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Rusiecki JA, McAdam J, Denic-Roberts H, Sjodin A, Davis M, Jones R, Hoang TD, Ward MH, Ma S, Zhang Y. Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study. Environ Health 2024; 23:28. [PMID: 38504322 PMCID: PMC10949709 DOI: 10.1186/s12940-024-01068-0] [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: 12/04/2023] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The effects of organochlorine pesticide (OCP) exposure on the development of human papillary thyroid cancer (PTC) are not well understood. A nested case-control study was conducted with data from the U.S. Department of Defense Serum Repository (DoDSR) cohort between 2000 and 2013 to assess associations of individual OCPs serum concentrations with PTC risk. METHODS This study included 742 histologically confirmed PTC cases (341 females, 401 males) and 742 individually-matched controls with pre-diagnostic serum samples selected from the DoDSR. Associations between categories of lipid-corrected serum concentrations of seven OCPs and PTC risk were evaluated for classical PTC and follicular PTC using conditional logistic regression, adjusted for body mass index category and military branch to compute odds ratios (OR) and 95% confidence intervals (CIs). Effect modification by sex, birth cohort, and race was examined. RESULTS There was no evidence of associations between most of the OCPs and PTC, overall or stratified by histological subtype. Overall, there was no evidence of an association between hexachlorobenzene (HCB) and PTC, but stratified by histological subtype HCB was associated with significantly increased risk of classical PTC (third tertile above the limit of detection (LOD) vs.
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Affiliation(s)
- Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room E-2009, Bethesda, MD, 20814, USA.
| | - Jordan McAdam
- Murtha Cancer Center Research Program, 4494 North Palmer Road, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 1401 Rockville Pike, Rockville, MD, USA
| | - Hristina Denic-Roberts
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room E-2009, Bethesda, MD, 20814, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
| | - Andreas Sjodin
- Division of Laboratory Sciences, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Mark Davis
- Division of Laboratory Sciences, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Richard Jones
- Division of Laboratory Sciences, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Thanh D Hoang
- Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Xing Q, Hong R, Shen Y, Shen Y. Design and validation of depth camera-based static posture assessment system. iScience 2023; 26:107974. [PMID: 37810248 PMCID: PMC10551660 DOI: 10.1016/j.isci.2023.107974] [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: 04/14/2023] [Revised: 07/20/2023] [Accepted: 09/16/2023] [Indexed: 10/10/2023] Open
Abstract
Postural abnormalities have become a prevalent issue affecting individuals of all ages, resulting in a diminished quality of life. Easy-use and reliable posture assessment tools can aid in screening for and correcting posture deviation at an early stage. In this study, we present a depth camera-based static posture assessment system to screen for common postural anomalies such as uneven shoulders, pelvic tilt, bowlegs and knock-knees, forward head, scoliosis, and shoulder blade inclination. The system consists of an Azure Kinect camera, a laptop, and evaluation software. Our system accurately measures skeleton and posture indexes and shows favorable agreement with a golden standard optical infrared motion capture system. The findings indicate that the system is a low-cost posture assessment tool with high precision and accuracy, suitable for initial screening of postural abnormalities in individuals of all ages.
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Affiliation(s)
- Qingjun Xing
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Ruiwei Hong
- School of Sport Engineering, Beijing Sport University, Beijing 100084, China
| | - Yuanyuan Shen
- School of Sport Engineering, Beijing Sport University, Beijing 100084, China
| | - Yanfei Shen
- School of Sport Engineering, Beijing Sport University, Beijing 100084, China
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3
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Russ DE, Josse P, Remen T, Hofmann JN, Purdue MP, Siemiatycki J, Silverman DT, Zhang Y, Lavoué J, Friesen MC. Evaluation of the updated SOCcer v2 algorithm for coding free-text job descriptions in three epidemiologic studies. Ann Work Expo Health 2023; 67:772-783. [PMID: 37071789 PMCID: PMC10324641 DOI: 10.1093/annweh/wxad020] [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: 04/28/2022] [Accepted: 03/21/2023] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVES Computer-assisted coding of job descriptions to standardized occupational classification codes facilitates evaluating occupational risk factors in epidemiologic studies by reducing the number of jobs needing expert coding. We evaluated the performance of the 2nd version of SOCcer, a computerized algorithm designed to code free-text job descriptions to US SOC-2010 system based on free-text job titles and work tasks, to evaluate its accuracy. METHODS SOCcer v2 was updated by expanding the training data to include jobs from several epidemiologic studies and revising the algorithm to account for nonlinearity and incorporate interactions. We evaluated the agreement between codes assigned by experts and the highest scoring code (a measure of confidence in the algorithm-predicted assignment) from SOCcer v1 and v2 in 14,714 jobs from three epidemiology studies. We also linked exposure estimates for 258 agents in the job-exposure matrix CANJEM to the expert and SOCcer v2-assigned codes and compared those estimates using kappa and intraclass correlation coefficients. Analyses were stratified by SOCcer score, score distance between the top two scoring codes from SOCcer, and features from CANJEM. RESULTS SOCcer's v2 agreement at the 6-digit level was 50%, compared to 44% in v1, and was similar for the three studies (38%-45%). Overall agreement for v2 at the 2-, 3-, and 5-digit was 73%, 63%, and 56%, respectively. For v2, median ICCs for the probability and intensity metrics were 0.67 (IQR 0.59-0.74) and 0.56 (IQR 0.50-0.60), respectively. The agreement between the expert and SOCcer assigned codes linearly increased with SOCcer score. The agreement also improved when the top two scoring codes had larger differences in score. CONCLUSIONS Overall agreement with SOCcer v2 applied to job descriptions from North American epidemiologic studies was similar to the agreement usually observed between two experts. SOCcer's score predicted agreement with experts and can be used to prioritize jobs for expert review.
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Affiliation(s)
- Daniel E Russ
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
- Data Science and Engineering Research Group, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Pabitra Josse
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Thomas Remen
- CHUM Research Center, Université de Montréal, Montréal, QC, Canada
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Jack Siemiatycki
- CHUM Research Center, Université de Montréal, Montréal, QC, Canada
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Jerome Lavoué
- CHUM Research Center, Université de Montréal, Montréal, QC, Canada
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
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Cytogenetic Effects in Patients after Computed Tomography Examination. LIFE (BASEL, SWITZERLAND) 2022; 12:life12121983. [PMID: 36556348 PMCID: PMC9784585 DOI: 10.3390/life12121983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/08/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022]
Abstract
Millions of people around the world are exposed to low doses of ionizing radiation from diagnostic computed tomography (CT) scans. Currently available data on the potential cancer risk after CT scans are contradictory and therefore demand further investigations. The aim of the current study was to obtain estimations of genome damage after CT scans in 42 non-cancer patients and to conduct a comparison of the results with 22 control subjects. The frequency of dicentric ring chromosomes and chromosome breaks was significantly increased in irradiated patients compared to the controls. The distribution of dicentrics among the cells demonstrated non-Poisson distribution that reflected non-uniform and partial-body radiation exposure. A fraction of patients followed Poisson distribution, which is typical for uniform whole-body exposures. Some patients demonstrated a level of dicentrics similar to the control subjects. The individual variations in the frequency and dicentric distribution suggested complex mechanisms of chromosome aberration induction and elimination that could be associated with individual radiosensitivity, as well as previous diagnostics that used ionizing radiation or the redistribution of small fractions of irradiated lymphocytes within the circulatory pull. In conclusion, CT scans may cause genome damage and possible increases in cancer risk. The introduction of a specific follow-up of such patients, especially in the case of repeated CT scans, is suggested.
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Kumari S, Sharma S, Advani D, Khosla A, Kumar P, Ambasta RK. Unboxing the molecular modalities of mutagens in cancer. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:62111-62159. [PMID: 34611806 PMCID: PMC8492102 DOI: 10.1007/s11356-021-16726-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/22/2021] [Indexed: 04/16/2023]
Abstract
The etiology of the majority of human cancers is associated with a myriad of environmental causes, including physical, chemical, and biological factors. DNA damage induced by such mutagens is the initial step in the process of carcinogenesis resulting in the accumulation of mutations. Mutational events are considered the major triggers for introducing genetic and epigenetic insults such as DNA crosslinks, single- and double-strand DNA breaks, formation of DNA adducts, mismatched bases, modification in histones, DNA methylation, and microRNA alterations. However, DNA repair mechanisms are devoted to protect the DNA to ensure genetic stability, any aberrations in these calibrated mechanisms provoke cancer occurrence. Comprehensive knowledge of the type of mutagens and carcinogens and the influence of these agents in DNA damage and cancer induction is crucial to develop rational anticancer strategies. This review delineated the molecular mechanism of DNA damage and the repair pathways to provide a deep understanding of the molecular basis of mutagenicity and carcinogenicity. A relationship between DNA adduct formation and cancer incidence has also been summarized. The mechanistic basis of inflammatory response and oxidative damage triggered by mutagens in tumorigenesis has also been highlighted. We elucidated the interesting interplay between DNA damage response and immune system mechanisms. We addressed the current understanding of DNA repair targeted therapies and DNA damaging chemotherapeutic agents for cancer treatment and discussed how antiviral agents, anti-inflammatory drugs, and immunotherapeutic agents combined with traditional approaches lay the foundations for future cancer therapies.
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Affiliation(s)
- Smita Kumari
- Molecular Neuroscience and Functional Genomics Laboratory, Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi, 110042, India
| | - Sudhanshu Sharma
- Molecular Neuroscience and Functional Genomics Laboratory, Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi, 110042, India
| | - Dia Advani
- Molecular Neuroscience and Functional Genomics Laboratory, Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi, 110042, India
| | - Akanksha Khosla
- Molecular Neuroscience and Functional Genomics Laboratory, Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi, 110042, India
| | - Pravir Kumar
- Molecular Neuroscience and Functional Genomics Laboratory, Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi, 110042, India
| | - Rashmi K Ambasta
- Molecular Neuroscience and Functional Genomics Laboratory, Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi, 110042, India.
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Michaud F, Lugrís U, Cuadrado J. Determination of the 3D Human Spine Posture from Wearable Inertial Sensors and a Multibody Model of the Spine. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22134796. [PMID: 35808293 PMCID: PMC9269490 DOI: 10.3390/s22134796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 05/16/2023]
Abstract
Determination of spine posture is of great interest for the effective prevention, evaluation, treatment and evolution monitoring of spinal disorders. Limitations of traditional imaging systems, including cost, radiation exposure (for X-ray based systems), projection volume issues and subject positioning requirements, etc., make non-invasive motion assessment tools effective alternatives for clinical and non-clinical use. In this work, a procedure was developed to obtain a subject-specific multibody model of the spine using either inertial or optical sensors and, based on this multibody model, to estimate the locations and orientations of the 17 vertebrae constituting the thoracolumbar spine. The number and calibration of the sensors, angular offsets, scaling difficulties and gender differences were addressed to achieve an accurate 3D-representation of the spine. The approach was validated by comparing the estimated positions of the sensors on 14 healthy subjects with those provided by an optical motion capture system. A mean position error of lower than 12 mm was obtained, thus showing that the proposed method can offer an effective non-invasive tool for the assessment of spine posture.
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Zhao Y, Sun P, Xiao J, Jin L, Ma N, Li Z, Feng G, Huang H, Deziel NC, Ma X, Ni X, Zhang Y. International patterns and trends of childhood and adolescent cancer, 1978-2012. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:78-89. [PMID: 39034956 PMCID: PMC11256536 DOI: 10.1016/j.jncc.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/23/2022] [Accepted: 02/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background This study aimed to provide a detailed analysis of the temporal trends of cancer incidence rates for individuals aged 0-19 years in selected regions globally from 1978 to 2012. Methods Data were obtained from Volumes V-XI of Cancer Incidence in Five Continents (CI5), published by the International Agency for Research on Cancer. A total of 53 registries in 23 regions from the Americas, Asia, Europe, and Oceania that contained information on cancer incidence throughout 1978-2012 (35 years) were included in this study. Joinpoint regression was used for the analysis of trends. Results Most regions showed increasing trends in overall childhood cancer among children (aged 0-14 years) and adolescents (aged 15-19 years). Nearly all regions showed rising trends in childhood and adolescent leukemia incidence rates, whereas the incidence of lymphoma among children generally decreased. Only France, Australia, and New Zealand showed decreasing trends for malignant central nervous system (CNS) tumors among adolescents. Kidney cancer and bone cancer incidence rates remained stable for most regions. The incidence of thyroid cancer among adolescents increased in most regions and that of testicular cancer decreased in approximately one-half of the regions studied. Conclusion The international temporal trends of cancer incidents among children and adolescents are varied by region, cancer type, age group, and gender, and have changed over time.
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Affiliation(s)
- Yawen Zhao
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Peiyuan Sun
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingyuan Xiao
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Lan Jin
- Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Ning Ma
- Department of Echocardiography, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhe Li
- National Center for Pediatric Cancer Surveillance, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Guoshuang Feng
- Center for Bigdata Research, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Huang Huang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nicole C. Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Xin Ni
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- National Center for Pediatric Cancer Surveillance, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Center for Bigdata Research, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yawei Zhang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Dahlberg J, Adok C, Bümming P, Demir A, Hedbäck G, Nilsson B, Nilsson M, Jansson S. Incidence, detection and outcome of differentiated thyroid cancer in Western Sweden. BJS Open 2021; 5:6408929. [PMID: 34686878 PMCID: PMC8536871 DOI: 10.1093/bjsopen/zrab099] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/24/2021] [Indexed: 11/12/2022] Open
Abstract
Background It is unclear whether the increasing incidence of thyroid cancer (TC) due to increased diagnosis of small and indolent tumours might mask a real increase of clinically significant cancers. The aim of this study was to correlate surgery, pathology and outcome data of individual patients to the mode of primary detection (palpation, by imaging or incidental) to assess if TC incidence has increased. Methods The Swedish Cancer Registry identified all patients with TC in Västra Götaland County representing approximately 1.6 million inhabitants. Clinical information was retrieved from medical records of patient cohorts from three study intervals (2001–2002, 2006–2007 and 2011–2014) comprising 60 per cent of all TC patients. Data were also obtained from the NORDCAN registry to compare of TC incidence with other Nordic countries. Results Between 2001 and 2014, the annualized standard incidence rate/100 000 population (ASR) of TC increased from 3.14 to 10.71 in women and from 1.12 to 3.77 in men. This was higher than the mean incidence for Sweden but similar to that in Norway and Finland. Differentiated TC (DTC) increased more than threefold. The majority of tumours (64 per cent) were detected by palpation. Larger tumours (10–20, 21–40 and greater than 40 mm) increased as much as microcarcinomas (less than 10 mm). Only 5 per cent of the tumours were detected by imaging. All disease-specific deaths (8.5 per cent of DTC in the first two cohorts) and most patients with recurrent or persistent disease (6.6 per cent of DTC cases) were diagnosed due to tumour-related symptoms. Conclusion DTC in Western Sweden gradually increased between 2001 and 2014. The majority of tumours were detected by palpation suggesting a real increase in the incidence of clinically significant thyroid malignancies.
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Affiliation(s)
- J Dahlberg
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.,Regional Cancer Centre West, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Adok
- Regional Cancer Centre West, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P Bümming
- Department of Surgery Skaraborg Hospital, Skaraborgs Sjukhus, Skövde, Sweden
| | - A Demir
- Department of Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G Hedbäck
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - B Nilsson
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - M Nilsson
- Sahlgrenska Centre for Cancer Research, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - S Jansson
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
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Lee YK, Lee S, Lee EK, Kim HC, Kong SY, Cha HS, Hwangbo Y. Can computed tomography scanning in adults lead to an increased risk of thyroid cancer? A nationwide nested case-control study. Eur Radiol 2021; 32:415-423. [PMID: 34245323 DOI: 10.1007/s00330-021-08186-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the association between computed tomography (CT) scanning and newly diagnosed thyroid cancer cases in relation to the confounding effect of the healthcare utilization rate. METHODS This nested case-control study used the Korean National Health Insurance Service-National Sample Cohort 2002-2015: 3557 adult thyroid cancer cases were matched to 17,785 controls by age, sex, and diagnosis date. Odds ratios (ORs) were estimated for thyroid cancer associated with cumulative exposure to CT scanning > 3 years before cancer diagnosis. Changes in estimated ORs with and without adjustment for outpatient visit frequency were investigated. RESULTS ORs for newly diagnosed thyroid cancer increased according to the higher number of total CT scans and thyroid-exposing CT scans (CT scans of the head, neck, or chest compartment; OR and 95% confidence interval [CI], 1.09 [1.03-1.16] and 1.28 [1.05-1.57], respectively). ORs for thyroid cancer increased according to higher outpatient visit frequency. The association between thyroid cancer incidence and CT scans became insignificant when outpatient visit frequency was adjusted in the models (OR [95% CI], 1.03 [0.97-1.10]: total CT scans, 1.14 [0.93-1.41]: thyroid-exposing CT scans). Subgroup analyses stratified by age, sex, and history of other malignancies did not reveal independent associations between CT scanning and thyroid cancer. CONCLUSIONS The high incidence of thyroid cancer in adults exposed to ionizing radiation during CT scanning can be largely explained by the confounding effect of the healthcare utilization rate. These effects should be considered to avoid overestimation of the CT scanning-associated risk of thyroid cancer. KEY POINTS • Studies indicate that diagnostic imaging using low-ionizing radiation may increase risks for thyroid cancer in adults. • Our findings suggest that the risk for radiation-induced thyroid cancer following CT scanning in adults may have been overestimated in observational studies due to medical surveillance-related biases.
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Affiliation(s)
- Young Ki Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sangwon Lee
- Cancer Big Data Center, National Cancer Center, Goyang, Republic of Korea
| | - Eun Kyung Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun-Young Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Hyo Soung Cha
- Cancer Big Data Center, National Cancer Center, Goyang, Republic of Korea.
| | - Yul Hwangbo
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea.
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Li M, Pei J, Xu M, Shu T, Qin C, Hu M, Zhang Y, Jiang M, Zhu C. Changing incidence and projections of thyroid cancer in mainland China, 1983-2032: evidence from Cancer Incidence in Five Continents. Cancer Causes Control 2021; 32:1095-1105. [PMID: 34152517 DOI: 10.1007/s10552-021-01458-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE An increasing incidence of thyroid cancer has been seen in China during the past several decades. The aim of this study was to analyze potential age, period, and cohort effects on the incidence of thyroid cancer in mainland China and to predict new cases up to 2032. METHODS We calculated age-adjusted and age-specific incidence rates of thyroid cancer, conducted an age-period-cohort analysis of 35,037 thyroid cancer incidence cases reported to Cancer Incidence in Five Continents from 1983 to 2012 in mainland China, and predicted incidence up to 2032 using the Bayesian age-period-cohort method. RESULTS The age-adjusted overall incidence rate of thyroid cancer increased from 1.93/100,000 in 1983-1987 to 12.18/100,000 in 2008-2012 among females and from 0.77/100,000 in 1983-1987 to 3.89/100,000 in 2008-2012 among males, with a female-to-male ratio of approximately 3.0 during the three decades. Strong birth cohort and period effects on the incidence of thyroid cancer were observed for both sexes, and such an increasing trend is predicted to continue for at least the next 20 years. More than 3.7 million new cases are projected in the 2028-2032 period. CONCLUSION The increasing trend of thyroid cancer in mainland China will cause a great burden in the future. In addition to the potential impact of improvement in medical diagnostics, potential exposure to risk factors have played a role in the observed rising trend. Further population-based epidemiologic studies are required to identify risk factors to aid in thyroid cancer prevention and control.
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Affiliation(s)
- Mandi Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiao Pei
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Minghan Xu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ting Shu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chengjie Qin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Meijing Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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11
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Deziel NC, Warren JL, Huang H, Zhou H, Sjodin A, Zhang Y. Exposure to polychlorinated biphenyls and organochlorine pesticides and thyroid cancer in connecticut women. ENVIRONMENTAL RESEARCH 2021; 192:110333. [PMID: 33068584 PMCID: PMC7736223 DOI: 10.1016/j.envres.2020.110333] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Thyroid cancer incidence has increased substantially over the past decades, and environmental risk factors have been suggested to play a role. Polychlorinated biphenyls (PCB) and organochlorine pesticides (OCP) are established thyroid hormone disruptors, but their relationship to thyroid cancer is not known. METHODS We investigated the relationship between serum PCB and OCP concentrations and papillary thyroid cancer (PTC) in 250 incident female PTC cases and 250 female controls frequency-matched on age, all residing in Connecticut. Interviews and serum samples were collected from 2010 to 2013. Samples were analyzed for 32 different chemicals using gas chromatography with isotope dilution high resolution mass spectrometry. We calculated odds ratios (OR) and 95% confidence intervals (CI) using single pollutant logistic regression models for concentrations (per interquartile range) of individual PCB/OCP and summed groups of structurally or biologically similar PCB/OCP, adjusted for education, family history of cancer, alcohol consumption, age, and body mass index. Sub-analyses included stratification by tumor size (≤ and >1 cm) and birth before or during peak PCB production (born in 1960 or earlier and born after 1960), as exposures during early life may be important. We also applied three multi-pollutant approaches (standard multi-pollutant regression, hierarchical Bayesian modeling, principal components regression analysis) to investigate associations with co-exposures to multiple PCB/OCPs. RESULTS No PCB/OCPs were positively associated with PTC in primary analyses. Statistically significant associations were observed for 9 of the 32 chemicals and 3 summed groups of similar chemicals in the those born during peak production based on single-pollutant models. Multi-pollutant analyses suggested null associations overall. CONCLUSIONS Our results using single and multi-pollutant modeling do not generally support an association between PCB or OCP exposure and PTC, but some associations in those born during peak production suggest that additional investigation into early-life exposures and subsequent thyroid cancer risk may be warranted.
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Affiliation(s)
- Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Huang Huang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Surgical Outcomes, Yale School of Medicine, New Haven, CT, USA
| | - Haoran Zhou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Surgical Outcomes, Yale School of Medicine, New Haven, CT, USA
| | - Andreas Sjodin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, 30341, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Surgical Outcomes, Yale School of Medicine, New Haven, CT, USA
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12
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Alqahtani WS, Almufareh NA, Domiaty DM, Albasher G, Alduwish MA, Alkhalaf H, Almuzzaini B, Al-Marshidy SS, Alfraihi R, Elasbali AM, Ahmed HG, Almutlaq BA. Epidemiology of cancer in Saudi Arabia thru 2010-2019: a systematic review with constrained meta-analysis. AIMS Public Health 2020; 7:679-696. [PMID: 32968686 PMCID: PMC7505779 DOI: 10.3934/publichealth.2020053] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/01/2020] [Indexed: 12/12/2022] Open
Abstract
Background Cancer is emerging as a major global health-care system challenge with a growing burden worldwide. Due to the inconsistent cancer registry system in Saudi Arabia, the epidemiology of cancer is still dispersed in the country. Consequently, this review aimed to assemble the epidemiological metrics of cancer in Saudi Arabia in light of the available published data during the period from (2010–2019). Methods Published literature from Saudi Arabia relating to cancer incidence, prevalence, risk factors, and other epidemiological metrics were accessed through electronic search in Medline/PubMed, Cochrane, Scopus, Web of Knowledge, Google Scholar, and public database that meet the inclusion criteria. Relevant keywords were used during the electronic search about different types of cancers in Saudi Arabia. No filters were used during the electronic searches. Data were pooled and odds ratios (ORs) and 95% confidence interval (95%CI) were calculated. A random-effects meta-analysis was performed to assess the well-determined risk factors associated with different types of cancers. Results The most common cancers in Saudi Arabia are breast, colorectal, prostate, brain, lymphoma, kidney and thyroid outnumbering respectively. Their prevalence rates and OR (95%CI) as follow: breast cancer 53% and 0.93 (0.84–1.00); colon-rectal cancer (CRC) 50.9% and 1.2 (0.81–1.77); prostate cancer 42.6% and 3.2 (0.88–31.11); brain/Central Nervous System cancer 9.6% and 2.3 (0.01–4.2); Hodgkin and non-Hodgkin's lymphoma 9.2% and 3.02 (1.48–6.17); kidney cancer 4.6% and 2.05 (1.61–2.61), and thyroid cancer 12.9% and 6.77 (2.34–19.53). Conclusion Within the diverse cancers reported from Saudi Arabia, the epidemiology of some cancers magnitude 3-fold in the latest years. This increase might be attributed to the changing in the Saudi population lifestyle (adopting western model), lack of cancer awareness, lack of screening & early detection programs, social barriers toward cancer investigations. Obesity, genetics, sedentary lifestyle, tobacco use, viral infection, and iodine & Vit-D deficiency represent the apparent cancer risk factors in Saudi Arabia.
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Affiliation(s)
| | - Nawaf Abdulrahman Almufareh
- Department of Pediatric Dentistry and Preventive Dental Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | - Gadah Albasher
- King Saud University, Department of Zoology, College of Science, Saudi Arabia
| | - Manal Abduallah Alduwish
- Prince Sattam bin Abdulaziz University, College of Science and Humanities, Biology Department, Alkarj, Saudi Arabia
| | - Huda Alkhalaf
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Bader Almuzzaini
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Rgya Alfraihi
- Pharm B, Pharmacy Services, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdelbaset Mohamed Elasbali
- Department of Clinical Laboratory Sciences, College of Applied Medical sciences, Jouf University, Qurayyat, Saudi Arabia
| | - Hussain Gadelkarim Ahmed
- College of Medicine, University of Hail, Saudi Arabia.,Department of Histopathology and Cytology, FMLS, University of Khartoum, Sudan
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13
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Vydro L, Kitahara CM, Lubin JH, Schneider AB, Mihailescu DV. Among Individuals Irradiated for Benign Conditions in Childhood, Developing Thyroid Cancer Does Not Affect All-Cause Survival. Thyroid 2020; 30:389-395. [PMID: 31797741 PMCID: PMC7133439 DOI: 10.1089/thy.2019.0439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Whether radiation-induced thyroid cancer affects survival rates has not been clearly elucidated. Survival could be affected by the thyroid cancer itself, its treatment, or by being a sign of susceptibility to other cancers. The objective of the current study was to determine if the development of thyroid cancer is associated with a differential survival in radiation-exposed individuals. Methods: We conducted a matched prospective cohort mortality follow-up study based on data from a cohort of 4296 individuals who were irradiated predominantly for enlarged tonsils during their childhood (between 1939 and 1962) and were prospectively followed since 1974. The study matched an irradiated subject who developed (was exposed to) thyroid cancer (a "case") and two irradiated subjects, who had not developed (were not exposed to) thyroid cancer ("controls") by the time of case incidence. The two controls were randomly matched to cases by sex, year of birth, age at radiation treatment, and radiation dose. Then, using a stratified Cox analysis, we compared survival time from the date of thyroid cancer diagnosis or time of selection to either date of death or the end of the observation period (December 31, 2016). Vital status and causes of death were determined using the National Death Index (1979-2016), the Social Security Death Index (1974-1979), and study files. Cause of death was categorized as cardiovascular, malignancy, or other. Results: A total of 1008 subjects were included in the analysis, including 353 thyroid cancer cases. At the end of the study period, 162 of 655 (24.7%) of individuals without thyroid cancer had died compared with 100 of 353 (28.3%) of the subjects with thyroid cancer. The hazard ratio (HR) for all-cause mortality, comparing the thyroid cancer cases to controls, was close to unity (HR = 1.01 [0.77-1.33]). HRs remained insignificant after eliminating matched sets with microcarcinomas, defined as tumor size <10 mm (HR = 1.39 [0.96-2.03]). Distribution of the causes of death taking into account age and the time of observation differed between cases and controls (p < 0.05). Neither increased cardiovascular-related nor malignancy-related mortality was associated with radiation-induced thyroid cancer. Conclusions: Among individuals irradiated for benign conditions in childhood, development of thyroid cancer was not associated with decreased all-cause survival.
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Affiliation(s)
- Leonid Vydro
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, Illinois
| | - Cari M. Kitahara
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Jay H. Lubin
- Division of Cancer Epidemiology & Genetics, Biostatistics Branch, National Cancer Institute, Bethesda, Maryland
| | - Arthur B. Schneider
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, Illinois
| | - Dan V. Mihailescu
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, Illinois
- Address correspondence to: Dan V. Mihailescu, MD, Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, 1819 West Polk Street, MC 640, Chicago, IL 60612
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14
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Luo J, Li H, Deziel NC, Huang H, Zhao N, Ma S, Ni X, Udelsman R, Zhang Y. Genetic susceptibility may modify the association between cell phone use and thyroid cancer: A population-based case-control study in Connecticut. ENVIRONMENTAL RESEARCH 2020; 182:109013. [PMID: 31918310 PMCID: PMC7061309 DOI: 10.1016/j.envres.2019.109013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 05/17/2023]
Abstract
Emerging studies have provided evidence on the carcinogenicity of radiofrequency radiation (RFR) from cell phones. This study aims to test the genetic susceptibility on the association between cell phone use and thyroid cancer. Population-based case-control study was conducted in Connecticut between 2010 and 2011 including 440 thyroid cancer cases and 465 population-based controls with genotyping information for 823 single nucleotide polymorphisms (SNPs) in 176 DNA genes. We used multivariate unconditional logistic regression models to estimate the genotype-environment interaction between each SNP and cell phone use and to estimate the association with cell phone use in populations according to SNP variants. Ten SNPs had P < 0.01 for interaction in all thyroid cancers. In the common homozygote groups, no association with cell phone use was observed. In the variant group (heterozygotes and rare homozygotes), cell phone use was associated with an increased risk for rs11070256 (odds ratio (OR): 2.36, 95% confidence interval (CI): 1.30-4.30), rs1695147 (OR: 2.52, 95% CI: 1.30-4.90), rs6732673 (OR: 1.59, 95% CI: 1.01-2.49), rs396746 (OR: 2.53, 95% CI: 1.13-5.65), rs12204529 (OR: 2.62, 95% CI: 1.33-5.17), and rs3800537 (OR: 2.64, 95% CI: 1.30-5.36) with thyroid cancers. In small tumors, increased risk was observed for 5 SNPs (rs1063639, rs1695147, rs11070256, rs12204529 and rs3800537), In large tumors, increased risk was observed for 3 SNPs (rs11070256, rs1695147, and rs396746). Our result suggests that genetic susceptibilities modify the associations between cell phone use and risk of thyroid cancer. The findings provide more evidence for RFR carcinogenic group classification.
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Affiliation(s)
- Jiajun Luo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Hang Li
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Huang Huang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Nan Zhao
- Peking Union Medical College Hospital, Beijing, China
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Xin Ni
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China; Big Data and Engineering Research Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Robert Udelsman
- Endocrine Neoplasm Institute, Miami Cancer Institute, Miami, FL, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
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15
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Huang H, Sjodin A, Chen Y, Ni X, Ma S, Yu H, Ward MH, Udelsman R, Rusiecki J, Zhang Y. Polybrominated Diphenyl Ethers, Polybrominated Biphenyls, and Risk of Papillary Thyroid Cancer: A Nested Case-Control Study. Am J Epidemiol 2020; 189:120-132. [PMID: 31742588 DOI: 10.1093/aje/kwz229] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 01/22/2023] Open
Abstract
A nested case-control study was carried out using data from the US Department of Defense cohort between 2000 and 2013 to investigate the associations of papillary thyroid cancer (PTC) with serum concentrations of polybrominated diphenyl ethers and polybrominated biphenyls. This study included 742 histologically confirmed PTC cases (in 341 women and 401 men) and 742 matched controls with prediagnostic serum samples from the Department of Defense Serum Repository. Lipid-corrected serum concentrations of 8 congeners were measured. Multivariate conditional logistic regression analyses were performed for classical PTC and follicular variant of PTC, respectively. We also examined effect modification by sex. BDE-28, a polybrominated diphenyl ether congener, was associated with significantly increased risk of classical PTC (for the third tertile vs. below the limit of detection, odds ratio = 2.09, 95% confidence interval: 1.05, 4.15; P for trend = 0.02), adjusting for other congeners, body mass index, and branch of military service. This association was observed mainly for larger classical PTC (tumor size > 10 mm), with a significantly stronger association among women than men (P for interaction = 0.004). No consistent associations were observed for other congeners, including those at higher concentrations. This study found a significantly increased risk of classical PTC associated with increasing levels of BDE-28. The risk varied by sex and tumor size.
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Affiliation(s)
- Huang Huang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Andreas Sjodin
- Persistent Pollutants Biomonitoring Laboratory, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yingtai Chen
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
- Yale Cancer Center, New Haven, Connecticut
- Cancer Institute and Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Ni
- Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Robert Udelsman
- Endocrine Neoplasia Institute, Miami Cancer Institute, Miami, Florida
| | - Jennifer Rusiecki
- and Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Department of Preventive Medicine and Biostatistics, Bethesda, Maryland
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
- Yale Cancer Center, New Haven, Connecticut
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16
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Liang J, Zhao N, Zhu C, Ni X, Ko J, Huang H, Ma S, Udelsman R, Zhang Y. Dietary patterns and thyroid cancer risk: a population-based case-control study. Am J Transl Res 2020; 12:180-190. [PMID: 32051747 PMCID: PMC7013212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Thyroid cancer (TC) incidence has increased greatly during the past decades with a few established risk factors, while the relationship between dietary factors and TC remains unclear. Limited literature has investigated the association with inconsistent findings. METHODS We examined the association between dietary pattern and risk of TC in a population based case-control study conducted in Connecticut (2010-2011). Our study population included 390 historically confirmed incident TC cases and 436 population-based controls who completed baseline dietary history questionnaires (DHQ). We identified 3 distinct dietary patterns ("Starchy Foods and Desserts", "Fruits and Vegetables", "High Protein and Fat") through principal components analysis. Multivariate unconditional logistic regression models were used to investigate the association between each dietary pattern and risk of TC, controlling for potential confounders. RESULTS A diet rich in fruits and vegetables was significantly associated with a reduced risk of overall TC (OR = 0.60, 95% CI: 0.39, 0.92; P trend = 0.02). Compared to younger women, a stronger protective effect was observed among women ≥ 50 years of age in overall TC and papillary TC risk. A diet rich in starchy foods and desserts was positively and negatively associated with an overall TC risk among men and women respectively. CONCLUSIONS Our study found a significant negative association between diet patterns rich in fruits and vegetables and TC risk, especially among women aged 50 years or older. While high in starchy foods and desserts may be positively and negatively associated with TC risk among men and women respectively, these results require confirmation in other populations.
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Affiliation(s)
- Jiaxin Liang
- Department of Environmental Health Sciences, Yale School of Public HealthNew Haven, CT, U.S.
| | - Nan Zhao
- Central Laboratories, Peking Union Medical College HospitalBeijing, China
| | - Cairong Zhu
- Department of Epidemic Disease and Health Statistics, School of Public Health, Sichuan UniversitySichuan, Chengdu, China
| | - Xin Ni
- Beijing Children’s Hospital, Capital Medical UniversityBeijing, China
| | - Jamie Ko
- Department of Chronic Disease Epidemiology, Yale School of Public HealthNew Haven, CT, U.S.
| | - Huang Huang
- Department of Environmental Health Sciences, Yale School of Public HealthNew Haven, CT, U.S.
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public HealthNew Haven, CT, U.S.
| | - Robert Udelsman
- The Endocrine Neoplasia Institute, Miami Cancer InstituteMiami, Florida, U.S.
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public HealthNew Haven, CT, U.S.
- Department of Surgery, Yale School of MedicineNew Haven, CT, U.S.
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17
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Wang Q, Huang H, Zhao N, Ni X, Udelsman R, Zhang Y. Phytoestrogens and Thyroid Cancer Risk: A Population-Based Case-Control Study in Connecticut. Cancer Epidemiol Biomarkers Prev 2019; 29:500-508. [PMID: 31826911 DOI: 10.1158/1055-9965.epi-19-0456] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/28/2019] [Accepted: 12/03/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Very few previous studies have examined the relationship between thyroid cancer risk and intake of phytoestrogens (PE); furthermore, these studies have reached inconsistent results. METHODS We analyzed data from a population-based case-control study in Connecticut from 2010 to 2011, including 387 histologically confirmed thyroid cancer cases and 433 population-based controls, with compound data available concerning specific PEs. Multivariate unconditional logistic regression models were used to estimate the associations between specific PEs and the risk of thyroid cancer, adjusting for potential confounders. RESULTS An elevated risk of thyroid cancer was associated with moderate to high levels of coumestrol intake [OR = 2.48, 95% confidence interval (CI), 1.39-4.43 for 40-80 μg/day; OR = 2.41, 95% CI, 1.32-4.40 for 80-130 μg/day; and OR = 2.38, 95% CI, 1.26-4.50 for >200 μg/day compared with <40 μg/day], and the main elevation in risk appeared among microcarcinomas (≤1 cm). A decreased risk of papillary macrocarcinomas (>1 cm; OR = 0.26, 95% CI, 0.08-0.85 for 1,860-3,110 μg/day compared with <760 μg/day) was associated with moderate genistein intake among women. CONCLUSIONS Our study suggests that high coumestrol intake increases the risk of thyroid cancer, especially microcarcinomas, whereas moderate amounts of genistein intake appear to be protective for females with thyroid macrocarcinomas. IMPACT The study highlights the importance of distinguishing between microcarcinomas and macrocarcinomas in future research on the etiology of thyroid cancer.
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Affiliation(s)
- Qian Wang
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Huang Huang
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Nan Zhao
- Central Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Ni
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Robert Udelsman
- Endocrine Neoplasm Institute, Miami Cancer Institute, Miami, Florida
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut. .,Department of Surgery, Yale School of Medicine, Yale University, New Haven, Connecticut
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18
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Sadeghi H, Rafei M, Bahrami M, Haghdoost A, Shabani Y. Attributable risk fraction of four lifestyle risk factors of thyroid cancer: a meta-analysis. J Public Health (Oxf) 2019; 40:e91-e98. [PMID: 28977647 DOI: 10.1093/pubmed/fdx088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 07/18/2017] [Indexed: 11/13/2022] Open
Abstract
Background Lifestyle risk factors such as obesity, overweight, smoking and radiation exposure related to thyroid cancer. This study estimated the amount of excess risk that attributed to risk factors. Methods Major electronic databases were searched until February 2016. Epidemiological studies addressing the association between lifestyle risk factors and thyroid cancer were enrolled. The results were expressed as ARF with 95% confidence intervals (CIs) using a random-effects-model. Results We identified a total of 13 321 references and included 17 studies. The excess risk of thyroid cancer attributable to radiation exposure was 14% (95% CI: 5%, 23%; eight studies, I2 = 88.7%), to obesity was 13% (95% CI: 5%, 21%; four studies, I2 = 68.7%), to overweight was 10% (95% CI: 2%, 17%; four studies, I2 = 4.1%) and to smoking was -13% (95% CI: -33%, 6%; five studies, I2 = 30.6%). So obesity, overweight and radiation exposure are significantly associated with increased thyroid cancer risk and smoking has a protective effect on thyroid cancer but not significant. Conclusion A significant amount of the incidence of thyroid cancer is attributable to lifestyle risk factors. Since these factors are entirely preventable, so it is necessary to reduce factors that are associated with increased thyroid cancer risk and proper education to the community. Thus weight loss and protection against radiation can effectively reduce the incidence rate of thyroid cancer but smoking can have a protective effect.
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Affiliation(s)
- Hajar Sadeghi
- Faculty of Khomein University of Medical Sciences, Khomein, Iran
| | | | | | - AliAkbar Haghdoost
- Community Medicine Department and Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Yazdan Shabani
- Member of Student Research Committee of Arak University of Medical Sciences, Arak, Iran
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19
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Memon A, Rogers I, Paudyal P, Sundin J. Dental X-Rays and the Risk of Thyroid Cancer and Meningioma: A Systematic Review and Meta-Analysis of Current Epidemiological Evidence. Thyroid 2019; 29:1572-1593. [PMID: 31502516 DOI: 10.1089/thy.2019.0105] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for thyroid cancer and brain and central nervous system tumors. Considering the high lifetime prevalence and frequency of exposure to dental X-rays, the most common source of diagnostic radiation exposure in the general population, even a small associated increase in cancer risk would be of considerable public health importance. With the objective to inform clinical practice and guidelines, we synthesized the current epidemiological evidence on the association between dental X-rays and the risk of thyroid cancer, meningioma, and other cancers of the head and neck region. Methods: The Medline, Embase, and Web of Science databases were searched to identify eligible studies. Summary odds ratio/relative risk estimates and confidence intervals were extracted, and pooled risk ratios (RRs) for each cancer were calculated using random effects meta-analysis. Results: The literature search identified 5537 publications; of these, 26 studies including 10,868 cancer patients were included in the synthesis. The random effects meta-analyses, based on seven studies of thyroid cancer (six case/control, one cohort) and eight studies of meningioma (all case/control), showed that multiple (or repeated) exposures to dental X-rays were significantly associated with an increased risk of thyroid cancer (pooled RR = 1.87 [95% confidence interval, CI 1.11-3.15]) and meningioma (pooled RR = 1.53 [CI 1.26-1.85]). There was no association with glioma, and there were too few studies of other cancers of the head and neck region to conduct a meaningful meta-analysis. Conclusions: Based on a meta-analysis of retrospective case/control studies, these findings provide some support to the hypothesis that multiple (or repeated) exposures to dental X-rays may be associated with an increased risk of thyroid cancer and meningioma. These studies did not include individual organ doses and ages at exposure, and are subject to recall bias and other limitations. Furthermore, the thyroid exposure has decreased dramatically over time from the use of thyroid shields and improved technology/equipment. Prospective studies, based on dental X-ray records and patient follow-up, are needed to test the hypothesis further and clarify the possible cancer risk associated with dental radiography, as although the risk at the individual level, particularly with improved technology/equipment, is likely to be very low, the proportion of the population exposed is high. Considering that about one-third of the general population in developed countries is routinely exposed to one or more dental X-rays per year, these findings manifest the need to reduce diagnostic radiation exposure as much as possible.
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Affiliation(s)
- Anjum Memon
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Priyamvada Paudyal
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Josefin Sundin
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
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20
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Deziel NC, Alfonso-Garrido J, Warren JL, Huang H, Sjodin A, Zhang Y. Exposure to Polybrominated Diphenyl Ethers and a Polybrominated Biphenyl and Risk of Thyroid Cancer in Women: Single and Multi-Pollutant Approaches. Cancer Epidemiol Biomarkers Prev 2019; 28:1755-1764. [PMID: 31387967 PMCID: PMC6774868 DOI: 10.1158/1055-9965.epi-19-0526] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/30/2019] [Accepted: 07/30/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Thyroid cancer incidence is the most rapidly increasing malignancy; rates are three times higher in women than men. Thyroid hormone-disrupting flame-retardant chemicals, including polybrominated diphenyl ethers (PBDE) and polybrominated biphenyls (PBB), may contribute to this trend. METHODS We investigated the relationship between PBDE/PBB exposure and papillary thyroid cancer (PTC) in 250 incident female papillary thyroid cancer cases and 250 female controls frequency-matched on age. Interviews and postdiagnostic serum samples were collected from 2010 to 2013. Serum samples were analyzed for 11 congeners. We calculated ORs and 95% confidence intervals (95% CI) using single-pollutant logistic regression models for continuous and categorical lipid-adjusted serum concentrations of PBDE/PBB, adjusted for age, alcohol consumption, and education. We applied three multi-pollutant approaches [standard multipollutant regression models, hierarchical Bayesian logistic regression modeling (HBLR), principal components analysis (PCA)] to investigate associations with PBDE/PBB mixtures. RESULTS In single-pollutant models, a decreased risk was observed at the highest (>90th percentile) versus lowest ( CONCLUSIONS Our results using single- and multi-pollutant modeling do not generally support a positive association with PBDE/PBB and PTC risk. IMPACT Prospective studies with more advanced statistical approaches to analyze mixtures and populations with higher exposures could reveal new insights.
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Affiliation(s)
- Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.
| | - Javier Alfonso-Garrido
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Huang Huang
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Andreas Sjodin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
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Han X, Meng L, Li Y, Li A, Turyk ME, Yang R, Wang P, Xiao K, Li W, Zhao J, Zhang Q, Jiang G. Associations between Exposure to Persistent Organic Pollutants and Thyroid Function in a Case-Control Study of East China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:9866-9875. [PMID: 31355638 DOI: 10.1021/acs.est.9b02810] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Animal studies have indicated that persistent organic pollutants (POPs) affect thyroid hormone homeostasis, while epidemiological studies involving human have not shown consistent results. In this study, we investigated the associations between POP exposure and thyroid function among adult population of East China. One hundred eighty-six participants diagnosed with thyroid disease and 186 participants without thyroid disease from Shandong, China were enrolled in the case-control study during 2016 to 2017. We found that POP exposure was significantly and positively associated with the risk of thyroid disease. The association of thyroid disease with a sum of 17 POPs followed a nonmonotonic dose response, with an adjusted odds ratio of 2.09 (95% confidence intervals: 1.13-3.87, p = 0.019) for the second quartile. Among 186 participants in the control group, concentrations of POPs showed negative associations with triiodothyronine (T3), free T3 (FT3), thyroxine (T4), and free T4 (FT4) in males and positive associations with T4 and FT4 in females. Taken together, these findings suggest that POP exposure can disrupt thyroid hormone homeostasis and increase the risk of thyroid disease.
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Affiliation(s)
- Xu Han
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
| | - Lingling Meng
- Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University , Jinan 250014 , China
| | - Yingming Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
| | - An Li
- School of Public Health , University of Illinois at Chicago , Chicago , Illinois 60612 , United States
| | - Mary E Turyk
- School of Public Health , University of Illinois at Chicago , Chicago , Illinois 60612 , United States
| | - Ruiqiang Yang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
| | - Pu Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
| | - Ke Xiao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
| | - Wenjuan Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
| | - Junpeng Zhao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
| | - Qinghua Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
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Shi F, Liu Y, Li M, Wen P, Qian QQ, Fan Y, Huang R. Analysis of lncRNA and mRNA Transcriptomes Expression in Thyroid Cancer Tissues Among Patients With Exposure of Medical Occupational Radiation. Dose Response 2019; 17:1559325819864223. [PMID: 31384241 PMCID: PMC6661800 DOI: 10.1177/1559325819864223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 06/19/2019] [Accepted: 06/25/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Occupational exposure of radiation among medical radiation workers
contributes to the subsequent increased risk of thyroid cancer. Long
noncoding RNAs (lncRNAs) are emerging as important regulators of cancer
biology. However, little is known about lncRNA expression in thyroid cancer
tissues from patients who are exposed to medical occupational radiation. The
purpose of this study is to reveal the transcriptomes difference between
thyroid cancer tissues and adjacent nonneoplastic thyroid tissues. Methods: Microarray technology was used in this study. Quantitative reverse
transcription polymerase chain reaction was adopted to verify 6
differentially expressed lncRNAs. Gene ontology and pathway analyses were
performed using standard enrichment computational methods. Potential target
genes of the differentially expressed lncRNAs were predicted with 2
independent algorithms. Results: A total of 23 lncRNA and messenger RNA transcripts were found differentially
expressed in the thyroid cancer tissues (fold change ≥2.0,
P < .05). This differential lncRNA expression may
affect many pathways, including those involved in cysteine and methionine
metabolism, Huntington disease, propanoate metabolism, and
carcinogenesis. Conclusions: Our study provides a transcriptome-wide screening and analysis of the lncRNA
expression profile in thyroid cancer tissues from patients with medical
occupational radiation exposure and lays the foundation for further
investigation of lncRNAs related to thyroid cancer development and
carcinogenic risk of medical occupational radiation exposure.
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Affiliation(s)
- Feng Shi
- Internal Medicine Department of Thyroid and Radionuclide Therapy, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China
| | - Ying Liu
- Internal Medicine Department of Thyroid and Radionuclide Therapy, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China
| | - Min Li
- Internal Medicine Department of Thyroid and Radionuclide Therapy, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China
| | - Peng Wen
- Internal Medicine Department of Thyroid and Radionuclide Therapy, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China
| | - Qiu Qin Qian
- Internal Medicine Department of Thyroid and Radionuclide Therapy, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China
| | - Yibin Fan
- Zhejiang provincial people's hospital, People's Hospital of Hangzhou Medical College, Hangzhou, People's Republic of China
| | - Ruixue Huang
- Department of Occupational and Environmental Health, School of Public Health, Central South University, Changsha, People's Republic of China
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Tuminello S, van Gerwen MAG, Genden E, Crane M, Lieberman-Cribbin W, Taioli E. Increased Incidence of Thyroid Cancer among World Trade Center First Responders: A Descriptive Epidemiological Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1258. [PMID: 30970543 PMCID: PMC6479621 DOI: 10.3390/ijerph16071258] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/20/2019] [Accepted: 04/04/2019] [Indexed: 12/15/2022]
Abstract
An increased incidence of thyroid cancer among 9/11 rescue workers has been reported, the etiology of which remains unclear but which may, at least partly, be the result of the increased medical surveillance this group undergoes. This study aimed to investigate thyroid cancer in World Trade Center (WTC) responders by looking at the demographic data and questionnaire responses of thyroid cancer cases from the Mount Sinai WTC Health Program (WTCHP). WTCHP thyroid cancer tumors were of a similar size (p = 0.4), and were diagnosed at a similar age (p = 0.2) compared to a subset of thyroid cancer cases treated at Mount Sinai without WTC exposure. These results do not support the surveillance bias hypothesis, under which smaller tumors are expected to be diagnosed at earlier ages. WTCHP thyroid cancer cases also reported a past history of radiation exposure and a family history of thyroid conditions at lower rates than expected, with higher than expected rates of previous cancer diagnoses, family histories of other cancers, and high Body Mass Indexes (BMIs). Further research is needed to better understand the underlying risk factors that may play a role in the development of thyroid cancer in this group.
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Affiliation(s)
- Stephanie Tuminello
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Maaike A G van Gerwen
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, 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.
| | - Michael Crane
- Division of Occupational and Environmental Medicine, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Wil Lieberman-Cribbin
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Emanuela Taioli
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
- Department of Thoracic Surgery, 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.
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Chauhan V, Wilkins RC. A comprehensive review of the literature on the biological effects from dental X-ray exposures. Int J Radiat Biol 2019; 95:107-119. [PMID: 30496029 DOI: 10.1080/09553002.2019.1547436] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Routine dental X-rays are among the most common sources of ionizing radiation exposure for healthy individuals globally, with 300 examinations/1000 individuals/year as documented by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) global survey of medical radiation usage and exposure. Furthermore, in the United States of America, an increased use of dental radiography is evident. However, with the shift from using film to digital image receptors, the dose of radiation per routine examination has decreased. Despite this, there remains public concern of dental X-rays. This continuing concern highlights the need to review the literature on biological and health effects related to exposure, from dental X-rays. MATERIAL AND METHODS This report presents studies investigating biological and health effects related to exposures using dental X-rays in patients and provides a critical evaluation. Relevant studies specific to dental X-rays are reviewed from 1970 and onward with the bulk data in this field resulting from epidemiological and biomonitoring studies. RESULTS While, most epidemiological studies suggest a possible correlation between head/neck related tumors and exposure to dental X-rays, evidence for causation is lacking. Biomonitoring studies suggest that exposure to low-level radiation such as that of dental radiography may not be a factor in inducing long-term chromosomal damage, but may result in localized cytotoxicity in the irradiated region of the mouth, with no long-term harm. CONCLUSIONS In general, the total number of studies is low and the majority of the data has been generated from poorly designed experiments. This review will highlight shortcomings that could influence outcomes and provide a more balanced interpretation that could impact the public perception and the level of public concern on the health effects resulting from dental X-rays.
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Affiliation(s)
- Vinita Chauhan
- a Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch , Health Canada , Ottawa , Canada
| | - Ruth C Wilkins
- a Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch , Health Canada , Ottawa , Canada
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25
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Luo J, Deziel NC, Huang H, Chen Y, Ni X, Ma S, Udelsman R, Zhang Y. Cell phone use and risk of thyroid cancer: a population-based case-control study in Connecticut. Ann Epidemiol 2018; 29:39-45. [PMID: 30446214 DOI: 10.1016/j.annepidem.2018.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/11/2018] [Accepted: 10/20/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE This study aims to investigate the association between cell phone use and thyroid cancer. METHODS A population-based case-control study was conducted in Connecticut between 2010 and 2011 including 462 histologically confirmed thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between cell phone use and thyroid cancer. RESULTS Cell phone use was not associated with thyroid cancer (OR: 1.05, 95% CI: 0.74-1.48). A suggestive increase in risk of thyroid microcarcinoma (tumor size ≤10 mm) was observed for long-term and more frequent users. Compared with cell phone nonusers, several groups had nonstatistically significantly increased risk of thyroid microcarcinoma: individuals who had used a cell phone >15 years (OR: 1.29, 95% CI: 0.83-2.00), who had used a cell phone >2 hours per day (OR: 1.40, 95% CI: 0.83-2.35), who had the most cumulative use hours (OR: 1.58, 95% CI: 0.98-2.54), and who had the most cumulative calls (OR: 1.20, 95% CI: 0.78-1.84). CONCLUSIONS This study found no significant association between cell phone use and thyroid cancer. A suggestive elevated risk of thyroid microcarcinoma associated with long-term and more frequent uses warrants further investigation.
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Affiliation(s)
- Jiajun Luo
- Department of Surgery, Yale School of Medicine, New Haven, CT
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT
| | - Huang Huang
- Department of Surgery, Yale School of Medicine, New Haven, CT
| | - Yingtai Chen
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Ni
- Department of Otorhinolaryngology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | - Robert Udelsman
- Endocrine Neoplasm Institute, Miami Cancer Institute, Miami, FL
| | - Yawei Zhang
- Department of Surgery, Yale School of Medicine, New Haven, CT; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT.
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27
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Hay JL, Baser RE, Westerman JS, Ford JS. Prevalence and Correlates of Worry About Medical Imaging Radiation Among United States Cancer Survivors. Int J Behav Med 2018; 25:569-578. [PMID: 29872990 DOI: 10.1007/s12529-018-9730-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Cancer survivors undergo lifelong surveillance regimens that involve repeated diagnostic medical imaging. As many of these diagnostic tests use ionizing radiation, which may modestly increase cancer risks, they may present a source of worry for survivors. The aims of this paper are to describe cancer survivors' level of worry about medical imaging radiation (MIR) and to identify patterns of MIR worry across subgroups defined by cancer type, other medical and demographic factors, and physician trust. METHOD This cross-sectional study used the 2012-2013 Health Information National Trends Survey of US adults conducted by the National Cancer Institute. The analysis focused on the 452 respondents identifying as cancer survivors. Weighted logistic regression analysis was used to evaluate factors associated with higher MIR worry (reporting "some" or "a lot" of MIR worry). RESULTS Nearly half (42%) of the sample reported higher worry about MIR. Unadjusted and adjusted logistic regressions indicated higher rates of MIR worry among those with lower incomes, those who self-reported poorer health, and those who completed cancer treatment within the past 10 years. Receipt of radiation treatment was associated with higher MIR worry in unadjusted analysis. CONCLUSION Worries about MIR are relatively common among cancer survivors. An accurate assessment of the rates and patterns of worry could aid efforts to improve these individuals' survivorship care and education.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA.
| | - Raymond E Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joy S Westerman
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA
| | - Jennifer S Ford
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA
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A case-control study of exposure to organophosphate flame retardants and risk of thyroid cancer in women. BMC Cancer 2018; 18:637. [PMID: 29871608 PMCID: PMC5989427 DOI: 10.1186/s12885-018-4553-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 05/25/2018] [Indexed: 11/29/2022] Open
Abstract
Background Growing evidence demonstrates that exposure to organophosphate flame retardants (PFRs) is widespread and that these chemicals can alter thyroid hormone regulation and function. We investigated the relationship between PFR exposure and thyroid cancer and whether individual or temporal factors predict PFR exposure. Methods We analyzed interview data and spot urine samples collected in 2010–2013 from 100 incident female, papillary thyroid cancer cases and 100 female controls of a Connecticut-based thyroid cancer case-control study. We measured urinary concentrations of six PFR metabolites with mass spectrometry. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) for continuous and categories (low, medium, high) of concentrations of individual and summed metabolites, adjusting for potential confounders. We examined relationships between concentrations of PFR metabolites and individual characteristics (age, smoking status, alcohol consumption, body mass index [BMI], income, education) and temporal factors (season, year) using multiple linear regression analysis. Results No PFRs were significantly associated with papillary thyroid cancer risk. Results remained null when stratified by microcarcinomas (tumor diameter ≤ 1 cm) and larger tumor sizes (> 1 cm). We observed higher urinary PFR concentrations with increasing BMI and in the summer season. Conclusions Urinary PFR concentrations, measured at time of diagnosis, are not linked to increased risk of thyroid cancer. Investigations in a larger population or with repeated pre-diagnosis urinary biomarker measurements would provide additional insights into the relationship between PFR exposure and thyroid cancer risk. Electronic supplementary material The online version of this article (10.1186/s12885-018-4553-9) contains supplementary material, which is available to authorized users.
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Hafezi L, Arianezhad SM, Hosseini Pooya SM. Evaluation of the radiation dose in the thyroid gland using different protective collars in panoramic imaging. Dentomaxillofac Radiol 2018; 47:20170428. [PMID: 29658781 DOI: 10.1259/dmfr.20170428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The value for the use of thyroid shield is one of the issues in radiation protection of patients in dental panoramic imaging. OBJECTIVES The objective of this research is to investigate the attenuation characteristics of some models of thyroid shielding in dental panoramic examinations. METHODS The effects of five different types of lead and lead-free (Pb-equivalent) shields on dose reduction of thyroid gland were investigated using implanted Thermoluminescence Dosemeters (TLDs) in head-neck parts of a Rando phantom. RESULTS The results show that frontal lead and Pb-equivalent shields can reduce the thyroid dose around 50% and 19%, respectively. CONCLUSIONS It can be concluded that the effective shielding area is an important parameter in thyroid gland dose reduction. Lead frontal collars with large effective shielding areas (>~300 cm2 but not necessarily very large) are appropriate for an optimized thyroid gland dose reduction particularly for the critical patients in dental panoramic imaging. Regardless of the shape and thickness, using the Pb-equivalent shields is not justifiable in dental panoramic imaging.
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Affiliation(s)
- Ladan Hafezi
- 1 Department of Maxillofacial Radiology, Dental Branch, Islamic Azad University , Tehran , Iran
| | - S Marjan Arianezhad
- 1 Department of Maxillofacial Radiology, Dental Branch, Islamic Azad University , Tehran , Iran
| | - Seyed Mahdi Hosseini Pooya
- 2 Radiation Application Research School, Nuclear Science and Technology Research Institute , Tehran , Iran
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Response to the commentary letter entitled 'Diagnostic radiography and thyroid cancer - causation or simply an association?' to our article entitled 'Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study' that was published in the European Journal of Cancer Prevention 2015; 24(5):439-446. Eur J Cancer Prev 2018; 25:572-3. [PMID: 27662225 DOI: 10.1097/cej.0000000000000206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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James BC, Aschebrook-Kilfoy B, White MG, Applewhite MK, Kaplan SP, Angelos P, Kaplan EL, Grogan RH. Quality of life in thyroid cancer-assessment of physician perceptions. J Surg Res 2018; 226:94-99. [PMID: 29661295 DOI: 10.1016/j.jss.2017.11.069] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/06/2017] [Accepted: 11/29/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Thyroid cancer is the fastest growing malignancy in the United States. Previous studies have shown a decrease in quality of life (QoL) after the treatment of thyroid cancer. To date, there have been no studies assessing physician perceptions regarding how a diagnosis of thyroid cancer affects QoL. Based on this and other findings from our study, we aim to assess physician perceptions on the effect of thyroid cancer on QoL. MATERIALS AND METHODS Physicians were recruited from two national organizations comprised physicians focusing on thyroid cancer. A 37-question survey was administered evaluating physician's perceptions of thyroid cancer patient satisfaction in various aspects of treatment, complications, and overall effects on QoL. QoL responses were categorized into overall QoL, physical, psychological, social, and spiritual well-being. RESULTS One hundred five physicians completed the survey. Physician's estimates of patient's overall QoL after thyroid cancer treatment was similar to overall QoL reported by patients. However, medical physicians overestimated the decrease in thyroid cancer survivor's QoL in several subcategories including physical, psychological, and social (P < 0.05). Both surgeons and medical physicians underestimated the percentage of patients with reported symptoms of temporary and permanent voice changes, temporary dry mouth, cold/heat sensitivity, and temporary and permanent hypocalcemia (P = 0.01-0.04). CONCLUSIONS Physicians have a varied estimation of the detrimental impact of thyroid cancer treatment on QoL. In addition, physicians underestimated the amount of physical symptoms associated with thyroid cancer treatments. Increased physician awareness of the detrimental effects of a thyroid cancer diagnosis on QoL should allow for a more accurate conversation about expected outcomes after thyroid cancer treatment.
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Affiliation(s)
- Benjamin C James
- Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | | | - Michael G White
- Department of Surgery, Endocrine Surgery Research Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Megan K Applewhite
- Department of Surgery, Endocrine Surgery Research Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Sharone P Kaplan
- Department of Surgery, Endocrine Surgery Research Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Peter Angelos
- Department of Surgery, Endocrine Surgery Research Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Edwin L Kaplan
- Department of Surgery, Endocrine Surgery Research Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Raymon H Grogan
- Department of Surgery, Endocrine Surgery Research Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois
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Abstract
BACKGROUND Radiation exposure is a well-known risk factor for thyroid cancer. However, the specific effects of diagnostic radiation exposure on thyroid cancer risk are controversial. The purpose of this study was to perform a systematic review and meta-analysis to assess the effects of diagnostic radiation exposure on thyroid cancer risk. METHODS The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and confidence intervals (CIs) were used to compute the risk of thyroid cancer using fixed- and random-effects models. Subgroup and sensitivity analyses were performed to evaluate the potential heterogeneity. RESULTS Nine studies from 12 publications were included in the meta-analysis. Overall exposure to diagnostic radiation exposure was associated with a significantly increased thyroid cancer risk (OR = 1.52 [CI 1.13-2.04]). The subgroup and sensitivity analyses revealed similar results. By type of exposure, exposure to computed tomography scans (OR = 1.46 [CI 1.27-1.68]) or dental x-rays (OR = 1.69 [CI 1.17-2.44]) were associated with an increased thyroid cancer risk. Head and neck (OR = 1.31 [CI 1.02-1.69]) and chest (OR = 1.71 [CI 1.09-2.69]) exposure to diagnostic radiation was associated with an increased thyroid cancer risk. CONCLUSIONS The results of this meta-analysis indicate that diagnostic radiation exposure is associated with an increased thyroid cancer risk. Therefore, to the extent that it will not compromise the information being sought, radiation exposure to the thyroid should be minimized during diagnostic examinations.
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Affiliation(s)
- Mi Ah Han
- 1 Department of Preventive Medicine, College of Medicine, Chosun University , Korea
| | - Jin Hwa Kim
- 2 Department of Internal Medicine, College of Medicine, Chosun University , Korea
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Hajeer MH, Awad HA, Abdullah NI, Almuhaisen GH, Abudalu LE. The rising trend in papillary thyroid carcinoma. True increase or over diagnosis? Saudi Med J 2018; 39:147-153. [PMID: 29436563 PMCID: PMC5885091 DOI: 10.15537/smj.2018.2.21211] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/18/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To assess the changes in parameters of thyroid carcinoma, particularly papillary type, in the era of widespread use of sensitive diagnostic methods. We aim to investigate whether the increased frequency of thyroid cancer is true or resulted from over diagnosis. Methods: We conducted a retrospective study of 313 cases of thyroid carcinoma diagnosed at Jordan University Hospital and King Hussein Cancer Center from 2007-2015. Papillary carcinoma accounted for 290 (92.7%) of all cases. Cases were sub classified according to demographic features, histological type, size, stage, and other variables. For comparison of data, cases were subdivided into 2 study periods: Group I included patients diagnosed in the period 2007-2010, and Group II in the period 2011-2015. Results: The frequency of thyroid carcinoma has increased across the study period. Papillary carcinoma was the major type accounting for this increase. Papillary micro carcinomas ≤1cm accounted for 34.8% of cases of PTC. Most cases (52.4%) of papillary thyroid carcinoma (PTC) were localized stage tumors. Group II of the study witnessed a more than doubled number of cases of PTC compared to group I, with increased frequency of tumors of all sizes as well as tumors of both localized and regional stages. Conclusions: Our observed trend cannot be totally explained by over diagnosis and increased diagnostic scrutiny. This increase could be of true nature and cannot be explained by single cause.
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Affiliation(s)
- Manar H Hajeer
- Department of Histopathology, Microbiology and Forensic Medicine, University of Jordan, Amman, Jordan. E-mail.
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Alcohol Consumption and Risk of Thyroid Cancer: A Population Based Case-Control Study in Connecticut. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1032:1-14. [DOI: 10.1007/978-3-319-98788-0_1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Sandler JE, Huang H, Zhao N, Wu W, Liu F, Ma S, Udelsman R, Zhang Y. Germline Variants in DNA Repair Genes, Diagnostic Radiation, and Risk of Thyroid Cancer. Cancer Epidemiol Biomarkers Prev 2017; 27:285-294. [PMID: 29263185 DOI: 10.1158/1055-9965.epi-17-0319] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/27/2017] [Accepted: 12/15/2017] [Indexed: 01/30/2023] Open
Abstract
Background: Radiation exposure is a well-documented risk factor for thyroid cancer; diagnostic imaging represents an increasing source of exposure. Germline variations in DNA repair genes could increase risk of developing thyroid cancer following diagnostic radiation exposure. No studies have directly tested for interaction between germline mutations and radiation exposure.Methods: Using data and DNA samples from a Connecticut population-based case-control study performed in 2010 to 2011, we genotyped 440 cases of incident thyroid cancer and 465 population-based controls for 296 SNPs in 52 DNA repair genes. We used multivariate unconditional logistic regression models to estimate associations between each SNP and thyroid cancer risk, as well as to directly estimate the genotype-environment interaction between each SNP and ionizing radiation.Results: Three SNPs were associated with increased risk of thyroid cancer and with thyroid microcarcinoma: HUS rs2708896, HUS rs10951937, and MGMT rs12769288. No SNPs were associated with increased risk of larger tumor (>10 mm) in the additive model. The gene-environment interaction analysis yielded 24 SNPs with Pinteraction < 0.05 for all thyroid cancer, 12 SNPs with Pinteraction < 0.05 for thyroid microcarcinoma, and 5 SNPs with Pinteraction < 0.05 for larger tumors.Conclusions: Germline variants in DNA repair genes are associated with thyroid cancer risk and are differentially associated with thyroid microcarcinoma and large tumor size. Our study provides the first evidence that germline genetic variations modify the association between diagnostic radiation and thyroid cancer risk.Impact: Thyroid microcarcinoma may represent a distinct subset of thyroid cancer. The effect of diagnostic radiation on thyroid cancer risk varies by germline polymorphism. Cancer Epidemiol Biomarkers Prev; 27(3); 285-94. ©2017 AACR.
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Affiliation(s)
| | - Huang Huang
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Nan Zhao
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Weiwei Wu
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.,School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Fangfang Liu
- The 302 Military Hospital, Beijing, China.,Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Robert Udelsman
- Endocrine Neoplasia Institute, Miami Cancer Center, Miami, Florida
| | - Yawei Zhang
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut. .,Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
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Can placing lead-rubber inferolateral to the light beam diaphragm limit ionising radiation to multiple radiosensitive organs? Radiography (Lond) 2017; 24:15-21. [PMID: 29306369 DOI: 10.1016/j.radi.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 09/06/2017] [Accepted: 09/07/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This article investigates a practical method of reducing the impact of scattered radiation during a lateral radiographic projection of the elbow. The light beam diaphragm (LBD) is generally accepted to limit ionising radiation using horizontal and longitudinal lead shutters, yet this article evidences further dose limitation by placing lead-rubber inferolateral to the LBD device. METHODS Using an anthropomorphic phantom and arm construction scattered radiation was recorded at multiple radiosensitive organs. A 15 cc ionisation chamber (model 10100 AT TRIAD) was placed on each radiosensitive organ (eye, thyroid, breast, testes, spleen and ovaries) measuring exposure rate (μGy/s). Dose readings were recorded before and after the placement of lead-rubber inferolateral to the LBD. A paired two sample t-test was undertaken affirming how likely dose limitation was attributable to chance (p < 0.05). RESULTS Descriptive and inferential statistics demonstrate dose reduction to radiosensitive organs (right eye 53%, right breast 53%, left eye 39%, thyroid 13%, left ovary 9%, testes 6%, left breast 3% and spleen 2%) upon placement of the lead-rubber inferolateral to the LBD. The paired two sample t-test demonstrated statistically significant dose limitation (t = 2.04, df = 7, p = 0.04) thus significant for radiographic practice. CONCLUSION Placement of lead-rubber inferolateral to the LBD limits dose to multiple radiosensitive organs. Right (53%) and left (39%) eye lens, right breast (53%), thyroid (13%), left ovary (9%), testes (6%), left breast (3%) and spleen (2%) statistically demonstrate dose limiting opportunities to patients.
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Chen-Scarabelli C, Scarabelli TM. The ethics of radiation exposure in cancer-treated patients : Editorial for: Frequent MUGA testing in a myeloma patient: a case-based ethics discussion. J Nucl Cardiol 2017; 24:1355-1360. [PMID: 27311452 DOI: 10.1007/s12350-016-0567-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Carol Chen-Scarabelli
- Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, 1530 3rd Avenue, South Tinsley Harrison Tower, Birmingham, AL, 35294-0006, USA
| | - Tiziano M Scarabelli
- Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, 1530 3rd Avenue, South Tinsley Harrison Tower, Birmingham, AL, 35294-0006, USA.
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
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Benign breast disease and risk of thyroid cancer. Cancer Causes Control 2017; 28:913-920. [DOI: 10.1007/s10552-017-0918-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/21/2017] [Indexed: 10/19/2022]
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Evaluation of an imaging protocol using ultrasound as the primary diagnostic modality in pediatric patients with superficial soft tissue infections of the face and neck. Int J Pediatr Otorhinolaryngol 2017; 96:89-93. [PMID: 28390621 DOI: 10.1016/j.ijporl.2017.02.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 02/21/2017] [Accepted: 02/25/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the clinical impact of an initiative to use ultrasound (US) as the primary diagnostic modality for children with superficial face and neck infections versus use of computed tomography (CT). METHODS Children with a diagnosis of lymphadenitis, face or neck abscess, or face and neck cellulitis were retrospectively evaluated by the otolaryngology service. Patients were separated into two groups based on implementation of a departmental initiative to use US as the primary diagnostic modality. The pre-implementation cohort consisted of patients treated prior to the initiative (2006-2009) and the current protocol cohort consisted of patients treated after the initiative was started (2010-2013). Demographics, use of US or CT, necessity of surgical intervention, and failure of medical management were compared. RESULTS Three hundred seventy three children were evaluated; 114 patients were included in the pre-implementation cohort and 259 patients were included in the current protocol cohort for comparison. Patients presenting during the current protocol period were more likely to undergo US (pre-implementation vs. current protocol, p-value) (12% vs. 49%, p < 0.0001) and less likely to undergo CT (66% vs. 41%, p < 0.0001) for their initial evaluation. There were no differences in the percentage of children who underwent prompt surgical drainage, prompt discharge without surgery, or trial inpatient observation. There were also no differences in the rate of treatment failure for patients undergoing prompt surgery or prompt discharge on antibiotics. For those patients who underwent repeat evaluation following trial medical management, US was used more frequently in the current protocol period (4% vs. 20%, p = 0.002) with no difference in CT use, selected treatment strategy, or treatment failure rates. CONCLUSION Increased use of US on initial evaluation of children with superficial face and neck infections resulted in decreased CT utilization, without negatively impacting outcome. Decreasing pediatric radiation exposure and potential long-term effects is of primary importance.
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Lee D, Park S, Noh WC, Im JS, Kim C. Photoacoustic imaging of dental implants in a porcine jawbone ex vivo. OPTICS LETTERS 2017; 42:1760-1763. [PMID: 28454154 DOI: 10.1364/ol.42.001760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Currently, x-ray-based imaging is used before and after the dental implant treatment, but the ionizing radiation is potentially harmful to patients and operators. Here, we demonstrate ex vivo photoacoustic imaging of a dental implant embedded in a porcine jawbone. By layering biological tissue over the jawbone to mimic a clinical environment, we demonstrate 10 mm deep imaging. Our results show that photoacoustic imaging can provide jawbone anatomical information, the location of an embedded implant fixture, and the thickness of the soft tissue above the jawbone.
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Kim C, Huang H, Zhao N, Lerro CC, Dai M, Chen Y, Li N, Ma S, Udelsman R, Zhang Y. Use of Dietary Vitamin Supplements and Risk of Thyroid Cancer: A Population-Based Case-Control Study in Connecticut. INT J VITAM NUTR RES 2017; 86:189-197. [PMID: 28436762 DOI: 10.1024/0300-9831/a000403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Certain dietary supplements have been reported to increase the risk of some cancers. Over half of the US population regularly uses dietary supplements. Thyroid cancer incidence has increased over the past several decades. However, few studies have investigated the association between dietary supplements and thyroid cancer. Thus, it is essential to clarify any association between dietary supplements and risk of thyroid cancer. MATERIALS AND METHODS A population-based case-control study in Connecticut was conducted during 2010-2011 among 462 histologically confi rmed incident thyroid cancer cases and 498 population-based controls. Dietary supplement intake was ascertained through in-person interviews and a food frequency questionnaire. Multivariate unconditional logistic regression models were used to estimate the risk of thyroid cancer and dietary supplement use. RESULTS Overall, no statistically signifi cant associations were observed between dietary supplementation and thyroid cancer risk. Stratifi ed analyses revealed a suggestive protective effect on risk of papillary microcarcinoma among longterm (> 10 years) use of multivitamins (OR = 0.59, 95 % CI: 0.33, 1.04) and calcium supplementation (OR = 0.45, 95 % CI: 0.22, 0.93). An increased risk of large papillary thyroid cancers (tumor size > 1 cm) was observed among short-term (< 5 years) users of calcium supplements (OR = 2.24, 95 % CI: 1.30, 3.88). DISCUSSION No signifi cant associations were observed between supplementation and overall thyroid cancer risk. The different associations between calcium supplements and risk of papillary thyroid cancer by tumor size warrant further investigation.
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Affiliation(s)
- Christopher Kim
- 1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Huang Huang
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
| | - Nan Zhao
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
| | - Catherine C Lerro
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
| | - Min Dai
- 3 Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China, USA
| | - Yingtai Chen
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA.,3 Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China, USA
| | - Ni Li
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA.,3 Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China, USA
| | - Shuangge Ma
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
| | - Robert Udelsman
- 4 Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, I. R. Iran
| | - Yawei Zhang
- 2 Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
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Huang H, Rusiecki J, Zhao N, Chen Y, Ma S, Yu H, Ward MH, Udelsman R, Zhang Y. Thyroid-Stimulating Hormone, Thyroid Hormones, and Risk of Papillary Thyroid Cancer: A Nested Case-Control Study. Cancer Epidemiol Biomarkers Prev 2017; 26:1209-1218. [PMID: 28377419 DOI: 10.1158/1055-9965.epi-16-0845] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/11/2017] [Accepted: 03/23/2017] [Indexed: 11/16/2022] Open
Abstract
Background: The effects of thyroid-stimulating hormone (TSH) and thyroid hormones on the development of human papillary thyroid cancer (PTC) remain poorly understood.Methods: The study population consisted of 741 (341 women, 400 men) histologically confirmed PTC cases and 741 matched controls with prediagnostic serum samples stored in the Department of Defense Serum Repository. Concentrations of TSH, total T3, total T4, and free T4 were measured in serum samples. Conditional logistic regression models were used to calculate ORs and 95% confidence intervals (CI).Results: The median time between blood draw and PTC diagnosis was 1,454 days. Compared with the middle tertile of TSH levels within the normal range, serum TSH levels below the normal range were associated with an elevated risk of PTC among women (OR, 3.74; 95% CI, 1.53-9.19) but not men. TSH levels above the normal range were associated with an increased risk of PTC among men (OR, 1.96; 95% CI, 1.04-3.66) but not women. The risk of PTC decreased with increasing TSH levels within the normal range among both men and women (Ptrend = 0.0005 and 0.041, respectively).Conclusions: We found a significantly increased risk of PTC associated with TSH levels below the normal range among women and with TSH levels above the normal range among men. An inverse association between PTC and TSH levels within the normal range was observed among both men and women.Impact: These results could have significant clinical implications for physicians who are managing patients with abnormal thyroid functions and those with thyroidectomy. Cancer Epidemiol Biomarkers Prev; 26(8); 1209-18. ©2017 AACR.
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Affiliation(s)
- Huang Huang
- Department of Surgery, Yale School of Medicine, Yale Cancer Center, New Haven, Connecticut
| | - Jennifer Rusiecki
- Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Department of Preventive Medicine & Biostatistics, Bethesda, Maryland
| | - Nan Zhao
- Yale School of Public Health, New Haven, Connecticut
| | - Yingtai Chen
- Yale School of Public Health, New Haven, Connecticut.,Cancer Institute & Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuangge Ma
- Yale School of Public Health, New Haven, Connecticut
| | - Herbert Yu
- Yale School of Public Health, New Haven, Connecticut.,Epidemiology Program, University of Hawaii Cancer Center, Hawaii
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Robert Udelsman
- Endocrine Neoplasia Institute, Miami Cancer Center, Miami, Florida
| | - Yawei Zhang
- Department of Surgery, Yale School of Medicine, Yale Cancer Center, New Haven, Connecticut. .,Yale School of Public Health, New Haven, Connecticut
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Zeng F, Lerro C, Lavoué J, Huang H, Siemiatycki J, Zhao N, Ma S, Deziel NC, Friesen MC, Udelsman R, Zhang Y. Occupational exposure to pesticides and other biocides and risk of thyroid cancer. Occup Environ Med 2017; 74:502-510. [PMID: 28202579 DOI: 10.1136/oemed-2016-103931] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 01/05/2017] [Accepted: 01/18/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess the associations between occupational exposure to biocides and pesticides and risk of thyroid cancer. METHODS Using data from a population-based case-control study involving 462 incident thyroid cancer cases and 498 controls in Connecticut collected in 2010-2011, we examined the association with occupational exposure to biocides and pesticides through a job-exposure matrix. We used unconditional logistic regression models to estimate OR and 95% CI, adjusting for potential confounders. RESULTS Individuals who were occupationally ever exposed to biocides had an increased risk of thyroid cancer (OR=1.65, 95% CI 1.16 to 2.35), and the highest risk was observed for the high cumulative probability of exposure (OR=2.18, 95% CI 1.28 to 3.73). The observed associations were similar when we restricted to papillary thyroid cancer and well-differentiated thyroid cancer. Stronger associations were observed for thyroid microcarcinomas (tumour size ≤1 cm). No significant association was observed for occupational exposure to pesticides. CONCLUSIONS Our study provides the first evidence linking occupational exposure to biocides and risk of thyroid cancer. The results warrant further investigation.
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Affiliation(s)
- Fanhua Zeng
- Chongqing Safety Engineering Institute, Chongqing University of Science and Technology, Chongqing, China.,Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Catherine Lerro
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Jérôme Lavoué
- Department of Environmental and Occupational Health, University of Montreal, Montreal, Canada
| | - Huang Huang
- Department of Surgery, Section of Surgical Outcomes and Epidemiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jack Siemiatycki
- Department of Environmental and Occupational Health, University of Montreal, Montreal, Canada
| | - Nan Zhao
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert Udelsman
- Department of Surgery and Yale Cancer Center, Yale School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA.,Department of Surgery, Section of Surgical Outcomes and Epidemiology, Yale School of Medicine, New Haven, Connecticut, USA
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Occupation and Thyroid Cancer: A Population-Based, Case-Control Study in Connecticut. J Occup Environ Med 2017; 58:299-305. [PMID: 26949881 DOI: 10.1097/jom.0000000000000637] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The study aims to explore the associations between various occupations and thyroid cancer risk. METHODS A population-based, case-control study involving 462 histologically confirmed incident cases and 498 controls was conducted in Connecticut in 2010 to 2011. RESULTS A significantly increased risk of thyroid cancer, particularly papillary microcarcinoma, was observed for those working as the health care practitioners and technical workers, health diagnosing and treating practitioners, and registered nurses. Those working in building and grounds cleaning, maintenance occupations, pest control, retail sales, and customer service also had increased risk for papillary thyroid cancer. Subjects who worked as cooks, janitors, cleaners, and customer service representatives were at an increased risk of papillary thyroid cancer with tumor size more than 1 cm. CONCLUSION Certain occupations were associated with an increased risk of thyroid cancer, with some tumor size and subtype specificity.
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Nielsen SM, White MG, Hong S, Aschebrook-Kilfoy B, Kaplan EL, Angelos P, Kulkarni SA, Olopade OI, Grogan RH. The Breast-Thyroid Cancer Link: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2016; 25:231-8. [PMID: 26908594 DOI: 10.1158/1055-9965.epi-15-0833] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Rates of thyroid cancer in women with a history of breast cancer are higher than expected. Similarly, rates of breast cancer in those with a history of thyroid cancer are increased. Explanations for these associations include detection bias, shared hormonal risk factors, treatment effect, and genetic susceptibility. With increasing numbers of breast and thyroid cancer survivors, clinicians should be particularly cognizant of this association. Here, we perform a systematic review and meta-analysis of the literature utilizing PubMed and Scopus search engines to identify all publications studying the incidence of breast cancer as a secondary malignancy following a diagnosis of thyroid cancer or thyroid cancer following a diagnosis of breast cancer. This demonstrated an increased risk of thyroid cancer as a secondary malignancy following breast cancer [OR = 1.55; 95% confidence interval (CI), 1.44-1.67] and an increased risk of breast cancer as a secondary malignancy following thyroid cancer (OR = 1.18; 95% CI, 1.09-1.26). There is a clear increase in the odds of developing either thyroid or breast cancer as a secondary malignancy after diagnosis with the other. Here, we review this association and current hypothesis as to the cause of this correlation.
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Affiliation(s)
- Sarah M Nielsen
- Department of Medicine, Center for Clinical Cancer Genetics and Global Health, The University of Chicago, Chicago, Illinois
| | - Michael G White
- Endocrine Surgery Research Program, Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Susan Hong
- Breast Cancer Survivorship Program, Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | | | - Edwin L Kaplan
- Endocrine Surgery Research Program, Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Peter Angelos
- Endocrine Surgery Research Program, Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Swati A Kulkarni
- Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Olufunmilayo I Olopade
- Department of Medicine, Center for Clinical Cancer Genetics and Global Health, The University of Chicago, Chicago, Illinois
| | - Raymon H Grogan
- Endocrine Surgery Research Program, Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, Illinois.
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Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP. Systematic Review of Trends in the Incidence Rates of Thyroid Cancer. Thyroid 2016; 26:1541-1552. [PMID: 27571228 DOI: 10.1089/thy.2016.0100] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND A large proportion of global increase in thyroid cancer (TC) incidence has been attributed to increased detection of papillary thyroid cancer (PTC). Nonetheless, some reports support a real increase in incidence. This study aimed to perform a systematic review to evaluate the changing trends in TC incidence and summarize potential risk factors predisposing to this trend. METHODS Literature published in the English language between 1980 and August 2014 was searched via PubMed (MEDLINE) and OvidSP (EMBASE). Original studies on changes in TC incidence in defined geographic areas that described clear methods of case selection and population estimates were included. Data on incidence rates and risk factors were collected. RESULTS Of 4719 manuscripts, 60 studies were included, of which 31 were from Europe, 13 from North America, and the rest from Asia (n = 9), Oceania (n = 4), and South America (n = 3). Fifty-three articles reported a significant increase in incidence (highest was a 10-fold increase in South Korea), six reported stable rates, and one noted a decrease. PTC was the commonest type reported to have increased in incidence (in 10 studies with relevant data). Follicular TC increased in incidence (in four studies), albeit at a lower rate compared with PTC. Data on risk factors were sparse; factors discussed included ionizing radiation, iodine deficiency, and supplementation. CONCLUSION This systematic review strongly supports a widespread and persistent increase in TC incidence. Evidence for over-detection of PTC as the predominant influence includes increased numbers of smaller size tumors and improved or unchanged survival.
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Affiliation(s)
| | - Thomas M Drake
- 1 Medical School, University of Sheffield , Sheffield, United Kingdom
| | - Lesley Uttley
- 2 School of Health and Related Research, University of Sheffield , Sheffield, United Kingdom
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Sierra MS, Soerjomataram I, Forman D. Thyroid cancer burden in Central and South America. Cancer Epidemiol 2016; 44 Suppl 1:S150-S157. [PMID: 27678317 DOI: 10.1016/j.canep.2016.07.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 07/15/2016] [Accepted: 07/24/2016] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVE Incidence of thyroid cancer (TC) is rapidly increasing worldwide, but little is known about the TC burden in Central and South America (CSA). We describe the geographic patterns and trends of TC by sex in CSA. METHODS We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and nationwide cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) per 100,000 person-years. We calculated ASRs by histological subtype. We estimated the annual percentage change (EAPC) to describe time trends. RESULTS Between CSA countries, TC incidence and mortality rates varied from 8-fold to 12-fold and from 2-fold to 5-fold, respectively. In 2003-2007, the highest TC ASRs in females and males were in Ecuador (16.0 and 3.5, respectively), Brazil (14.4 and 3.4), Costa Rica (12.6 and 2.1) and Colombia (10.7 and 2.5). The highest ASMRs were in Ecuador, Colombia, Mexico, Peru and Panama (0.68-0.91 in females and 0.41-0.48 in males). Papillary TC was the most commonly diagnosed histological subtype, following the same incidence pattern as overall TC. In Argentinean, Brazilian, Chilean and Costa Rican females TC incidence increased by 2.2-17.9% annually, and papillary TC increased by 9.1-15.0% annually, while mortality remained stable between 1997 and 2008. In males, trends in TC were stable. CONCLUSION TC occurred more frequently in females than in males. The overall high incidence and low mortality of TC suggest identification of subclinical disease due to improved detection methods.
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Affiliation(s)
- Mónica S Sierra
- International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France.
| | - Isabelle Soerjomataram
- International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France
| | - David Forman
- International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France
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White MG, Cipriani NA, Abdulrasool L, Kaplan S, Aschebrook-Kilfoy B, Angelos P, Kaplan EL, Grogan RH, Onel K. Radiation-Induced Differentiated Thyroid Cancer Is Associated with Improved Overall Survival but Not Thyroid Cancer-Specific Mortality or Disease-Free Survival. Thyroid 2016; 26:1053-60. [PMID: 27279587 PMCID: PMC4976248 DOI: 10.1089/thy.2015.0634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Radiation is a well-described risk factor for differentiated thyroid carcinoma (DTC). Although the natural history of DTC following nuclear disasters and in healthcare workers with chronic radiation exposure (RE) has been described, little is known about DTC following short-term exposure to therapeutic medical radiation for benign disease. This study compares DTC morphology and outcomes in patients with and without a prior history of therapeutic external RE. METHODS A retrospective review was performed of patients with DTC treated at The University of Chicago between 1951 and 1987, with a median follow-up of 27 years (range 0.3-60 years). Patients were classified as either having (RE+) or not having (RE-) a history of therapeutic RE. Variables examined included sex, age at RE, dose of RE, indication for RE, DTC histology, and outcome. Morphology was determined by blinded retrospective review of all available histologic slides. Outcomes were assessed using Cox proportional hazards model and Kaplan-Meier curves. RESULTS Of 257 DTC patients, 165 (64%) were RE- and 92 (36%) were RE+, with males comprising a greater proportion of the RE+ group (43.5% vs. 27.3%; p = 0.01). A total of 94.2% of DTC cases were classic papillary cancers; histology did not differ between RE+ and RE- cohorts (p = 0.73). RE was associated with an increased median overall survival (OS; 43 years vs. 38 years; hazard ratio [HR] = 0.55 [confidence interval (CI) 0.34-0.89]; p = 0.01). Survival for males in the RE- group was significantly worse than it was for RE- females (HR = 1.78 [CI 1.05-3.03]; p = 0.03) or RE+ males (HR = 2.98 [CI 1.39-6.38]; p = 0.01). Recurrence did not differ between the RE+ and RE- groups (HR = 0.85 [CI 0.52-1.41]; p = 0.54), nor did DTC-specific mortality (HR = 0.54 [CI 0.21-1.37]; p = 0.20). CONCLUSIONS While DTC following RE has historically been considered a more aggressive variant than DTC in the absence of RE, the present data indicate that RE+ DTC is associated with better OS than RE- DTC, especially for males. Additionally, recent reports are confirmed of equivalent rates of thyroid cancer recurrence. These results warrant further investigation into the factors underlying this unexpected finding.
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Affiliation(s)
- Michael G. White
- Endocrine Surgery Research Group, Department of Surgery, The University of Chicago, Chicago, Illinois
| | | | - Layth Abdulrasool
- Endocrine Surgery Research Group, Department of Surgery, The University of Chicago, Chicago, Illinois
| | - Sharone Kaplan
- Endocrine Surgery Research Group, Department of Surgery, The University of Chicago, Chicago, Illinois
| | | | - Peter Angelos
- Endocrine Surgery Research Group, Department of Surgery, The University of Chicago, Chicago, Illinois
| | - Edwin L. Kaplan
- Endocrine Surgery Research Group, Department of Surgery, The University of Chicago, Chicago, Illinois
| | - Raymon H. Grogan
- Endocrine Surgery Research Group, Department of Surgery, The University of Chicago, Chicago, Illinois
| | - Kenan Onel
- Department of Pediatrics, The University of Chicago, Knapp Center for Biomedical Discovery, Chicago, Illinois
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Grogan RH, Aschebrook-Kilfoy B, White MG, Kaplan EL, Angelos P. Thyroid incidentalomas and the overdiagnosis conundrum. INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2016. [DOI: 10.2217/ije-2016-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Raymon H Grogan
- Endocrine Surgery Research Group, Department of Surgery, University of Chicago, 5841 S Maryland Ave MC 4052, Chicago, IL 60637, USA
| | - Briseis Aschebrook-Kilfoy
- Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave MC N109, Chicago, IL 60637, USA
| | - Michael G White
- Endocrine Surgery Research Group, Department of Surgery, University of Chicago, 5841 S Maryland Ave MC 4052, Chicago, IL 60637, USA
| | - Edwin L Kaplan
- Endocrine Surgery Research Group, Department of Surgery, University of Chicago, 5841 S Maryland Ave MC 4052, Chicago, IL 60637, USA
| | - Peter Angelos
- Endocrine Surgery Research Group, Department of Surgery, University of Chicago, 5841 S Maryland Ave MC 4052, Chicago, IL 60637, USA
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Prasad ML, Vyas M, Horne MJ, Virk RK, Morotti R, Liu Z, Tallini G, Nikiforova MN, Christison-Lagay ER, Udelsman R, Dinauer CA, Nikiforov YE. NTRK fusion oncogenes in pediatric papillary thyroid carcinoma in northeast United States. Cancer 2016; 122:1097-107. [PMID: 26784937 DOI: 10.1002/cncr.29887] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 12/15/2015] [Accepted: 12/15/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND An increase in thyroid cancers, predominantly papillary thyroid carcinoma (PTC), has been recently reported in children. METHODS The histopathology of 28 consecutive PTCs from the northeast United States was reviewed. None of the patients (ages 6-18 years; 20 females, 8 males) had significant exposure to radiation. Nucleic acid from tumors was tested for genetic abnormalities (n = 27). Negative results were reevaluated by targeted next-generation sequencing. RESULTS Seven of 27 PTCs (26%) had neurotrophic tyrosine kinase receptor (NTRK) fusion oncogenes (NTRK type 3/ets variant 6 [NTRK3/ETV6], n =5; NTRK3/unknown, n = 1; and NTRK type 1/translocated promoter region, nuclear basket protein [NTRK1/TPR], n = 1), including 5 tumors that measured >2 cm and 3 that diffusely involved the entire thyroid or lobe. All 7 tumors had lymphatic invasion, and 5 had vascular invasion. Six of 27 PTCs (22%) had ret proto-oncogene (RET) fusions (RET/PTC1, n = 5; RET/PTC3, n = 1); 2 tumors measured >2 cm and diffusely involved the thyroid, and 5 had lymphatic invasion, with vascular invasion in 2. Thirteen PTCs had the B-Raf proto-oncogene, serine/threonine kinase (BRAF) valine-to-glutamic acid mutation at position 600 (BRAF(V) (600E)) (13 of 27 tumors; 48%), 11 measured <2 cm, and 6 had lymphatic invasion (46%), with vascular invasion in 3. Fusion oncogene tumors, compared with BRAF(V) (600E) PTCs, were associated with large size (mean, 2.2 cm vs 1.5 cm, respectively; P = .05), solid and diffuse variants (11 of 13 vs 0 of 13 tumors, respectively; P < .001), and lymphovascular invasion (12 of 13 vs 6 of 13 tumors, respectively; P = .02); BRAF(V) (600E) PTCs were predominantly the classic variant (12 of 13 vs 1 of 13 tumors). Two tumors metastasized to the lung, and both had fusion oncogenes (NTRK1/TPR, n = 1; RET/PTC1, n = 1). CONCLUSIONS Fusion oncogene PTC presents with more extensive disease and aggressive pathology than BRAF(V) (600E) PTC in the pediatric population. The high prevalence of the NTRK1/NTRK3 fusion oncogene PTCs in the United States is unusual and needs further investigation.
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Affiliation(s)
- Manju L Prasad
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Monika Vyas
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Matthew J Horne
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Renu K Virk
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Raffaella Morotti
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Zongzhi Liu
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Giovanni Tallini
- Anatomic Pathology, Bellaria Hospital, University of Bologna School of Medicine, Bologna, Italy
| | - Marina N Nikiforova
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Robert Udelsman
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | | | - Yuri E Nikiforov
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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