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A pooled analysis of case-control studies of thyroid cancer¶ III. Oral contraceptives, menopausal replacement therapy and other female hormones

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Abstract

Objective: The relations between oral contraceptives (OC), hormone replacement therapy (HRT) for menopause, and other female hormone use and thyroid cancer risk was analyzed using the original data from 13 studies from North America, Asia and Europe.

Methods: Based on 2,132 cases and 3,301 controls, odds ratios (OR) and the corresponding 95% confidence intervals (CI) were obtained by conditional regression models, conditioning on study and age at diagnosis, and adjusting for age, radiation exposure and parity.

Results: Overall, 808 (38%) cases versus 1,290 (39%) controls had ever used OCs, corresponding to an OR of 1.2 (95% CI 1.0 to 1.4). There was no relation with duration of use, age at first use, or use before first birth. The OR was significantly increased for current OC users (OR=1.5, 95% 1.0 to 2.1), but declined with increasing time since stopping (OR=1.1 for >10 years since stopping). The association was stronger for papillary cancers (OR=1.6 for current users) than for other histologic types. No significant heterogeneity was observed across studies or geographic areas. Eight studies had data on HRT, for a total of 1,305 cases and 2,300 controls: 110 (8%) cases and 205 (9%) controls reported ever using HRT (OR=0.8; 95% CI 0.6 to 1.1). The ORs were 1.6 (95% to 0.9 to 2.9) for use of fertility drugs, and 1.5 (95% CI 1.1 to 2.1) for lactation suppression treatment.

Conclusions: The studies considered in these analyses include most of the epidemiological data on the role of exogenous hormone use in the etiology of thyroid cancer, and they provide reassuring evidence on the absence of an association of practical relevance. The moderate excess risk in current OC users, if not due to increased surveillance for thyroid masses among OC users, is similar to that described for breast cancer, and would imply a role of female hormones on thyroid cancer promotion. There was no indication of increased thyroid cancer risk 10 or more years after discontinuing OC use.

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References

  1. Franceschi F, Boyle P, Maisonneuve P, et al. (1993) The epidemiology of thyroid carcinoma. Crit Rev Oncogen 4: 25-52.

    Google Scholar 

  2. Weeke J, Hansen AP (1975) Serum TSH and serum T3 levels during normal menstrual cycles and during cycles on oral contraceptives. Acta Endocrinol 79: 431-438.

    Google Scholar 

  3. McTiernan AM, Weiss NS, Daling JR (1984) Incidence of thyroid cancer in women in relation to reproductive and hormonal factors. Am J Epidemiol 120: 423-435.

    Google Scholar 

  4. Preston-Martin S, Bernstein L, Pike MC, Maldonado AA, Henderson BE (1987) Thyroid cancer among young women related to prior thyroid disease and pregnancy history. Br J Cancer 55: 191-195.

    Google Scholar 

  5. Preston-Martin S, Jin F, Duda MJ, Mack WJ (1993) A case-control study of thyroid cancer in women under age 55 in Shanghai (People's Republic of China). Cancer Causes Control 4: 431-442.

    Google Scholar 

  6. Ron E, Kleinerman RA, Boice JD Jr, et al. (1987) A population-based case-control study of thyroid cancer. J Natl Cancer Inst 79: 1-12.

    Google Scholar 

  7. Franceschi S, Fassina A, Talamini R, et al. (1990) The influence of reproductive and hormonal factors on thyroid cancer in women. Rev Epidém Santé Publ 38: 27-34.

    Google Scholar 

  8. Kolonel LN, Hankin JH, Wilkens LR, Fukunaga FH, Hinds MW (1990) An epidemiological study of thyroid cancer in Hawaii. Cancer Causes Control 1: 223-234.

    Google Scholar 

  9. Hallquist A, Hardell L, Degerman A, Boquist L (1994) Thyroid cancer: reproductive factors, previous diseases, drug intake, family history and diet. A case-control study. Eur J Cancer Prev 3: 481-488.

    Google Scholar 

  10. Galanti MR, Hansson L, Lund E, et al. (1996) Reproductive history and cigarette smoking as risk factors for thyroid cancer in women: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 5: 425-431.

    Google Scholar 

  11. Negri E, Ron E, Franceschi S, et al. A pooled analysis of case-control studies of thyroid cancer. I. Methods. Cancer Causes Control 10: 131-142.

  12. Wingren G, Hatscheck T, Axelson O (1993) Determinants of papillary cancer of the thyroid. Am J Epidemiol 138: 482-491.

    Google Scholar 

  13. Levi F, Franceschi S, Gulie C, Negri E, La Vecchia C (1993) Female thyroid cancer: The role of reproductive and hormonal factors in Switzerland. Oncology 50: 309-315.

    Google Scholar 

  14. Linos A, Linos DA, Vgotza N, Souvatzoglou A, Koutras DA (1989) Does coffee consumption protect against thyroid diseases? Acta Chir Scand 155: 317-320.

    Google Scholar 

  15. Glattre E, Haldorsen T, Berg JP, Stensvold I, Solvoll K (1993) Norwegian case-control study testing the hypothesis that seafood increases the risk of thyroid cancer. Cancer Causes Control 4: 11-16.

    Google Scholar 

  16. Breslow NE, Day NE (1980) Statistical Methods in Cancer Research, Vol. 1, The Analysis of Case-Control Studies. Lyon, IARC: IARC Sci. Publ. No. 32.

    Google Scholar 

  17. La Vecchia C, Tavani A, Franceschi S, Parazzini F (1996) Oral contraceptives and cancer. A review of the evidence. Drug Safety 14: 260-272.

    Google Scholar 

  18. Collaborative Group on Hormonal Factors in Breast Cancer (1996) Breast cancer and hormonal contraceptives. Lancet 347: 1713-1727.

    Google Scholar 

  19. Day NE (1983) Time as a determinant of risk in cancer epidemiology: the role of multistage models. Cancer Surveys 2: 577-593.

    Google Scholar 

Download references

Author information

Author notes

  1. Maria Rosaria Galanti

    Present address: Tobacco Prevention Centre, SE-141 57, Huddinge, Sweden)

Authors and Affiliations

  1. Laboratory of General Epidemiology Istituto di Ricerche Farmacologiche “Mario Negri”, Via Eritrea, 62, 20157, Milan, ITALY (

    Carlo La Vecchia, Liliane Chatenoud, Claudia Braga & Eva Negri

  2. Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, 20133, Milan, Italy

    Carlo La Vecchia

  3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, 6120 Executive Boulevard, Rockville, MD, 20852, USA (

    Elaine Ron & Steven D. Mark

  4. Centro di Riferimento Oncologico, 33081, Aviano, PN, Italy

    Silvia Franceschi & Luigino Dal Maso

  5. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90033-0800, USA

    Susan Preston-Martin

  6. Fred Hutchinson Cancer Research Center, Seattle, WA, 98109-1024, USA

    Anne McTiernan

  7. Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii, 96813, USA

    Laurence Kolonel

  8. Radiation Effects Research Foundation, Hiroshima, 732, Japan

    Kiyohiko Mabuchi

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

    Fan Jin

  10. Division of Occupational and Environmental Medicine, Faculty of Health Sciences, Linköping University, SE-581 85, Linköping, Sweden

    Gun Wingren

  11. Department of Cancer Epidemiology, University Hospital, SE-57185, Uppsala, Sweden

    Maria Rosaria Galanti

  12. Department of Oncology, Karolinska Institute and Stockholms Sjukhem, SE-112 35, Stockholm, Sweden

    Arne Hallquist

  13. Institute of Community Medicine, University of Tromsø, NO-9037, Tromsø, Norway

    Eiliv Lund

  14. Registre Vaudois des Tumeurs, CH-1011, Lausanne, Switzerland

    Fabio Levi

  15. Institute of Preventive Medicine, GR-145 61, Kifissia, Greece

    Dimitrios Linos

Authors
  1. Carlo La Vecchia
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  2. Elaine Ron
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  3. Silvia Franceschi
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  4. Luigino Dal Maso
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  5. Steven D. Mark
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  6. Liliane Chatenoud
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  7. Claudia Braga
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  8. Susan Preston-Martin
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  9. Anne McTiernan
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  10. Laurence Kolonel
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  11. Kiyohiko Mabuchi
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  12. Fan Jin
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  13. Gun Wingren
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  14. Maria Rosaria Galanti
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  15. Arne Hallquist
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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. Eva Negri
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Corresponding author

Correspondence to Elaine Ron.

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Vecchia, C.L., Ron, E., Franceschi, S. et al. A pooled analysis of case-control studies of thyroid cancer¶ III. Oral contraceptives, menopausal replacement therapy and other female hormones. Cancer Causes Control 10, 157–166 (1999). https://doi.org/10.1023/A:1008832513932

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  • DOI: https://doi.org/10.1023/A:1008832513932

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