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Thyroid-Stimulating Hormone, Thyroglobulin, and Thyroid Hormones and Risk of Differentiated Thyroid Carcinoma: The EPIC Study

Rinaldi, Sabina ; Plummer, Martyn ; Biessy, Carine ; Tsilidis, Konstantinos K. ; Ostergaard, Jane Nautrup ; Overvad, Kim ; Tjonneland, Anne ; Halkjaer, Jytte ; Boutron-Ruault, Marie-Christine and Clavel-Chapelon, Francoise , et al. (2014) In Journal of the National Cancer Institute 106(6). p.097-097
Abstract
Background Increased levels of thyroglobulin (Tg) and thyroid-stimulating hormone (TSH) are associated with differentiated thyroid carcinoma (TC) risk, but strong epidemiological evidence is lacking. Methods Three hundred fifty-seven incident TC case patients (n = 300 women and 57 men; mean age at blood collection = 51.5 years) were identified in the EPIC cohort study and matched with 2 (women) or 3 (men) control subjects using incidence density sampling. Matching included study center, sex, age, date, time, and fasting status at blood collection. Levels of total and free (f) thyroxine (T4) and triiodo-thyronine (T3), TSH, Tg, and anti-Tg antibodies (TgAb) were measured by commercially available immunoassays. Odds ratios (ORs) and 95%... (More)
Background Increased levels of thyroglobulin (Tg) and thyroid-stimulating hormone (TSH) are associated with differentiated thyroid carcinoma (TC) risk, but strong epidemiological evidence is lacking. Methods Three hundred fifty-seven incident TC case patients (n = 300 women and 57 men; mean age at blood collection = 51.5 years) were identified in the EPIC cohort study and matched with 2 (women) or 3 (men) control subjects using incidence density sampling. Matching included study center, sex, age, date, time, and fasting status at blood collection. Levels of total and free (f) thyroxine (T4) and triiodo-thyronine (T3), TSH, Tg, and anti-Tg antibodies (TgAb) were measured by commercially available immunoassays. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using conditional logistic regression. All statistical tests were two-sided. Results TC risk was positively associated with Tg (OR for the highest vs lowest quartile = 9.15; 95% CI = 5.28 to 15.90; P < .001) and negatively associated with TSH level (OR = 0.56; 95% CI = 0.38 to 0.81; P = .001). Odds ratios were not modified by adjustment for weight and height and were consistent across sexes, age groups, and countries. The association with Tg was stronger in follicular than papillary TC. The odds ratio for TgAb-positivity was 1.50 (95% CI = 1.05 to 2.15; P = .03). Among case patients, TSH level was stable over time, whereas Tg level was higher in proximity to TC diagnosis. Areas under the receiver operating characteristic curve were 57% and 74% for TSH and Tg level, respectively. Conclusions High Tg levels precede by up to 8 years the detection of TC, pointing to a long sojourn time of the disease. Low TSH levels may predispose to TC onset. Neither marker has sufficient accuracy to be a screening test. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the National Cancer Institute
volume
106
issue
6
pages
097 - 097
publisher
Oxford University Press
external identifiers
  • wos:000341636800008
  • pmid:24824312
  • scopus:84905188724
ISSN
1460-2105
DOI
10.1093/jnci/dju097
language
English
LU publication?
yes
id
1948d101-6a41-4def-921f-cbd98843c8a4 (old id 4717009)
date added to LUP
2016-04-01 13:42:54
date last changed
2022-03-21 20:03:45
@article{1948d101-6a41-4def-921f-cbd98843c8a4,
  abstract     = {{Background Increased levels of thyroglobulin (Tg) and thyroid-stimulating hormone (TSH) are associated with differentiated thyroid carcinoma (TC) risk, but strong epidemiological evidence is lacking. Methods Three hundred fifty-seven incident TC case patients (n = 300 women and 57 men; mean age at blood collection = 51.5 years) were identified in the EPIC cohort study and matched with 2 (women) or 3 (men) control subjects using incidence density sampling. Matching included study center, sex, age, date, time, and fasting status at blood collection. Levels of total and free (f) thyroxine (T4) and triiodo-thyronine (T3), TSH, Tg, and anti-Tg antibodies (TgAb) were measured by commercially available immunoassays. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using conditional logistic regression. All statistical tests were two-sided. Results TC risk was positively associated with Tg (OR for the highest vs lowest quartile = 9.15; 95% CI = 5.28 to 15.90; P &lt; .001) and negatively associated with TSH level (OR = 0.56; 95% CI = 0.38 to 0.81; P = .001). Odds ratios were not modified by adjustment for weight and height and were consistent across sexes, age groups, and countries. The association with Tg was stronger in follicular than papillary TC. The odds ratio for TgAb-positivity was 1.50 (95% CI = 1.05 to 2.15; P = .03). Among case patients, TSH level was stable over time, whereas Tg level was higher in proximity to TC diagnosis. Areas under the receiver operating characteristic curve were 57% and 74% for TSH and Tg level, respectively. Conclusions High Tg levels precede by up to 8 years the detection of TC, pointing to a long sojourn time of the disease. Low TSH levels may predispose to TC onset. Neither marker has sufficient accuracy to be a screening test.}},
  author       = {{Rinaldi, Sabina and Plummer, Martyn and Biessy, Carine and Tsilidis, Konstantinos K. and Ostergaard, Jane Nautrup and Overvad, Kim and Tjonneland, Anne and Halkjaer, Jytte and Boutron-Ruault, Marie-Christine and Clavel-Chapelon, Francoise and Dossus, Laure and Kaaks, Rudolf and Lukanova, Annekatrin and Boeing, Heiner and Trichopoulou, Antonia and Lagiou, Pagona and Trichopoulos, Dimitrios and Palli, Domenico and Agnoli, Claudia and Tumino, Rosario and Vineis, Paolo and Panico, Salvatore and Bueno-de-Mesquita, H. Bas and Peeters, Petra H. and Weiderpass, Elisabete and Lund, Eiliv and Quiros, J. Ramon and Agudo, Antonio and Molina, Esther and Larranaga, Nerea and Navarro, Carmen and Ardanaz, Eva and Manjer, Jonas and Almquist, Martin and Sandstrom, Maria and Hennings, Joakim and Khaw, Kay-Tee and Schmidt, Julie and Travis, Ruth C. and Byrnes, Graham and Scalbert, Augustin and Romieu, Isabelle and Gunter, Marc and Riboli, Elio and Franceschi, Silvia}},
  issn         = {{1460-2105}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{097--097}},
  publisher    = {{Oxford University Press}},
  series       = {{Journal of the National Cancer Institute}},
  title        = {{Thyroid-Stimulating Hormone, Thyroglobulin, and Thyroid Hormones and Risk of Differentiated Thyroid Carcinoma: The EPIC Study}},
  url          = {{http://dx.doi.org/10.1093/jnci/dju097}},
  doi          = {{10.1093/jnci/dju097}},
  volume       = {{106}},
  year         = {{2014}},
}