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Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study

Zamora-Ros, Raul; Rinaldi, Sabina; Biessy, Carine; Tjonneland, Anne; Halkjaer, Jytte; Fournier, Agnes; Boutron-Ruault, Marie-Christine; Mesrine, Sylvie; Tikk, Kaja and Fortner, Renee T., et al. (2015) In International Journal of Cancer 136(5). p.1218-1227
Abstract
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... (More)
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. (Less)
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keywords
reproductive factors, menstrual factors, hormone use, differentiated, thyroid carcinoma, EPIC
in
International Journal of Cancer
volume
136
issue
5
pages
1218 - 1227
publisher
John Wiley & Sons
external identifiers
  • wos:000346350500047
  • scopus:84918787441
ISSN
0020-7136
DOI
10.1002/ijc.29067
language
English
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yes
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fc207bfd-aea8-4747-b9c9-c3b6782d9b9e (old id 5084911)
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2015-03-02 07:09:33
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@article{fc207bfd-aea8-4747-b9c9-c3b6782d9b9e,
  abstract     = {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.},
  author       = {Zamora-Ros, Raul and Rinaldi, Sabina and Biessy, Carine and Tjonneland, Anne and Halkjaer, Jytte and Fournier, Agnes and Boutron-Ruault, Marie-Christine and Mesrine, Sylvie and Tikk, Kaja and Fortner, Renee T. and Boeing, Heiner and Foerster, Jana and Trichopoulou, Antonia and Trichopoulos, Dimitrios and Papatesta, Eleni-Maria and Masala, Giovanna and Tagliabue, Giovanna and Panico, Salvatore and Tumino, Rosario and Polidoro, Silvia and Peeters, Petra H. M. and Bueno-de-Mesquita, H. B(as) and Weiderpass, Elisabete and Lund, Eiliv and Argueelles, Marcial and Agudo, Antonio and Molina-Montes, Esther and Navarro, Carmen and Barricarte, Aurelio and Larranaga, Nerea and Manjer, Jonas and Almquist, Martin and Sandstrom, Maria and Hennings, Joakim and Tsilidis, Konstantinos K. and Schmidt, Julie A. and Khaw, Kay-Thee and Wareham, Nicholas J. and Romieu, Isabelle and Byrnes, Graham and Gunter, Marc J. and Riboli, Elio and Franceschi, Silvia},
  issn         = {0020-7136},
  keyword      = {reproductive factors,menstrual factors,hormone use,differentiated,thyroid carcinoma,EPIC},
  language     = {eng},
  number       = {5},
  pages        = {1218--1227},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study},
  url          = {http://dx.doi.org/10.1002/ijc.29067},
  volume       = {136},
  year         = {2015},
}