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Gong Y, Jiang Q, Zhai M, Tang T, Liu S. Thyroid cancer trends in China and its comparative analysis with G20 countries: Projections for 2020-2040. J Glob Health 2024; 14:04131. [PMID: 38873786 DOI: 10.7189/jogh.14.04131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
Background Thyroid cancer, a leading type of endocrine cancer, accounts for 3-4% of all cancer diagnoses. This study aims to analyse and compare thyroid cancer patterns in China and the Group twenty (G20) countries, and predict these trend for the upcoming two decades. Methods This observational longitudinal study utilised data from the Global Burden of Disease (GBD) study 2019. We used metrics including incidence, mortality, mortality-incidence ratio (MIR), age-standardised rate (ASR) and average annual percent change (AAPC) to examine thyroid cancer trends. Joinpoint regression analysis was used to identify periods manifesting notable changes. The association between sociodemographic index (SDI) and AAPC were investigated. The autoregressive integrated moving average (ARIMA) model was used to predict thyroid cancer trends from 2020 to 2040. Results From 1990 to 2019, thyroid cancer incidence cases in China increased by 289.6%, with a higher AAPC of age-standardised incidence rate (ASIR) in men. Contrastingly, the G20 demonstrated a smaller increase, particularly among women over 50. Despite the overall age-standardised mortality rate (ASMR) was higher in the G20, the increase in mortality was less pronounced than in China. Age-standardised incidence rate increased across all age groups and genders, with a notable rise among men aged 15-49. ASMR decreased in specific age groups and genders, especially among women. Conversely, the ASMR significantly increased in group aged over 70. The MIR exhibited a declining trend, but this decrease was less noticeable in men and the group aged over 70. Joinpoint analysis pinpointed significant shifts in overall ASIR and ASMR, with the most pronounced increase in ASIR during 2003-2011 in China and 2003-2010 in the G20. Predictions suggested a continual ASIR uptrend, especially in the 50-69 age group, coupled with a predicted ASMR downturn among the elderly by 2040. Moreover, the proportion of thyroid cancer deaths attributable to high body mass index (BMI) escalated, with significant increase in Saudi Arabia and a rise to 7.4% in China in 2019. Conclusions Thyroid cancer cases in incidence and mortality are escalating in both China and the G20. The increasing trend may be attributed to factors beyond overdiagnosis, including environmental and genetic factors. These findings emphasise the necessity for augmenting prevention, control, and treatment strategies. They also highlight the significance of international collaboration in addressing the global challenge posed by thyroid cancer.
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Affiliation(s)
- Yi Gong
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qin Jiang
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mimi Zhai
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Tenglong Tang
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sushun Liu
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Cheng X, Zhou J, Chen Y, Zhao Y, Zheng H, Wang Q, Li X, Jiang S. Patterns and trends of mortality from metastatic colorectal cancer in Shanghai, China from 2005 to 2021: a population-based retrospective analysis. J Cancer Res Clin Oncol 2024; 150:68. [PMID: 38305905 PMCID: PMC10837271 DOI: 10.1007/s00432-023-05518-z] [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: 08/08/2023] [Accepted: 12/07/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE Metastatic colorectal cancer (mCRC) is the leading cause of CRC deaths, however, the relative epidemiological research was insufficient. We aimed to analyze the patterns and trends of mortality of mCRC in Shanghai with a more complete system for monitoring the cause of death of the population and find potential methods to reduce the burden of CRC in China. METHODS Mortality data from 2005 to 2021 of mCRC deaths were obtained from the mortality registration system in Shanghai. We analyzed the crude mortality rates, age-standardized mortality rates, and rates of years of life lost (YLL rates) of mCRC. In addition, the trends were quantified using Joinpoint Regression software. RESULTS A total of 4,386 mCRC deaths were included, with 1,937 (44.16%) liver metastases and 1,061 (24.19%) lung metastases. The crude mortality rate and age-standardized mortality rate of mCRC were 9.09 per 105 person-years and 3.78 per 105 person-years, respectively. The YLL was 50,533.13 years, and the YLL rate was 104.67 per 105 person-years. The overall annual crude mortality rate of mCRC increased by 1.47% (95% CI 0.28-2.68%, P < 0.001) from 2005 to 2021. The crude mortality rate of mCRC increased by 3.20% per year (95% CI 1.80-4.70%, P < 0.001) from 2005 to 2013, but the trend of mortality growth remained stable from 2013 to 2021. The YLL rates remained stable between 2005 and 2021. CONCLUSIONS Population aging was the most likely factor responsible for the increase in CRC mortality in Pudong. Physical examinations and screenings for the elderly were possible reasons for reducing the burden of CRC in fast-growing regions.
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Affiliation(s)
- Xuelin Cheng
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Zhou
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China
| | - Yajun Zhao
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huichao Zheng
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qizhe Wang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China
| | - Sunfang Jiang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China.
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China.
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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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Jiang H, Li Y, Shen J, Lin H, Fan S, Qiu R, He J, Lin E, Chen L. Cigarette smoking and thyroid cancer risk: A Mendelian randomization study. Cancer Med 2023; 12:19866-19873. [PMID: 37746910 PMCID: PMC10587937 DOI: 10.1002/cam4.6570] [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] [Received: 04/21/2023] [Revised: 06/06/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The association between cigarette smoking and thyroid cancer has been reported in prospective cohort studies, but the relationship remains controversial. To investigate this potential correlation further, we employed Mendelian randomization methodology to evaluate the causative impact of smoking on thyroid cancer incidence. METHODS From the genome-wide association study and Sequencing Consortium of Alcohol and Nicotine use, we obtained genetic variants associated with smoking initiation and cigarettes per day (1.2 million individuals). We also extracted genetic variants associated with past tobacco smoking from the UK Biobank (424,960 individuals). Thyroid cancer outcomes were selected from the FinnGen GWAS (989 thyroid cancer cases and 217,803 control cases). Sensitivity analyses employing various approaches such as weighted median, MR-Egger, and MR-pleiotropy residual sum and outlier (MR-PRESSO) have been executed, as well as leave-one-out analysis to identify pleiotropy. RESULTS Using the IVW approach, we did not find evidence that any of the three smoking phenotypes were related to thyroid cancer (smoking initiation: odds ratio (OR) = 1.56, p = 0.61; cigarettes per day: OR = 0.85, p = 0.51; past tobacco smoking: OR = 0.80, p = 0.78). The heterogeneity (p > 0.05) and pleiotropy (p > 0.05) testing provided confirmatory evidence for the validity of our MR estimates. CONCLUSIONS The MR analysis revealed that there may not exist a causative link between smoking exposure and elevated incidence rates of thyroid malignancies.
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Affiliation(s)
- Hongzhan Jiang
- School of NursingFujian University of Traditional Chinese MedicineFuzhouChina
| | - Yi Li
- The School of Clinical MedicineFujian Medical UniversityFuzhouChina
| | - Jiali Shen
- School of NursingFujian University of Traditional Chinese MedicineFuzhouChina
| | - Huihui Lin
- School of NursingFujian University of Traditional Chinese MedicineFuzhouChina
| | - Siyue Fan
- School of NursingFujian University of Traditional Chinese MedicineFuzhouChina
| | - Rongliang Qiu
- The School of Clinical MedicineFujian Medical UniversityFuzhouChina
| | - Jiaxi He
- School of MedicineXiamen UniversityXiamenChina
| | - Ende Lin
- Department of General SurgeryZhongshan Hospital of Xiamen University, School of MedicineXiamenChina
| | - Lijuan Chen
- Department of General SurgeryZhongshan Hospital of Xiamen University, School of MedicineXiamenChina
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Floud S, Hermon C, Simpson RF, Reeves GK. Alcohol consumption and cancer incidence in women: interaction with smoking, body mass index and menopausal hormone therapy. BMC Cancer 2023; 23:758. [PMID: 37587405 PMCID: PMC10428611 DOI: 10.1186/s12885-023-11184-8] [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: 02/07/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Alcohol consumption has been associated with increased risks of certain site-specific cancers and decreased risks of some other cancers. There is, however, little reliable evidence as to whether the alcohol-associated risks for specific cancers are modified by smoking, body mass index (BMI) and menopausal hormone therapy (MHT) use. METHODS In the prospective UK Million Women Study, 1,233,177 postmenopausal women without prior cancer, mean age 56 (SD 5) years, reported their alcohol consumption in median year 1998 (IQR 1998-1999), and were followed by record-linkage for incident cancer. 438,056 women who drank no alcohol or < 1 drink/week were excluded. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CIs) for 21 cancers by alcohol amount; statistical significance of interactions with smoking, BMI and MHT use was assessed after allowing for multiple testing. RESULTS In 795,121 participants, mean consumption was 6.7 (SD 6.4) alcoholic drinks/week. During 17 (SD 5) years of follow-up, 140,203 incident cancers were recorded. There was strong evidence for a substantial association between alcohol intake and risk of upper aero-digestive cancers (oesophageal squamous cell carcinoma, oral cavity, pharynx and larynx; RR per 1 drink/day = 1.38 [95% CI 1.31-1.46]). There was also strong evidence for more moderate positive associations with breast, colorectal and pancreatic cancer (RRs per 1 drink/day = 1.12 [1.10-1.14], 1.10 [1.07-1.13], 1.08 [1.02-1.13] respectively), and moderate negative associations with thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma (RRs per 1 drink/day = 0.79 [0.70-0.89], 0.91 [0.86-0.95], 0.88 [0.83-0.94], 0.90 [0.84-0.97] respectively). Significant interactions between alcohol and smoking were seen for upper aero-digestive cancers (RRs per 1 drink/day = 1.66 [1.54-1.79], 1.23 [1.11-1.36], 1.12 [1.01-1.25] in current, past, and never smokers respectively). BMI and MHT did not significantly modify any alcohol-associated risks. CONCLUSIONS These findings provide robust evidence that greater alcohol intake, even within relatively moderate ranges, increases the risk of cancers of the aerodigestive tract, breast, colorectal and pancreatic cancer, and probably decreases the risk of thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma. Associations of alcohol intake with cancer risk were not modified by MHT use, adiposity or smoking, except in the case of upper aero-digestive cancers, where the alcohol-associated risk was largely confined to smokers.
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Affiliation(s)
- Sarah Floud
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Carol Hermon
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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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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Cho SW, Kim JH, Choi HS, Ahn HY, Kim MK, Rhee EJ. Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database. Endocrinol Metab (Seoul) 2023; 38:10-24. [PMID: 36758542 PMCID: PMC10008661 DOI: 10.3803/enm.2023.102] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
The Korean National Health Information Database (NHID) contains big data combining information obtained from the National Health Insurance Service and health examinations. Data are provided in the form of a cohort, and the NHID can be used to conduct longitudinal studies and research on rare diseases. Moreover, data on the cause and date of death are provided by Statistics Korea. Research and publications based on the NHID have increased explosively in the field of endocrine disorders. However, because the data were not collected for research purposes, studies using the NHID have limitations, particularly the need for the operational definition of diseases. In this review, we describe the characteristics of the Korean NHID, operational definitions of endocrine diseases used for research, and an overview of recent studies in endocrinology using the Korean NHID.
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Affiliation(s)
- Sun Wook Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Han Seok Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Hwa Young Ahn
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Korea
| | - Eun Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Yoo JE, Han K, Shin DW, Kim D, Kim BS, Chun S, Jeon KH, Jung W, Park J, Park JH, Choi KS, Kim JS. Association Between Changes in Alcohol Consumption and Cancer Risk. JAMA Netw Open 2022; 5:e2228544. [PMID: 36001313 PMCID: PMC9403779 DOI: 10.1001/jamanetworkopen.2022.28544] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IMPORTANCE Although numerous studies have shown an association between alcohol consumption and cancer, how changes in drinking behavior increase or decrease the incidence of cancer is not well understood. OBJECTIVE To investigate the association between the reduction, cessation, or increase of alcohol consumption and the development of alcohol-related cancers and all cancers. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study analyzed adult beneficiaries in the Korean National Health Insurance Service. Participants (aged ≥40 years) included those who underwent a national health screening in both 2009 and 2011 and had available data on their drinking status. Data were analyzed from April 16 to July 6, 2020. EXPOSURES Alcohol consumption level, which was self-reported by participants in health screening questionnaires, was categorized into none (0 g/d), mild (<15 g/d), moderate (15-29.9 g/d), and heavy (≥30 g/d) drinking. Based on changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, sustainer, increaser, quitter, and reducer. MAIN OUTCOMES AND MEASURES The primary outcome was newly diagnosed alcohol-related cancers (including cancers of the head and neck, esophagus, colorectum, liver, larynx, and female breast), and the secondary outcome was all newly diagnosed cancers (except for thyroid cancer). RESULTS Among the 4 513 746 participants (mean [SD] age, 53.6 [9.6] years; 2 324 172 [51.5%] men), the incidence rate of cancer was 7.7 per 1000 person-years during a median (IQR) follow-up of 6.4 (6.1-6.6) years. Compared with the sustainer groups at each drinking level, the increaser groups had a higher risk of alcohol-related cancers and all cancers. The increased alcohol-related cancer incidence was associated with dose; those who changed from nondrinking to mild (adjusted hazard ratio [aHR], 1.03; 95% CI, 1.00-1.06), moderate (aHR, 1.10; 95% CI, 1.02-1.18), or heavy (aHR, 1.34; 95% CI, 1.23-1.45) drinking levels had an associated higher risk than those who did not drink. Those with mild drinking levels who quit drinking had a lower risk of alcohol-related cancer (aHR, 0.96; 95% CI, 0.92-0.99) than those who sustained their drinking levels. Those with moderate (aHR, 1.07; 95% CI, 1.03-1.12) or heavy (aHR, 1.07; 95% CI, 1.02-1.12) drinking levels who quit drinking had a higher all cancer incidence than those who sustained their levels, but when quitting was sustained, this increase in risk disappeared. Compared with sustained heavy drinking, reduced heavy drinking levels to moderate levels (alcohol-related cancer: aHR, 0.91 [95% CI, 0.86-0.97]; all cancers: aHR, 0.96 [95% CI, 0.92-0.99]) or mild levels (alcohol-related cancer: aHR, 0.92 [95% CI, 0.86-0.98]; all cancers: aHR, 0.92 [95% CI, 0.89-0.96]) were associated with decreased cancer risk. CONCLUSIONS AND RELEVANCE Results of this study showed that increased alcohol consumption was associated with higher risks for alcohol-related and all cancers, whereas sustained quitting and reduced drinking were associated with lower risks of alcohol-related and all cancers. Alcohol cessation and reduction should be reinforced for the prevention of cancer.
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Affiliation(s)
- Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong-seong Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sohyun Chun
- International Healthcare Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Keun Hye Jeon
- Department of Family Medicine, Cha Gumi Medical Center, Cha University, Gumi-si, Gyeongsangbuk-do, Republic of Korea
| | - Wonyoung Jung
- Department of Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jinsung Park
- Department of Urology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Jin Ho Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kitahara CM, Schneider AB. Epidemiology of Thyroid Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1284-1297. [PMID: 35775227 PMCID: PMC9473679 DOI: 10.1158/1055-9965.epi-21-1440] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 01/03/2023] Open
Affiliation(s)
- Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Arthur B. Schneider
- University of Illinois at Chicago, College of Medicine, Department of Medicine, Chicago, IL, USA
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Huang L, Feng X, Yang W, Li X, Zhang K, Feng S, Wang F, Yang X. Appraising the Effect of Potential Risk Factors on Thyroid Cancer: A Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e2783-e2791. [PMID: 35366326 DOI: 10.1210/clinem/dgac196] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Various risk factors have been associated with the risk of thyroid cancer in observational studies. However, the causality of the risk factors is not clear given the susceptibility of confounding and reverse causation. OBJECTIVE A 2-sample Mendelian randomization approach was used to estimate the effect of potential risk factors on thyroid cancer risk. METHODS Genetic instruments to proxy 55 risk factors were identified by genome-wide association studies (GWAS). Associations of these genetic variants with thyroid cancer risk were estimated in GWAS of the FinnGen Study (989 cases and 217 803 controls). A Bonferroni-corrected threshold of P = 9.09 × 10-4 was considered significant, and P < 0.05 was considered to be suggestive of an association. RESULTS Telomere length was significantly associated with increased thyroid cancer risk after correction for multiple testing (OR 4.68; 95% CI, 2.35-9.31; P = 1.12 × 10-5). Suggestive associations with increased risk were noted for waist-to-hip ratio (OR 1.85; 95% CI, 1.02-3.35; P = 0.042) and diastolic blood pressure (OR 1.60; 95% CI, 1.08-2.38; P = 0.019). Suggestive associations were noted between hemoglobin A1c (HbA1c) (OR 0.20; 95% CI, 0.05-0.82; P = 0.025) and decreased risk of thyroid cancer. Risk of thyroid cancer was not associated with sex hormones and reproduction, developmental and growth, lipids, diet and lifestyle, or inflammatory factors (All P > 0.05). CONCLUSION Our study identified several potential targets for primary prevention of thyroid cancer, including central obesity, diastolic blood pressure, HbA1c, and telomere length, which should inform public health policy.
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Affiliation(s)
- Lulu Huang
- Department of Radiotherapy, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiuming Feng
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Wenjun Yang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Guangxi Collaborative Innovation Center for Biomedicine (Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment), Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiangzhi Li
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Public Health, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
| | - Kang Zhang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Public Health, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
| | - Shuzhen Feng
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Basic Medicine, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
| | - Fei Wang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiaobo Yang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
- Department of Public Health, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
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