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Rinaldi S, Dossus L, Keski-Rahkonen P, Kiss A, Navionis AS, Biessy C, Travis R, Weiderpass E, Romieu I, Eriksen AK, Tjonneland A, Kvaskoff M, Canonico M, Truong T, Katzke V, Kaaks R, Catalano A, Panico S, Masala G, Tumino R, Lukic M, Olsen KS, Zamora-Ros R, Santiuste C, Aizpurua Atxega A, Guevara M, Rodriguez-Barranco M, Sandstrom M, Hennings J, Almquist M, Aglago Kouassivi E, Christakoudi S, Gunter M, Franceschi S. Circulating endogenous sex steroids and risk of differentiated thyroid carcinoma in men and women. Int J Cancer 2024; 154:2064-2074. [PMID: 38357914 DOI: 10.1002/ijc.34872] [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: 08/04/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
Thyroid cancer (TC) is substantially more common in women than in men, pointing to a possible role of sex steroid hormones. We investigated the association between circulating sex steroid hormones, sex hormone binding globulin (SHBG) and the risk of differentiated TC in men and women within the European Prospective Investigation into Cancer and nutrition (EPIC) cohort. During follow-up, we identified 333 first primary incident cases of differentiated TC (152 in pre/peri-menopausal women, 111 in post-menopausal women, and 70 in men) and 706 cancer-free controls. Women taking exogenous hormones at blood donation were excluded. Plasma concentrations of testosterone, androstenedione, dehydroepiandrosterone, estradiol, estrone and progesterone (in pre-menopausal women only) were performed using liquid chromatography/mass spectrometry method. SHBG concentrations were measured by immunoassay. Odds ratios (ORs) were estimated using conditional logistic regression models adjusted for possible confounders. No significant associations were observed in men and postmenopausal women, while a borderline significant increase in differentiated TC risk was observed with increasing testosterone (adjusted OR T3 vs T1: 1.68, 95% CI: 0.96-2.92, ptrend = .06) and androstenedione concentrations in pre/perimenopausal women (adjusted OR T3 vs T1: 1.78, 95% CI: 0.96-3.30, ptrend = .06, respectively). A borderline decrease in risk was observed for the highest progesterone/estradiol ratio (adjusted OR T3 vs T1: 0.54, 95% CI: 0.28-1.05, ptrend = .07). Overall, our results do not support a major role of circulating sex steroids in the etiology of differentiated TC in post-menopausal women and men but may suggest an involvement of altered sex steroid production in pre-menopausal women.
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Affiliation(s)
- Sabina Rinaldi
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Laure Dossus
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Agneta Kiss
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Carine Biessy
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Mexico, Mexico
| | | | - Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marina Kvaskoff
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Marianne Canonico
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Thérèse Truong
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alberto Catalano
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology and Public Health, University of Turin, Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Marko Lukic
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | | | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Carmen Santiuste
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Amaia Aizpurua Atxega
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - Marcela Guevara
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miguel Rodriguez-Barranco
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Maria Sandstrom
- Department of Radiation Sciences, Oncology Umeå University, Umeå, Sweden
| | - Joakim Hennings
- Department of Surgical and Perioperative Sciences, Umeå University, Östersund, Sweden
| | - Martin Almquist
- Department of Clinical Sciences Lund, Skåne University Hospital, Lund University, Lund, Sweden
- Department of Surgery Section of Endocrine and Sarcoma Lund, Skåne University Hospital, Lund University, Lund, Sweden
| | - Elom Aglago Kouassivi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Marc Gunter
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
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Papantoniou K, Konrad P, Haghayegh S, Strohmaier S, Eliassen AH, Schernhammer E. Rotating Night Shift Work, Sleep, and Thyroid Cancer Risk in the Nurses' Health Study 2. Cancers (Basel) 2023; 15:5673. [PMID: 38067376 PMCID: PMC10705158 DOI: 10.3390/cancers15235673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 02/12/2024] Open
Abstract
Night shift work has been associated with breast, prostate, and colorectal cancer, but evidence on other types of cancer is limited. We prospectively evaluated the association of rotating night shift work, sleep duration, and sleep difficulty with thyroid cancer risk in the Nurses' Health Study 2 (NHS2). We assessed rotating night shift work duration (years) at baseline and throughout follow-up (1989-2015) and sleep characteristics in 2001. Cox proportional hazard models, adjusted for potential confounders, were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for (a) shift work duration, (b) sleep duration, and (c) difficulty falling or staying asleep. We stratified the analyses of night shift work by sleep duration and sleep difficulty. Over 26 years of follow-up, 588 incident cases were identified among 114,534 women in the NHS2 cohort. We observed no association between night shift work and the risk of thyroid cancer. Difficulty falling or staying asleep was suggestively associated with a higher incidence of thyroid cancer when reported sometimes (HR 1.26, 95% CI 0.95, 1.66) and all or most of the time (HR 1.35, 95% CI 1.00, 1.81). Night shift workers (10+ years) with sleep difficulty all or most of the time (HR 1.47; 0.58-3.73) or with >7 h of sleep duration (HR 2.17; 95% CI, 1.21-3.92) had a higher risk of thyroid cancer. We found modest evidence for an increased risk of thyroid cancer in relation to sleep difficulty, which was more pronounced among night shift workers.
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Affiliation(s)
- Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - Peter Konrad
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - Shahab Haghayegh
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Wang P, Zhang H, Wang J, Che Y, Zhuo L, Yu M, Hu X, Li P, Geng R, Zhan S, Li B. Metabolic Disease and Risk of Thyroid Disease: Evidence from the National Nurse Health Cohort in China. Biol Res Nurs 2023; 25:627-634. [PMID: 37271585 DOI: 10.1177/10998004231177297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Previous studies have shown that metabolic diseases are risk factors for thyroid disease; most studies are cross-sectional design. We aimed to evaluate the causal relationship between thyroid and metabolic diseases in a cohort of Chinese nurses. METHODS We conducted an ambispective cohort study of the National Nurses' Health Study. Thyroid disease data based on ultrasonography from 2017 to 2021 were collected. We described thyroid disease incidence and the risk factors associated with a cluster of metabolic factors. We used the Mann‒Whitney U test, repeated-measures ANOVA and multivariable Cox proportional hazard regression to analyze the data. RESULTS A total of 1529 female nurses without thyroid disease were enrolled in 2017, of which, complete data were available for 1269 nurses. In 2018-2020, thyroid nodule incidence ranged from 32.8%-46.3%, thyroiditis incidence was 13.4%-14.3%, and goiter incidence was 4.1%-29.1%, thyroid adenoma and thyroid tumors incidence were 0.1%-0.5% and 1%-1.5%. We also found that NAFLAD was an independent risk factor for thyroid adenoma (p = .003). The age at diagnosis was an independent risk factor for goiter (p <. 001) and thyroid nodules (p < .001). Fasting blood glucose was an independent risk factor for thyroid tumors (p = .004). The age at diagnosis (p = .003), Body Mass Index (p = .006) and menopause (p = .031) were risk factors for thyroiditis. CONCLUSION Thyroid disease incidence among nurses is increasing. Age at diagnosis, BMI, fasting blood glucose, and nonalcoholic fatty liver disease are independent risk factors for different types of thyroid disease. This study provides evidence for future studies to further explore the pathogenesis and prevention of thyroid diseases.
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Affiliation(s)
- Peng Wang
- Medical Examination Center, Peking University Third Hospital, Beijing, China
| | - Heli Zhang
- Rehabilitation Medicine Department, Peking University Third Hospital, Beijing, China
| | - Jing Wang
- Nursing Department, Peking University Third Hospital, Beijing, China
| | - Ying Che
- Medical Examination Center, Peking University Third Hospital, Beijing, China
| | - Lin Zhuo
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Miao Yu
- Nursing Department, Peking University Third Hospital, Beijing, China
| | - Xianjing Hu
- School of Nursing, Peking University, Beijing, China
| | - Peitao Li
- Reproductive Medicine Centre, Peking University Third Hospital, Beijing, China
| | - Rongmei Geng
- Nursing Department, Peking University Third Hospital, Beijing, China
| | - Siyan Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Baohua Li
- Nursing Department, Peking University Third Hospital, Beijing, China
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Kim SH, Han MA. Impact of modifiable reproductive factors on cancer incidence and mortality in Korea: a systematic review protocol. BMJ Open 2022; 12:e067826. [PMID: 36442899 PMCID: PMC9710340 DOI: 10.1136/bmjopen-2022-067826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Cancer is a leading cause of death worldwide. In Korea, it is also a major public health problem. Cancer burden may increase significantly due to ageing population and changes in lifestyle. The features of reproductive factors have changed, which include increased age at first childbirth and decreased breastfeeding duration. This study aims to systematically summarise the association between modifiable reproductive factors and cancer incidence and mortality to provide evidence for planning strategies aimed at reducing cancer incidence and mortality in women. METHODS AND ANALYSIS A literature search was performed using the EMBASE, MEDLINE, Cochrane Library and Korean databases such as the Korean Studies Information Service System, Research Information Sharing Service, KoreaMED, Korean Medical Database, National Assembly Library and Korea Institute from their inception to 24 August 2022. We will include cohort studies addressing the associations between at least one of the reproductive factors and the incidence and mortality of all or specific cancers among Korean women. Two reviewers will screen the references, extract the data, and assess the risk of bias independently and in duplicates. Discrepancies will be resolved through discussion or consultation with a third-party reviewer. We will use the Grading of Recommendations, Assessment, Development and Evaluation approach to evaluate the certainty of evidence. We will summarise the findings of the included systematic reviews through quantitative or narrative syntheses and present the summarised findings in tables. ETHICS AND DISSEMINATION Ethical approval is not required, since we will use only the published data. We will disseminate the study findings in peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42022356085.
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Affiliation(s)
- Seo-Hee Kim
- Department of Preventive Medicine, Chosun University, Gwangju, The Republic of Korea
- Department of Public Health, Graduate School, Chosun University, Gwangju, The Republic of Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University, Gwangju, The Republic of Korea
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Toro-Wills MF, Imitola-Madero A, Alvarez-Londoño A, Hernández-Blanquisett A, Martínez-Ávila MC. Thyroid cancer in women of reproductive age: Key issues for the clinical team. WOMEN'S HEALTH 2022; 18:17455057221136392. [PMID: 36373610 PMCID: PMC9666833 DOI: 10.1177/17455057221136392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Women who are fertile experience a significant burden from thyroid cancer. In
reality, delaying childbirth is the current trend in maternity. Women who have
thyroid cancer may later want to get pregnant after it has been treated, which
presents a multidisciplinary issue for their doctors. A variety of specialists
are frequently involved in the treatment of thyroid cancer. This review aims to
address the key elements of the strategy and places special emphasis on the
significance of fertility in women with thyroid cancer diagnosis and remission.
We will cover topics including the role of thyroid hormones in pregnancy and
fertility.
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Affiliation(s)
| | - Angélica Imitola-Madero
- Endocrinology Division, Internal Medicine Department, Centro Hospitalario Serena del Mar, Cartagena, Colombia
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