (D.-W.S.)
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul 06591, Korea;
| | - Su-Min Jeong
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
| | - Sohyun Chun
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
- International Healthcare Center, Samsung Medical Center, Seoul 06351, Korea
| | - In-Young Choi
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
- International Healthcare Center, Samsung Medical Center, Seoul 06351, Korea
| | - Keun-Hye Jeon
- CHA Gumi Medical Center, Department of Family Medicine, Gumi 39295, Korea;
| | - Tae-Hyuk Kim
- Thyroid Center, Samsung Medical Center, Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
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Muciño-Hernández MI, Montoya-Fuentes H, Ochoa-Plascencia MR, Vázquez-Camacho G, Morales-Jeanhs EA, Bencomo-Álvarez AE, Chejfec-Ciociano JM, Fuentes-Orozco C, Barbosa-Camacho FJ, González-Ojeda A. Molecular Identification of Human Papillomavirus DNA in Thyroid Neoplasms: Association or Serendipity? Cureus 2021; 13:e14578. [PMID: 33898151 PMCID: PMC8057935 DOI: 10.7759/cureus.14578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Human papillomavirus (HPV) is recognized as the most important cofactor in the etiology of cancers of the cervix, esophagus, larynx, and nasopharynx. Experimental evidence suggests that HPV could have an oncogenic influence on thyroid follicular cells; however, to the best of our knowledge, there is no record of its role in human thyroid gland neoplasms. Objective: The purpose of this study is to describe the frequency and the types of HPV present in neoplastic thyroid tissue by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Methods: Over 157 samples were analyzed of paraffin-embedded tissue from malignant and benign thyroid tumors. All the paraffin blocks were selected consecutively from the Pathology Tissue Bank archive of the Western Medical Center. The molecular detection and typing were performed at the Molecular Microbiology Laboratory of the Biomedical Research Center, Mexican Institute of Social Security. Results: The frequency of HPV findings was 2.5% (four cases). HPV-6 was found in two cases of thyroid hyperplasia (2.5%), and HPV-33 in two cases of papillary cancer (4.6%). Conclusion: The presence of HPV is not frequent in thyroid neoplasms, at least in the studied population. Due to the low prevalence of this virus in our sample, it is not possible to reach conclusions. Further research is needed.
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Affiliation(s)
| | - Héctor Montoya-Fuentes
- Molecular Microbiology Laboratory, Biomedical Research Center 01, Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
| | | | - Gonzalo Vázquez-Camacho
- Basic Science, School of Medicine, Instituto Tecnológico de Estudios Superiores de Monterrey, Monterrey, MEX
| | - Elías Adrián Morales-Jeanhs
- Molecular Microbiology Laboratory, Biomedical Research Center 01, Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
| | - Alfonso Enrique Bencomo-Álvarez
- Molecular Microbiology Laboratory, Biomedical Research Center 01, Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
| | - Jonathan Matias Chejfec-Ciociano
- Biomedical Research Unit 02, Specialties Hospital - Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Specialties Hospital - Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
| | - Francisco José Barbosa-Camacho
- Biomedical Research Unit 02, Specialties Hospital - Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
| | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Specialties Hospital - Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX
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Kim SY, Song YS, Wee JH, Min C, Yoo DM, Lee CH, Song CM, Park B, Choi HG. Evaluation of the relationship between previous statin use and thyroid cancer using Korean National Health Insurance Service-Health Screening Cohort data. Sci Rep 2021; 11:7912. [PMID: 33846511 PMCID: PMC8041859 DOI: 10.1038/s41598-021-87297-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/26/2021] [Indexed: 12/11/2022] Open
Abstract
The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04–1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82–0.95, P = 0.001). According to age and sex subgroups, the younger (< 60 years old) male group showed lower odds for thyroid cancer according to previous statin use (adjusted OR = 0.70, 95% CI 0.55–0.88, P = 0.003), but this finding was not observed in other subgroups of older men or in any groups of women. Thyroid cancer was negatively associated with statin use in the previous 2 years in the adjusted model.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Young Shin Song
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jee Hye Wee
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
| | - Chang-Ho Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Myeon Song
- Department of Otorhinolaryngology-Head & Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea. .,Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.
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20
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van Gerwen M, Alpert N, Alsen M, Ziadkhanpour K, Taioli E, Genden E. The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis. TOXICS 2020; 8:toxics8040116. [PMID: 33316920 PMCID: PMC7768414 DOI: 10.3390/toxics8040116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 01/09/2023]
Abstract
Perfluoroalkyl acids (PFAS) are known endocrine disrupting chemicals, potentially affecting thyroid function. Smoking has been associated with PFAS levels as well as with thyroid function. The impact of smoking on the association between PFAS and thyroid function remains to be elucidated, so the objective was to assess the effect of PFAS exposure on thyroid function in the general population, stratified by smoking status, using the National Health and Nutrition Examination Survey (NHANES). NHANES adult participants who were part of the 2011–2012 laboratory subsample and had PFAS and thyroid function measured were included (n = 1325). Adjusted linear regression models and stratified analyses were performed. There was a significant positive association between perfluorooctanesulfonic acid (PFOS) (p = 0.003), perfluorononanoic acid (PFNA) (p = 0.014), total PFAS (p = 0.004) concentrations and free T4 (FT4). No significant associations were found between perfluorooctanoic acid (PFOA), PFOS, perfluorohexane sulfonate (PFHxS), PFNA, total PFAS and total T4 (TT4) or thyroid stimulating hormone (TSH). In non-smokers, a significant positive association was found between PFOS (p = 0.003), PFHxS (p = 0.034), PFNA (p = 0.012), total PFAS (p = 0.003) and FT4 while no significant associations were found in smokers. The present study showed that increased PFAS exposure was associated with increased FT4 in non-smokers, while no association was found in smokers. These results confirm that smoking modifies the association between PFAS exposure and thyroid function.
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Affiliation(s)
- Maaike van Gerwen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.A.); (E.G.)
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (N.A.); (E.T.)
- Correspondence: ; Tel.: +1-212-659-9620; Fax: +1-212-423-2998
| | - Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (N.A.); (E.T.)
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mathilda Alsen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.A.); (E.G.)
| | - Kimia Ziadkhanpour
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (N.A.); (E.T.)
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Eric Genden
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.A.); (E.G.)
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21
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Wang M, Gong WW, Lu F, He QF, Hu RY, Zhong JM, Yu M. Associations of intensity, duration, cumulative dose, and age at start of smoking, with thyroid cancer in Chinese males: A hospital-based case-control study in Zhejiang Province. Tob Induc Dis 2020; 18:97. [PMID: 33281531 PMCID: PMC7713696 DOI: 10.18332/tid/130350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/25/2020] [Accepted: 11/10/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION There has been considerable research on the association between smoking status and thyroid cancer risk in males, yet the findings are inconsistent. In this study, we investigated the associations of intensity, duration, cumulative dose, and age at start of smoking, with thyroid cancer in Chinese males. METHODS From a 1:1 matched case–control study conducted between 2015 and 2017 in Zhejiang Province, China, 676 pairs of male subjects were included in the analysis. The associations between smoking characteristics and thyroid cancer were evaluated in logistic regression models by odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Compared with never smokers, the former smokers were 0.096 times (95% CI: 0.012–0.778) less likely to have thyroid cancer. The significant inverse association was not observed in current smokers (OR=0.333; 95% CI: 0.084–1.322). Among both former and current smokers, higher smoking intensity (>10 cigarettes/day), duration (>15 years), and cumulative dose of smoking (>10 packyears) were significantly associated with reduced occurrence of thyroid cancer. CONCLUSIONS Our findings indicate that former smoking is inversely associated with thyroid cancer occurrence in Chinese males. The reduction in the occurrence of thyroid cancer was also confirmed for both former and current smokers with higher smoking intensity, duration, and cumulative dose.
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Affiliation(s)
- Meng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wei W Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Feng Lu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qing F He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ru Y Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jie M Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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22
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An SY, Kim SY, Oh DJ, Min C, Sim S, Choi HG. Obesity is positively related and tobacco smoking and alcohol consumption are negatively related to an increased risk of thyroid cancer. Sci Rep 2020; 10:19279. [PMID: 33159164 PMCID: PMC7648098 DOI: 10.1038/s41598-020-76357-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 10/28/2020] [Indexed: 12/13/2022] Open
Abstract
The purpose of this study was to evaluate the relationships of smoking, alcohol consumption, and obesity with thyroid cancer in Korean residents. The Korean National Health Insurance Service-Health Screening Cohort includes individuals ≥ 40 years who were assessed from 2002 to 2013. In total, 4977 thyroid cancer participants were matched with respect to age, sex, income, and region of residence with 19,908 controls at a ratio of 1:4. Crude and adjusted (for the Charlson comorbidity index, smoking status, frequency of alcohol consumption, and obesity) odds ratios (ORs) were analyzed using conditional logistic regression analyses. Additionally, 95% confidence intervals (CIs) were calculated. The adjusted OR of smoking for thyroid cancer was 0.62 (95% CI 0.54–0.72, P < 0.001), and that of alcohol consumption was 0.83 (95% CI 0.75–0.92, P < 0.001). The adjusted ORs of the BMI categories were 1.13 (95% CI 1.05–1.22, P = 0.002) for obese I, and 1.24 (95% CI 1.04–1.47, P = 0.014) for obese II. The ORs of smoking and alcohol consumption were lower, and those of overweight and obesity were higher in thyroid cancer patients than in individuals in the control group.
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Affiliation(s)
- Soo-Youn An
- Department of Otorhinolaryngology-Head & Neck Surgery, Thyroid/Head & Neck Cancer Center of the Dongnam Institute of Radiological & Medical Sciences (DIRAMS), Busan, Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dong Jun Oh
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Songyoung Sim
- Department of Statistics and Institute of Statistics, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea. .,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.
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23
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Lee JH, Youn S, Jung S, Kim K, Chai YJ, Chung YS, Park WS, Lee KE, Yi KH. A national database analysis for factors associated with thyroid cancer occurrence. Sci Rep 2020; 10:17791. [PMID: 33082385 PMCID: PMC7576121 DOI: 10.1038/s41598-020-74546-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023] Open
Abstract
In order to analyze the associations between thyroid cancer and environmental factors, we analyzed the national sample cohort representative of the entire population provided by the Korean National Health Insurance Service database record from 2006 to 2015. The cohort was categorized according to age, body mass index, income, residential areas, frequency of exercise, frequency of alcohol drinking, diet, presence or absence of hyperthyroidism, presence or absence of hypothyroidism, and smoking data. Age ≥ 55 years (HR 0.68, 95% CI 0.53–0.88), lower income (0.57, 0.40–0.80), and current smoking (0.69, 0.55–0.85) were associated with lower thyroid cancer occurrence among men. Body mass index (BMI) ≥ 25 kg/m2 (1.51, 1.26–1.82), higher income (1.44, 1.19–1.76), urban residence (1.24, 1.03–1.49), and presence of hypothyroidism (3.31, 2.38–4.61) or hyperthyroidism (2.46, 1.75–3.46) were associated with higher thyroid cancer occurrence among men. Age ≥ 55 years (0.63, 0.56–0.71), moderate alcohol drinking (0.87, 0.77–0.99), and current smoking (0.56, 0.37–0.85) were associated with lower thyroid cancer occurrence among women. BMI ≥ 25 kg/m2 (1.41, 1.26–1.57), frequent exercise (1.21, 1.07–1.36), higher income (1.18, 1.06–1.32), urban residence (1.17, 1.06–1.29), and presence of hypothyroidism (1.60, 1.40–1.82) or hyperthyroidism (1.38, 1.19–1.61) were associated with higher thyroid cancer occurrence among women. In conclusion, age ≥ 55 years and current smoking were associated with lower thyroid cancer occurrence, while BMI ≥ 25 kg/m2, higher income, urban residence, hypothyroidism, and hyperthyroidism were associated with higher occurrence in both men and women.
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Affiliation(s)
- Joon-Hyop Lee
- Department of Surgery, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea
| | - Sora Youn
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, 71 Daehak-ro, Jongno-gu, Seoul, 03082, Korea
| | - Sohee Jung
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, 71 Daehak-ro, Jongno-gu, Seoul, 03082, Korea
| | - Kwangsoo Kim
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, 71 Daehak-ro, Jongno-gu, Seoul, 03082, Korea.
| | - Young Jun Chai
- Department of Surgery, Seoul National University Boramae Medical Center, 20 Boramaep-ro 5-gil, Dongjak-gu, Seoul, 07061, Korea.
| | - Yoo Seung Chung
- Department of Surgery, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea
| | - Won Seo Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
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24
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Association between Family Histories of Thyroid Cancer and Thyroid Cancer Incidence: A Cross-Sectional Study Using the Korean Genome and Epidemiology Study Data. Genes (Basel) 2020; 11:genes11091039. [PMID: 32899186 PMCID: PMC7563790 DOI: 10.3390/genes11091039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 02/08/2023] Open
Abstract
This study assessed the association between thyroid cancer and family history. This cross-sectional study used epidemiological data from the Korean Genome and Epidemiology Study from 2001 to 2013. Among 211,708 participants, 988 were in the thyroid cancer group and 199,588 were in the control group. Trained interviewers questioned the participants to obtain their thyroid cancer history and age at onset. The participants were examined according to their age, sex, monthly household income, obesity, smoking, alcohol consumption, and past medical history. The adjusted odds ratios (95% confidence intervals) for the family histories of fathers, mothers, and siblings were 6.59 (2.05–21.21), 4.76 (2.59–8.74), and 9.53 (6.92–13.11), respectively, and were significant. The results for the subgroup analyses according to sex were consistent. The rate of family histories of thyroid cancer for fathers and siblings were not different according to the thyroid cancer onset, while that of mothers were higher in participants with a younger age at onset (<50 years old group, 11/523 [2.1%], p = 0.007). This study demonstrated that thyroid cancer incidence was associated with thyroid cancer family history. This supports regular examination of individuals with a family history of thyroid cancer to prevent disease progression and ensure early management.
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25
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Lee YK, Hwangbo Y, Lee S, Lee DE, Lee EK, Yeom MS, Joo J, Kong SY. Aspirin Use Is Not Associated with Lower Thyroid Cancer Risk: A Nationwide Nested Case-Control Study. Thyroid 2020; 30:829-837. [PMID: 31950888 DOI: 10.1089/thy.2019.0641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: While aspirin use is known to be associated with reduced incidence of various cancer types, it is unclear whether this benefit extends to thyroid cancer. We aimed to evaluate the association between aspirin use and thyroid cancer development. Methods: This nested case-control study used nationwide data from the Korean National Health Insurance Service-National Sample Cohort 2002-2015. In total, 4547 individuals with newly developed thyroid cancer were matched with 13,641 controls based on age, sex, and follow-up period. Odds ratios (ORs) and 95% confidence intervals (CIs) for thyroid cancer development according to aspirin use were analyzed using a multivariable conditional logistic regression model. Results: The number of days for which patients with thyroid cancer used aspirin (the proportions of no use, <30 days/year, 30-90 days/year, and ≥90 days/year were 93.03%, 6.51%, 0.31%, and 0.15%, respectively) was comparable with that of the controls (p = 0.371, chi-squared test). The risk of thyroid cancer development was not associated with the duration of aspirin use (ORs [CI] for aspirin use <30 days/year, 30-90 days/year, and ≥90 days/year were 1.11 [0.96-1.28], 1.01 [0.54-1.88], and 1.23 [0.50-3.06], respectively, compared with no use) after adjusting for body mass index, smoking status, hypertension, Charlson comorbidity index, and number of outpatient visits per year. In addition, subgroup analyses stratified by age, sex, and follow-up duration did not reveal any significant association between aspirin use and thyroid cancer. Conclusions: Our findings suggest that even extended aspirin use may not impact the prevention or onset of thyroid cancer.
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Affiliation(s)
- Young Ki Lee
- Center for Thyroid Cancer; National Cancer Center, Goyang, Republic of Korea
| | - Yul Hwangbo
- Center for Thyroid Cancer; National Cancer Center, Goyang, Republic of Korea
| | - Sangwon Lee
- Cancer Data Center; National Cancer Center, Goyang, Republic of Korea
| | - Dong-Eun Lee
- Biostatistics Collaboration Team, Research Core Center, Research Institute; National Cancer Center, Goyang, Republic of Korea
| | - Eun Kyung Lee
- Center for Thyroid Cancer; National Cancer Center, Goyang, Republic of Korea
| | - Min Sun Yeom
- Center for Supercomputing Applications, Korea Institute of Science and Technology Information, Daejeon, Republic of Korea
| | - Jungnam Joo
- Division of Cancer Epidemiology and Management; National Cancer Center, Goyang, Republic of Korea
| | - Sun-Young Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, Republic of Korea
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26
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Loomans-Kropp HA, Dunn BK, Kramer BS, Pinsky P. Thyroid Incidentalomas in Association With Low-Dose Computed Tomography in the National Lung Screening Trial. Am J Epidemiol 2020; 189:27-33. [PMID: 31595954 DOI: 10.1093/aje/kwz219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/18/2019] [Indexed: 02/06/2023] Open
Abstract
Advances in cancer screening methods have opened avenues for incidental findings and cancer overdiagnosis. We performed a secondary analysis of the National Lung Screening Trial (enrollment from 2002-2004), a randomized controlled trial comparing low-dose computed tomography (LDCT; n = 26,722) with chest radiography (CXR; n = 26,732) for lung cancer detection, to examine incidental findings related to thyroid cancer (ThCa). Three screening rounds were included, and median follow-up was 6.6 years for LDCT and 6.5 years for CXR. Radiologists reported lung and non-lung-related abnormalities. In the LDCT arm, 5.7%, 4.7%, and 4.5% of participants had abnormalities above the diaphragm (AADs) detected at baseline, year 1, and year 2, respectively, compared with 2.3%, 1.5%, and 1.3% in the CXR arm. In the LDCT arm, 205 AADs (7.0%) were thyroid-related. Overall, 60 ThCas were reported, 35 in the LDCT arm and 25 in the CXR arm (P = 0.2). In the LDCT arm, participants with a prior AAD had a 7.8-fold increased risk (95% confidence interval: 4.0, 15.1) of ThCa compared with those who did not have an AAD. Early and persistent excess of ThCas diagnosed earlier in the LDCT arm suggests overdiagnosis. The use of sensitive screening modalities for early detection of lung cancer might result in the discovery of thyroid incidentalomas.
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Affiliation(s)
- Holli A Loomans-Kropp
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
- Gastrointestinal and Other Cancers Branch, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Barbara K Dunn
- Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Barnett S Kramer
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Paul Pinsky
- Early Detection Research Branch, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
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27
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Tcheandjieu C, Cordina-Duverger E, Mulot C, Baron-Dubourdieu D, Guizard AV, Schvartz C, Laurent-Puig P, Guénel P, Truong T. Role of GSTM1 and GSTT1 genotypes in differentiated thyroid cancer and interaction with lifestyle factors: Results from case-control studies in France and New Caledonia. PLoS One 2020; 15:e0228187. [PMID: 31999731 PMCID: PMC6992216 DOI: 10.1371/journal.pone.0228187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023] Open
Abstract
Background GSTM1 and GSTT1 are involved in detoxification of xenobiotics, products of oxidative stress and in steroid hormones metabolism. We investigated whether GSTM1 and GSTT1 gene deletion was associated with DTC risk and explored interaction with non-genetic risk factors of DTC. Methods The study included 661 DTC cases and 736 controls from two case-control studies conducted in France and New Caledonia. Odds ratios (OR) and their confidence interval (CI) for DTC associated with GST genotypes, alcohol drinking, tobacco smoking, body mass index and hormonal factors were calculated using logistic regression models. Results Results are presented for Europeans and Melanesians combined, as no heterogeneity between groups was detected. We found that DTC risk increased with obesity and decrease with alcohol drinking. After stratification by gene deletion status, the OR for obesity was 5.75, (95%CI 2.25–14.7) among individuals with GSTT1 and GSTM1-deleted genotype, and 1.26, (95%CI 0.89–1.77) in carriers of both genes (p-interaction = 0.02). The OR for drinking ≥1 glass/week was 0.33 (95%CI 0.15–0.74) in GSTT1-null individuals while it was 1.01 (95%CI 0.67–1.52) in non-null carriers of the gene (p-interaction = 0.01). No interaction between GST genotypes and other non-genetic risk factors was detected. Conclusion GSTM1 and GSTT1 genotypes may modulate the DTC risk associated with BMI and alcohol consumption.
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Affiliation(s)
| | | | - Claire Mulot
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | | | - Anne-Valérie Guizard
- Registre Général des Tumeurs du Calvados, Centre François Baclesse, Caen, France
- U1086 INSERM–UCN “ANTICIPE”, Caen, France
| | - Claire Schvartz
- Registre spécialisé des Cancers de la Thyroide Marne-Ardennes Institut GODINOT, Reims, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, EPIGENETEC, Paris, France
| | - Pascal Guénel
- Université Paris-Saclay, UVSQ, INSERM, CESP, Villejuif, France
- * E-mail: (PG); (TT)
| | - Thérèse Truong
- Université Paris-Saclay, UVSQ, INSERM, CESP, Villejuif, France
- * E-mail: (PG); (TT)
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28
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Abdel-Rahman O. Prediagnostic BMI and thyroid cancer incidence in the PLCO trial. Future Oncol 2019; 15:3451-3456. [DOI: 10.2217/fon-2019-0292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the correlation between prediagnostic BMI and thyroid cancer risk within the prostate, lung, colorectal and ovary (PLCO) trial. Methods: PLCO trial participants without a history of thyroid cancer before study enrollment who have complete information about prediagnostic BMI were included. Multivariable Cox regression analyses were conducted to assess the impact of prediagnostic BMI on thyroid cancer risk. Results: Higher BMI at the time of the study enrollment was associated with a higher thyroid cancer risk (hazard ratio: 1.046; p < 0.01). Furthermore, compared with a normal to normal prediagnostic BMI trajectory, both normal to overweight as well as normal to obese trajectories were associated with a higher thyroid cancer risk (p = 0.04 and p = 0.03, respectively). Conclusion: Higher BMI at the time of study entry as well as an increasing prediagnostic BMI trajectory are associated with a higher thyroid cancer risk.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta T6G 1Z2, Canada
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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29
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Zhang C, Wu HB, Cheng MX, Wang L, Gao CB, Huang F. Association of exposure to multiple metals with papillary thyroid cancer risk in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:20560-20572. [PMID: 31104243 DOI: 10.1007/s11356-019-04733-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Abstract
Papillary thyroid cancer (PTC) has inflicted huge threats to the health of mankind. Metal pollution could be a potential risk factor of PTC occurrence, but existing relevant epidemiological researches are limited. The current case-control study was designed to evaluate the relationships between exposure to multiple metals and the risk of PTC. A total of 262 histologically confirmed PTC cases were recruited. Age- and gender-matched controls were enrolled at the same time. Urine samples were used as biomarkers to reflect the levels of environmental exposure to 13 metals. Conditional logistic regression models were adopted to assess the potential association. Single-metal and multi-metal models were separately conducted to evaluate the impacts of single and co-exposure to 13 metals. The increased concentration of urinary Cd, Cu, Fe, and Pb quartiles was found significant correlated with PTC risk. We also found the decreased trends of urinary Se, Zn, and Mn quartiles with the ORs for PTC. These dose-response associations between Pb and PTC were observed in the single-metal model and remained significant in the multi-metal model (OR25-50th=1.39, OR50-75th=3.32, OR>75th=7.62, p for trend <0.001). Our study suggested that PTC was positively associated with urinary levels of Cd, Cu, Fe, Pb, and inversely associated with Se, Zn, and Mn. Targeted public health policies should be made to improve the environment and the recognition of potential risk factors. These findings need additional studies to confirm in other population.
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Affiliation(s)
- Chi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Hua-Bing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Meng-Xia Cheng
- Laboratory of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Chao-Bing Gao
- Department of Otolaryngology-Head and Neck surgery, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China.
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China.
- Laboratory of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China.
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Zara-Lopes T, Galbiatti-Dias ALS, Castanhole-Nunes MMU, Padovani-Júnior JA, Maniglia JV, Pavarino EC, Goloni-Bertollo EM. Polymorphisms in MTHFR, MTR, RFC1 and CßS genes involved in folate metabolism and thyroid cancer: a case-control study. Arch Med Sci 2019; 15:522-530. [PMID: 30899306 PMCID: PMC6425207 DOI: 10.5114/aoms.2018.73091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/15/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Polymorphisms in genes coding enzymes involved in folate metabolism may cause alterations in this metabolic pathway and contribute to carcinogenesis, because folate is essential for DNA synthesis, methylation and repair. The objective of this study was to investigate the association of MTHFR 677C>T (rs1801133), MTR 2756A>G (rs1805087), RFC1 80A>G (rs1051266) and CßS 844ins(68) (no rs#) polymorphisms and thyroid cancer development. The association of these polymorphisms with demographic risk factors and clinical histopathological parameters was also evaluated. MATERIAL AND METHODS The study is a case-control analysis with a total of 462 individuals (151 patients and 311 controls). Polymerase chain reaction-restriction fragment length polymorphism technique was used for genotyping. The χ2 and multiple logistic regression were utilized for statistical analysis. RESULTS The polymorphisms analysis revealed an association between the MTHFR 677C>T polymorphism (OR = 2.87, 95% CI: 1.50-5.48, p < 0.01, codominant model), (OR = 1.76, 95% CI: 1.18-2.64, p < 0.01, dominant model), (OR = 2.37, 95% CI: 1.28-4.39, p < 0.01, recessive model) and thyroid cancer. RFC1 80A>G polymorphism also was associated with thyroid cancer under recessive mode of inheritance (OR = 1.55; 95% CI: 1.02-2.38; p = 0.04); however, this polymorphism showed Hardy-Weinberg disequilibrium in the control group (χ2 = 24.71, p < 0.001). Furthermore, alcohol (OR = 1.56, 95% CI: 1.36-1.89, p < 0.01) and tobacco consumption (OR = 1.97, 95% CI: 1.28-3.04, p < 0.01) were associated with increased risk for thyroid cancer. The MTR 2756A>G polymorphism showed an association with tumor extent (OR = 2.69, 95% CI: 1.27-5.71, p < 0.01) and aggressiveness (OR = 4.51, 95% CI: 1.67-12.1, p < 0.01). CONCLUSIONS MTHFR 677C>T is significantly associated with increased risk for thyroid cancer and MTR 2756A>G is associated with tumor extent and aggressiveness. In addition, alcohol and tobacco consumption were associated with increased risk of thyroid cancer. These results may contribute to a better prognosis for thyroid cancer.
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Affiliation(s)
- Tairine Zara-Lopes
- Genetics and Molecular Biology Research Unit – UPGEM, Molecular Biology Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
| | - Ana Lívia Silva Galbiatti-Dias
- Genetics and Molecular Biology Research Unit – UPGEM, Molecular Biology Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
| | - Márcia M. Urbanin Castanhole-Nunes
- Genetics and Molecular Biology Research Unit – UPGEM, Molecular Biology Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
| | - João Armando Padovani-Júnior
- Otorhinolaryngology and Head and Neck Surgery Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
| | - José Victor Maniglia
- Otorhinolaryngology and Head and Neck Surgery Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
| | - Erika Cristina Pavarino
- Genetics and Molecular Biology Research Unit – UPGEM, Molecular Biology Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
| | - Eny Maria Goloni-Bertollo
- Genetics and Molecular Biology Research Unit – UPGEM, Molecular Biology Department, São José do Rio Preto Medical School – FAMERP, São Paulo, Brazil
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Zheng J, Cui NH, Zhang S, Wang XB, Ming L. Leukocyte Mitochondrial DNA Copy Number and Risk of Thyroid Cancer: A Two-Stage Case-Control Study. Front Endocrinol (Lausanne) 2019; 10:421. [PMID: 31312182 PMCID: PMC6614343 DOI: 10.3389/fendo.2019.00421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/12/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Mitochondrial DNA copy number (mtDNA-CN) may contribute to the development of various cancer types in a tumor-specific manner. However, little is known about whether leukocyte mtDNA content confers susceptibility to thyroid cancer (TC). This study aimed to investigate the associations of leukocyte mtDNA-CN with the risk and clinicopathological features of TC in a Chinese population. Methods: In this two-stage case-control study with a total of 402 TC patients and 406 controls, leukocyte mtDNA-CN content was measured with a quantitative PCR method. In a subset of 100 cases and 100 controls, levels of leukocyte 8-hydroxy-2'-deoxyguanosine (8-OHdG) and plasma malondialdehyde, as two biomarkers for oxidative stress, were determined by ELISA and colorimetric kits, respectively. Results: In a combined analysis of discovery and validation sets, high mtDNA-CN content was positively associated with increased TC risk, after adjusting for confounders (OR for per SD increment: 1.43; 95%CI, 1.23-1.66; P < 0.001; OR for tertile 3 vs. tertile 1: 2.10; 95%CI, 1.48-3.00; P trend < 0.001). This linear dose-response relationship was more pronounced in subtype analyses for papillary and follicular thyroid carcinoma (P < 0.001 for all), as well as in subgroup analyses for subjects with overweight and obesity (P interaction = 0.015). In TC patient, we observed the positive correlations of mtDNA-CN with advanced TNM stage (P = 0.006) and the presence of lymph node metastasis (P = 0.012). Leukocyte mtDNA-CN content was also identified to increase with the levels of leukocyte 8-OHdG (P < 0.001), a biomarker for oxidative DNA damage. Conclusion: Our data suggest that the increase in leukocyte mtDNA-CN content may correlate with oxidative DNA damage, and serve as an independent risk factor for TC.
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Affiliation(s)
- Jian Zheng
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ning-hua Cui
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Shuai Zhang
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xue-bin Wang
- Department of Clinical Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Xue-bin Wang
| | - Liang Ming
- Department of Clinical Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Liang Ming
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Soheylizad M, Khazaei S, Jenabi E, Delpisheh A, Veisani Y. The Relationship Between Human Development Index and Its Components with Thyroid Cancer Incidence and Mortality: Using the Decomposition Approach. Int J Endocrinol Metab 2018; 16:e65078. [PMID: 30464773 PMCID: PMC6218660 DOI: 10.5812/ijem.65078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/28/2018] [Accepted: 09/29/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The link between age specific-rates of thyroid cancer (TC) and human development index (HDI) and also its components can be a new direction for planning by policy makers. OBJECTIVES This study aimed at identifying the relationship between TC rates by gender, and HDI and its components in different regions of the world. METHODS An ecological study was conducted; the data was obtained from the GLOBOCAN project in 2012. Inequality in TC estimates (age-specific incidence and mortality rates), according to the HDI and its components was calculated. Concentration index (CI) was used to estimate inequality and CI was decomposed to determine contribution of HDI and its components in inequality. RESULTS The inequality index (CI) was 0.29 (95% CI: 0.21 - 0.38) and -0.15 (95% CI: -0.23 - 0.06) for incidence and mortality of TC by HDI, respectively. The important contributors in inequality for incidence rates of TC were life expectancy at birth (0.30), mean years of schooling (0.26), and expected years of schooling (0.18). The important contributors in inequality of mortality rates were mean years of schooling (0.19), expected years of schooling (0.17), and urbanization (0.17). CONCLUSIONS According to the findings of this study, global inequalities exist in the TC incidence and mortality rates; incidence rates of TC are more concentrated in countries with high HDI, yet inequality index showed that deaths occurred more in disadvantaged countries.
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Affiliation(s)
- Mokhtar Soheylizad
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ensiyeh Jenabi
- Pediatric Developmental Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Delpisheh
- Department of Clinical Epidemiology, Ilam University of Medical Sciences, Ilam, Iran
| | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
- Corresponding Author: Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
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Cigarette smoking and thyroid cancer risk: a cohort study. Br J Cancer 2018; 119:638-645. [PMID: 30111870 PMCID: PMC6162293 DOI: 10.1038/s41416-018-0224-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/29/2022] Open
Abstract
Background We evaluated the association between smoking status and thyroid cancer risk and whether this association is mediated by body mass index (BMI) and thyroid-stimulating hormone (TSH). Methods We performed a cohort study of 96,855 Korean adults who were followed annually or biennially for a median of 5.9 years. Results During 511,052.9 person-years of follow-up, 1,250 participants developed thyroid cancer. In men, we observed a dose-dependent inverse association between current smoking, pack-years, and thyroid cancer. After adjustment for confounders, adjusted hazard ratios (95% confidence intervals) for thyroid cancer comparing current and former smokers to never smokers were 0.58 (0.45–0.75) and 0.93 (0.73–1.18), respectively. After further adjustment for BMI and TSH as potential mediators, this association was slightly attenuated, but remained significant. For women, current smokers tended to have a lower risk of thyroid cancer, but this association did not reach statistical significance. Conclusions In this cohort study, current smoking was associated with a decreased risk of incident thyroid cancer in men but not in women and this association was observed even after adjusting for TSH and BMI levels as potential mediators. Further mechanistic studies are needed to elucidate the possible effect of smoking on the pathogenesis of thyroid cancer development.
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Nettore IC, Colao A, Macchia PE. Nutritional and Environmental Factors in Thyroid Carcinogenesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081735. [PMID: 30104523 PMCID: PMC6121258 DOI: 10.3390/ijerph15081735] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/05/2018] [Accepted: 08/05/2018] [Indexed: 02/06/2023]
Abstract
Several epidemiological studies suggest an increased incidence of thyroid carcinoma (TC) in recent years, especially for the papillary histotype (PTC), suggesting that specific carcinogens might promote molecular abnormalities that are typical of PTC. The increased incidence is probably attributed to more intensive and sensitive diagnostic procedures, even if recent data suggest that various toxic elements could explain the phenomenon. Ionizing radiation exposure represents the most accepted risk factor for differentiated thyroid cancer that includes both the follicular and papillary histotypes. In this review, we examined the other environmental carcinogens that play a role in TC, such as eating habits, living in volcanic areas, and xenobiotic elements. Among eating habits, iodine intake represents one of the more discussed elements, because its deficiency is associated with follicular thyroid carcinomas (FTCs), while its progressive increment seems to be responsible for PTC. The gas, ash, and lava emissions of volcanoes are composed of various toxic compounds that pollute ground water, vegetables, and animals, contaminating humans via the food chain. Finally, the risk of developing PTC has also been associated with exposure of the population to xenobiotics in the environment or in the home. Their carcinogenic effects are probably caused by their accumulation, but additional studies are necessary to better understand the mechanisms of action.
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Affiliation(s)
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
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A Comparison Study: The Risk Factors in the Lifestyles of Thyroid Cancer Patients and Healthy Adults of South Korea. Cancer Nurs 2018; 41:E48-E56. [PMID: 27941352 DOI: 10.1097/ncc.0000000000000449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND In South Korea, there has been a rapid increase in thyroid cancer diagnoses, and the thyroid cancer incidence rate is the highest in the world. This study explored possible risk factors that may influence the development of thyroid cancer by comparing life habits of thyroid cancer patients and healthy adults. OBJECTIVE The aims of this study were to identify lifestyle and habit differences in thyroid cancer patients and healthy adults and to investigate risk factors that influence the development of thyroid cancer. METHODS The study was designed as a retrospective comparison survey study of thyroid cancer patient group and healthy adult group. One hundred two thyroid cancer patients in a university hospital and 115 healthy adults were recruited for this study. Data were analyzed using descriptive statistics, χ test/t test, and logistic regression with SPSS program. RESULTS Previous smoking history, lower physical activity level, higher stress, and unhealthy eating habits (consumption of instant food products) were shown to be risk factors in the development of thyroid cancer. CONCLUSION Based on the results of this study comparing thyroid cancer patients and healthy adults, it is recommended to encourage an increase in physical activity, minimize both direct and indirect exposure to smoking, develop healthy eating habits of consuming more vegetables, and effectively manage stress levels. IMPLICATIONS FOR PRACTICE Lifestyle preferences and habits may influence the development of thyroid cancer. It is imperative to identify and modify the risk factors in order to prevent thyroid cancer development.
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Abstract
During the past few decades, the incidence of thyroid cancer has increased substantially in many countries, including the USA. The rise in incidence seems to be attributable both to the growing use of diagnostic imaging and fine-needle aspiration biopsy, which has led to enhanced detection and diagnosis of subclinical thyroid cancers, and environmental factors. The latest American Thyroid Association (ATA) practice guidelines for the management of adult patients with thyroid nodules and differentiated thyroid cancer differ substantially from the previous ATA guidelines published in 2009. Specifically, the problems of overdiagnosis and overtreatment of a disease that is typically indolent, where treatment-related morbidity might not be justified by a survival benefit, now seem to be acknowledged. As few modifiable risk factors for thyroid cancer have been established, the specific environmental factors that have contributed to the rising incidence of thyroid cancer remain speculative. However, the findings of several large, well-designed epidemiological studies have provided new information about exposures (such as obesity) that might influence the development of thyroid cancer. In this Review, we describe the changing incidence of thyroid cancer, suggest potential explanations for these trends, emphasize the implications for patients and highlight ongoing and potential strategies to combat this growing clinical and public health issue.
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MESH Headings
- Adenocarcinoma, Follicular/diagnostic imaging
- Adenocarcinoma, Follicular/epidemiology
- Adenocarcinoma, Follicular/pathology
- Age Distribution
- Biopsy, Fine-Needle
- Carcinoma/diagnostic imaging
- Carcinoma/epidemiology
- Carcinoma/pathology
- Carcinoma, Neuroendocrine/diagnostic imaging
- Carcinoma, Neuroendocrine/epidemiology
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Papillary
- Humans
- Incidence
- Medical Overuse
- Obesity/epidemiology
- Radiation Exposure/statistics & numerical data
- Risk Factors
- Sex Distribution
- Smoking/epidemiology
- Thyroid Cancer, Papillary
- Thyroid Carcinoma, Anaplastic/diagnostic imaging
- Thyroid Carcinoma, Anaplastic/epidemiology
- Thyroid Carcinoma, Anaplastic/pathology
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/pathology
- Thyroid Nodule/diagnostic imaging
- Thyroid Nodule/epidemiology
- Thyroid Nodule/pathology
- United States/epidemiology
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Affiliation(s)
- Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 7E-536, Bethesda, Maryland 20892-9778, USA
| | - Julie A Sosa
- Section of Endocrine Surgery, Department of Surgery, Duke University, Seeley Mudd Building #484, 10 Searle Center Drive, DUMC #2945, Durham, North Carolina 27710, USA
- Duke Clinical Research Institute, North Pavilion, 2400 Pratt Street, Durham, North Carolina 27705, USA
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Brown P, Jiang H, Ezzat S, Sawka AM. A detailed spatial analysis on contrasting cancer incidence patterns in thyroid and lung cancer in Toronto women. BMC Public Health 2016; 16:950. [PMID: 27609137 PMCID: PMC5016996 DOI: 10.1186/s12889-016-3634-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/02/2016] [Indexed: 11/18/2022] Open
Abstract
Background Thyroid cancer has been rapidly rising in incidence in Canada; however, in contrast, lung cancer appears to be decreasing in incidence in Canadian men and stable in women. Moreover, disease-related mortality risk is generally very low in TC but high in LC. We performed a geographic spatial analysis in metropolitan Toronto, Canada to determine if there is regional variability of respective risks of thyroid cancer (TC) and lung cancer (LC), among women. Women were of particular interest for this study, given their known predilection for thyroid cancer. Methods The postal codes of all females with TC or LC, residing in metropolitan Toronto from 2004 to 2008, were geocoded to point locations according to 2006 Canadian Census data. The data were analysed using a log-Gaussian Cox Process, where the intensity of age-adjusted cancer cases was modelled as a log-linear combination of the population at risk, explanatory variables (race, immigration, and median household income), and a residual spatially varying random effect. For each respective malignancy, statistical models were fit to make quantify the relationship between cancer incidence and explanatory variables. Results We included 2230 women with TC and 2412 with LC. The distribution of TC and LC cases contrasted inversely among Toronto neighbourhoods with the highest TC incidence in the Northeast and the highest LC incidence in the Southeast. A higher proportion of Asian ethnicity was associated with higher regional risk of TC and lower risk of LC. A higher proportion of recent immigrants was associated with increased LC and lower TC risk, whereas median household income and proportions of African ethnicity were not significantly associated with risk of either cancer, after adjustment for other socio-demographic variables. Conclusions We observed contrasting regional distributions of female TC and LC cases in Toronto. The differences were partly attributed to ethnic composition variability and the proportion of recent immigrants, but substantial unexplained residual variation of incidence patterns of these malignancies exists, suggesting that more individual-level research is needed to explain the regional variability of incidence of these malignancies.
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Affiliation(s)
- Patrick Brown
- Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada
| | - Hedy Jiang
- Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada
| | - Shereen Ezzat
- Endocrine Oncology, Princess Margaret Cancer Centre, 585 University Avenue, 9NU-986, Toronto, Ontario, M5G 2N2, Canada
| | - Anna M Sawka
- Division of Endocrinology, Department of Medicine, University Health Network and University of Toronto, Toronto General Hospital, 200 Elizabeth Street, 12 EN-212, Toronto, Ontario, M5G 2C4, Canada.
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Hong SH, Myung SK, Kim HS. Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies. Cancer Res Treat 2016; 49:534-547. [PMID: 27456949 PMCID: PMC5398382 DOI: 10.4143/crt.2016.161] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/19/2016] [Indexed: 11/21/2022] Open
Abstract
Purpose The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. Materials and Methods We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). Results We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I2=38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I2=29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I2=0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. Conclusion The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer.
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Affiliation(s)
- Seung-Hee Hong
- Division of Food Science and Culinary Arts, Food and Nutrition Major, Shinhan University, Uijeongbu, Korea
| | - Seung-Kwon Myung
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, Goyang, Korea.,Department of Family Medicine, Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Korea
| | - Hyeon Suk Kim
- School of Nursing, Shinhan University, Uijeongbu, Korea
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Myung SK, Lee CW, Lee J, Kim J, Kim HS. Risk Factors for Thyroid Cancer: A Hospital-Based Case-Control Study in Korean Adults. Cancer Res Treat 2016; 49:70-78. [PMID: 27338034 PMCID: PMC5266399 DOI: 10.4143/crt.2015.310] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 06/06/2016] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Although the incidence of thyroid cancer in Korea has rapidly increased over the past decade, few studies have investigated its risk factors. This study examined the risk factors for thyroid cancer in Korean adults. MATERIALS AND METHODS The study design was a hospital-based case-control study. Between August 2002 and December 2011, a total of 802 thyroid cancer cases out of 34,211 patients screened from the Cancer Screenee. Cohort of the National Cancer Center in South Korea were included in the analysis. A total of 802 control cases were selected from the same cohort, and matched individually (1:1) by age (±2 years) and area of residence for control group 1 and additionally by sex for control group 2. RESULTS Multivariate conditional logistic regression analysis using the control group 1 showed that females and those with a family history of thyroid cancer had an increased risk of thyroid cancer, whereas ever-smokers and those with a higher monthly household income had a decreased risk of thyroid cancer. On the other hand, the analysis using control group 2 showed that a family history of cancer and alcohol consumption were associated with a decreased risk of thyroid cancer, whereas higher body mass index (BMI) and family history of thyroid cancer were associated with an increased risk of thyroid cancer. CONCLUSION These findings suggest that females, those with a family history of thyroid cancer, those with a higher BMI, non-smokers, non-drinkers, and those with a lower monthly household income have an increased risk of developing thyroid cancer.
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Affiliation(s)
- Seung-Kwon Myung
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Center for Cancer Prevention and Detection, National Cancer Center Hospital, National Cancer Center, Goyang, Korea.,Department of Family Medicine, National Cancer Center Hospital, National Cancer Center, Goyang, Korea.,Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Chan Wha Lee
- Center for Cancer Prevention and Detection, National Cancer Center Hospital, National Cancer Center, Goyang, Korea.,Department of Radiology, Center for Diagnostic Oncology, National Cancer Center Hospital, National Cancer Center, Goyang Korea
| | - Jeonghee Lee
- Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Jeongseon Kim
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Hyeon Suk Kim
- School of Nursing, Shinhan University, Dongducheon, Korea
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Cho YA, Lee J, Kim J. Association between nutrient intake and thyroid cancer risk in Korean women. Nutr Res Pract 2016; 10:336-41. [PMID: 27247731 PMCID: PMC4880734 DOI: 10.4162/nrp.2016.10.3.336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 01/20/2016] [Accepted: 01/26/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES The incidence of thyroid cancer has increased in many countries, including Korea. International differences in the incidence of thyroid cancer may indicate a role of diet, but findings from previous studies are inconclusive. Therefore, we aimed to investigate the roles of nutrients in thyroid cancer risk in Korean women. SUBJECTS/METHODS We conducted a case-control study comprising 113 cases and 226 age-matched controls. Nutrient intake was assessed using a validated food frequency questionnaire, and the association between nutrient intake and thyroid cancer risk was estimated using a logistic regression model. RESULTS We found that high calcium intake was associated with a reduced risk of thyroid cancer (OR [95% CI] = 0.55 [0.35-0.89]). Significant associations were observed among subjects who were older than 50 years, had low BMI, and had low calorie intake. However, other nutrients included in this study did not show any significant associations with thyroid cancer risk. CONCLUSIONS This study suggested a possible protective effect of calcium on thyroid cancer risk. Well-designed prospective studies are required to confirm these findings.
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Affiliation(s)
- Young Ae Cho
- Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Gyeonggi 10408, Korea
| | - Jeonghee Lee
- Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Gyeonggi 10408, Korea
| | - Jeongseon Kim
- Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Gyeonggi 10408, Korea
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Dralle H, Machens A, Basa J, Fatourechi V, Franceschi S, Hay ID, Nikiforov YE, Pacini F, Pasieka JL, Sherman SI. Follicular cell-derived thyroid cancer. Nat Rev Dis Primers 2015; 1:15077. [PMID: 27188261 DOI: 10.1038/nrdp.2015.77] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Follicular cell-derived thyroid cancers are derived from the follicular cells in the thyroid gland, which secrete the iodine-containing thyroid hormones. Follicular cell-derived thyroid cancers can be classified into papillary thyroid cancer (80-85%), follicular thyroid cancer (10-15%), poorly differentiated thyroid cancer (<2%) and undifferentiated (anaplastic) thyroid cancer (<2%), and these have an excellent prognosis with the exception of undifferentiated thyroid cancer. The advent and expansion of advanced diagnostic techniques has driven and continues to drive the epidemic of occult papillary thyroid cancer, owing to overdiagnosis of clinically irrelevant nodules. This transformation of the thyroid cancer landscape at molecular and clinical levels calls for the modification of management strategies towards personalized medicine based on individual risk assessment to deliver the most effective but least aggressive treatment. In thyroid cancer surgery, for instance, injuries to structures outside the thyroid gland, such as the recurrent laryngeal nerve in 2-5% of surgeries or the parathyroid glands in 5-10% of surgeries, negatively affect quality of life more than loss of the expendable thyroid gland. Furthermore, the risks associated with radioiodine ablation may outweigh the risks of persistent or recurrent disease and disease-specific mortality. Improvement in the health-related quality of life of survivors of follicular cell-derived thyroid cancer, which is decreased despite the generally favourable outcome, hinges on early tumour detection and minimization of treatment-related sequelae. Future opportunities include more widespread adoption of molecular and clinical risk stratification and identification of actionable targets for individualized therapies.
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Affiliation(s)
- Henning Dralle
- Department of General, Visceral and Vascular Surgery, University Hospital, University of Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097 Halle, Germany
| | - Andreas Machens
- Department of General, Visceral and Vascular Surgery, University Hospital, University of Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097 Halle, Germany
| | - Johanna Basa
- Division of Surgical Oncology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Vahab Fatourechi
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Silvia Franceschi
- Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Ian D Hay
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Yuri E Nikiforov
- Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Furio Pacini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Janice L Pasieka
- Division of Surgical Oncology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Steven I Sherman
- Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Vandraas KF, Grjibovski AM, Støer NC, Troisi R, Stephansson O, Ording AG, Vangen S, Grotmol T, Vikanes ÅV. Hyperemesis gravidarum and maternal cancer risk, a Scandinavian nested case-control study. Int J Cancer 2015; 137:1209-16. [PMID: 25665163 DOI: 10.1002/ijc.29475] [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: 11/12/2014] [Accepted: 01/26/2015] [Indexed: 12/19/2022]
Abstract
Reproductive factors have been shown to influence cancer risk. Several pathological conditions during pregnancy have also been associated with subsequent altered cancer risk in the mother. Hyperemesis gravidarum (hyperemesis) is an early pregnancy condition characterized by severe nausea and vomiting resulting in weight loss and metabolic disturbances. Studies have reported associations between hyperemesis and cancer, but results are inconsistent. In this nested case-control study we linked the population-based medical birth registries and cancer registries in Norway, Sweden and Denmark in order to examine overall cancer risk and risk of specific cancer types in women with a history of hyperemesis, using conditional logistic regression. In total, 168,501 cases of cancer in addition to up to 10 cancer-free controls per case were randomly sampled, matched on year of birth and birth registry (n = 1,721,626). Hyperemesis was defined through the International Classification of Diseases. Analyses were adjusted for potential confounders. Hyperemesis was inversely associated with overall cancer risk with adjusted relative risk (aRR) of 0.93 (95% CI: 0.88-0.99), with cancer in the lungs (aRR: 0.60, 95% CI: 0.44-0.81), cervix (aRR: 0.66, 95% CI: 0.49-0.91) and rectum (aRR: 0.48, 95% CI: 0.29-0.78). Thyroid cancer was positively associated with hyperemesis (aRR 1.45, 95% CI: 1.06-1.99) and risk increased with more than one hyperemetic pregnancy (aRR 1.80, 95% CI: 1.23-2.63). Hormonal factors, in particular human chorionic gonadotropin, are likely to be involved in mediating these effects. This study is the first to systematically address these associations and provides valuable knowledge on potential long-term consequences of hyperemesis.
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Affiliation(s)
- Kathrine F Vandraas
- Norwegian Advisory Unit for Women'S Health, Oslo University Hospital, Oslo, Norway.,Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Andrej M Grjibovski
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan.,International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
| | - Nathalie C Støer
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Rebecca Troisi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD
| | - Olof Stephansson
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Women and Children'S Health, Division of Obstetrics and Gynecology, Karolinska University Hospital and Institute, Stockholm, Sweden
| | - Anne Gulbech Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Siri Vangen
- Norwegian Advisory Unit for Women'S Health, Oslo University Hospital, Oslo, Norway
| | | | - Åse V Vikanes
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway.,The Intervention Center, Oslo University Hospital, Oslo, Norway
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