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A pooled analysis of case–control studies of thyroid cancer. IV. Benign thyroid diseases

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Abstract

Objective: To obtain more precise estimates of the association between thyroid cancer and benign thyroid diseases and to elucidate the role of potential confounders or effect modifiers.

Methods: The original data from 12 case–control studies from the United States, Asia, and Europe were pooled. Based on 2094 women and 425 men with cancer of the thyroid and, respectively, 3248 and 928 control subjects, odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were obtained by conditional regression models, conditioning on study and age at diagnosis, and adjusting for age and radiotherapy.

Results: A history of hypothyroidism was not associated with cancer risk (pooled ORs = 0.9, 95% confidence interval, CI: 0.7–1.3 in women and 1.7, 95% CI: 0.3–11.7 in men). ORs for hyperthyroidism were 1.4 (95% CI: 1.0–2.1) in women and 3.1 (95% CI: 1.0–9.8) in men. In women, however, risk was lower in the absence of or after allowance for history of goiter. Pooled ORs for a history of goiter were 5.9 (95% CI: 4.2–8.1) in women and 38.3 (95% CI: 5.0–291.2) in men. Risk for a history of benign nodules/adenomas was especially high (OR = 29.9, 95% CI: 14.5–62.0, in women; 18 cases versus 0 controls in men). The excess risk for goiter and benign nodules/adenomas was greatest within 2–4 years prior to thyroid cancer diagnosis, but an elevated OR was present 10 years or more before cancer.

Conclusions: Goiter and benign nodules/adenomas are the strongest risk factors for thyroid cancer, apart from radiation in childhood.

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Authors and Affiliations

  1. Servizio di Epidemiologia, Centro di Riferimento Oncologico, via Pedemontana, 33081, Aviano (PN), Italy

    Silvia Franceschi & Luigino Dal Maso

  2. Department of Preventive Medicine, University of Southern California, Los Angeles, USA

    Susan Preston-Martin

  3. Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy

    Eva Negri & Carlo La Vecchia

  4. Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy

    Carlo La Vecchia

  5. Department of Preventive Medicine, University of Southern California, Los Angeles, USA

    Wendy J. Mack

  6. Fred Hutchinson Cancer Research Center, Seattle, USA

    Anne McTiernan

  7. Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, USA

    Laurence Kolonel

  8. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA

    Steven D. Mark

  9. Radiation Effects Research Foundation, Hiroshima, Japan

    Kiyohiko Mabuchi

  10. Shanghai Cancer Institute, Shanghai, People's Republic of China

    Fan Jin

  11. Department of Health and Environment, Division of Occupational and Environmental Medicine, Linköping University, Linköping, Sweden

    Gun Wingren

  12. Centrum för Tobakprevention, Huddinge, Sweden

    Rosaria Galanti

  13. Stockholm Sjukhem, Stockholms, Sweden

    Arne Hallquist

  14. Cancer Registry of Norway, Montebello, Norway

    Eystein Glattre

  15. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    Eiliv Lund

  16. Registre Vaudois des Tumeurs, Lausanne, Switzerland

    Fabio Levi

  17. Radiation Epidemiology Branch, National Cancer Institute, Rockville, USA

    Dimitrios Linos

  18. Epidemiology Branch, National Cancer Institute, Rockville, USA

    Elaine Ron

Authors
  1. Silvia Franceschi
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  2. Susan Preston-Martin
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  3. Luigino Dal Maso
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  4. Eva Negri
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  5. Carlo La Vecchia
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  6. Wendy J. Mack
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  7. Anne McTiernan
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  8. Laurence Kolonel
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  9. Steven D. Mark
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  10. Kiyohiko Mabuchi
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  11. Fan Jin
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  12. Gun Wingren
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  13. Rosaria Galanti
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  14. Arne Hallquist
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  15. Eystein Glattre
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  16. Eiliv Lund
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  17. Fabio Levi
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  18. Dimitrios Linos
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  19. Elaine Ron
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Franceschi, S., Preston-Martin, S., Maso, L.D. et al. A pooled analysis of case–control studies of thyroid cancer. IV. Benign thyroid diseases. Cancer Causes Control 10, 583–595 (1999). https://doi.org/10.1023/A:1008907227706

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