TY - JOUR
T1 - Reproductive and menstrual factors and risk of differentiated thyroid carcinoma
T2 - The EPIC study
AU - Zamora-Ros, Raul
AU - Rinaldi, Sabina
AU - Biessy, Carine
AU - Tjonneland, Anne
AU - Halkjaer, Jytte
AU - Fournier, Agnes
AU - Boutron-Ruault, Marie-Christine
AU - Mesrine, Sylvie
AU - Tikk, Kaja
AU - Fortner, Renee T.
AU - Boeing, Heiner
AU - Foerster, Jana
AU - Trichopoulou, Antonia
AU - Trichopoulos, Dimitrios
AU - Papatesta, Eleni-Maria
AU - Masala, Giovanna
AU - Tagliabue, Giovanna
AU - Panico, Salvatore
AU - Tumino, Rosario
AU - Polidoro, Silvia
AU - Peeters, Petra H. M.
AU - Bueno-de-Mesquita, H. B(as)
AU - Weiderpass, Elisabete
AU - Lund, Eiliv
AU - Argueelles, Marcial
AU - Agudo, Antonio
AU - Molina-Montes, Esther
AU - Navarro, Carmen
AU - Barricarte, Aurelio
AU - Larranaga, Nerea
AU - Manjer, Jonas
AU - Almquist, Martin
AU - Sandstrom, Maria
AU - Hennings, Joakim
AU - Tsilidis, Konstantinos K.
AU - Schmidt, Julie A.
AU - Khaw, Kay-Thee
AU - Wareham, Nicholas J.
AU - Romieu, Isabelle
AU - Byrnes, Graham
AU - Gunter, Marc J.
AU - Riboli, Elio
AU - Franceschi, Silvia
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for 5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for 9 vs. 1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR=1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR=1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.
AB - Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for 5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for 9 vs. 1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR=1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR=1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.
KW - reproductive factors
KW - menstrual factors
KW - hormone use
KW - differentiated thyroid carcinoma
KW - EPIC
KW - CANCER-RISK
KW - HORMONAL FACTORS
KW - ORAL-CONTRACEPTIVES
KW - REPLACEMENT THERAPY
KW - POOLED ANALYSIS
KW - HEALTH
KW - COHORT
KW - WOMEN
KW - METAANALYSIS
KW - VARIANTS
U2 - 10.1002/ijc.29067
DO - 10.1002/ijc.29067
M3 - Article
C2 - 25041790
SN - 0020-7136
VL - 136
SP - 1218
EP - 1227
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 5
ER -