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A pooled analysis of case-control studies of thyroid cancer ¶II. Menstrual and reproductive factors

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Abstract

Objective: It has been suggested that female hormones, and hence menstrual and reproductive factors, play a role in thyroid cancer etiology. Epidemiological data, however, are limited and inconsistent, partly because of the small number of cases included in each study. To clarify the etiology of thyroid cancer, we conducted a pooled analysis of original data from 14 case-control studies, 4 from the United States, 2 from Asia, and 8 from Europe.

Methods: This analysis included a total of 2,247 female cases of thyroid cancer (80% papillary) and 3,699 control women. Pooled odds ratios (OR) were estimated using logistic regression, conditioning on study and (i) matching sets for individually matched studies, or (ii) quinquennia of age for the other studies. Additional terms for age and history of radiation exposure were included in the regression equations.

Results: The OR per year of later menarche was 1.04 (95% confidence interval (CI) 1.0–1.1). Compared to pre-menopausal women, the OR was 1.3 for women with natural menopause, and 1.8 for those with artificial menopause, but the studies were heterogeneous and the association may be due, at least in part, to diagnostic or ascertainment bias. Parity, spontaneous or induced abortions and history of infertility were not associated with thyroid cancer risk. The OR was above unity in women reporting later age at first birth (OR=1.1, 95% CI 1.0–1.3 for 5-year delay) and higher in the first years after a birth.

Conclusions: The associations of menstrual and reproductive factors with thyroid cancer risk were generally weak, but appeared stronger among women diagnosed with thyroid cancer at younger ages.

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References

  1. dos Santos Silva I, Swerdlow AJ (1993) Sex differences in the risks of hormone-dependent cancers. Am J Epidemiol 138: 10-28.

    Google Scholar 

  2. Correa P, Chen VW (1995) Endocrine gland cancer. Cancer 75: 338-352.

    Google Scholar 

  3. Malkasian GD, Mayberry WE (1970) Serum total and free thyroxine and thyrotropin in normal and pregnant women, neonates, and women receiving progestogens. Am J Obstet Gynecol 108: 1234-1238.

    Google Scholar 

  4. Rastogi GK, Sawhney RC, Sinha MK, et al. (1974) Serum and urinary levels of thyroid hormones in normal pregnancy. Obstet Gynecol 44: 176-180.

    Google Scholar 

  5. Chan V, Paraskevaides CA, Hale JF (1975) Assessment of thyroid function during pregnancy. Br J Obstet Gynaecol 82: 137-141.

    Google Scholar 

  6. Pacchiarotti A, Martino E, Bartalena L, et al. (1986) Serum thyrotropin by ultrasensitive immunoradiometric assay and serum free thyroid hormones in pregnancy. J Endocrinol Invest 9: 185-189.

    Google Scholar 

  7. Henderson BE, Ross RK, Pike MC, et al. (1982) Endogenous hormones as a major factor in human cancer. Cancer Res 42: 3232-3239.

    Google Scholar 

  8. Williams ED (1990) TSH and thyroid cancer. Horm Metab Res Suppl 23: 72-75.

    Google Scholar 

  9. Robbins SL, Cotram RS, Kumar V (1984) Pathologic Basis of Disease. Thyroid Gland. Philadelphia: WB Saunders, pp. 1201-1225.

    Google Scholar 

  10. Chaudhuri PK, Prinz R (1989) Estrogen receptor in normal and neoplastic human thyroid tissue. Am J Otolaryngol 10: 322-326.

    Google Scholar 

  11. Miki H, Oshimo K, Inoue H, Morimoto T, Monden Y (1990) Sex hormone receptors in human thyroid tissues. Cancer 66: 1759-1762.

    Google Scholar 

  12. Takeichi N, Ito H, Haruta R, et al. (1991) Relation between estrogen receptor and malignancy of thyroid cancer. Jpn J Cancer Res 82: 19-22.

    Google Scholar 

  13. Mori M, Naito M, Watanabe H, et al. (1990) Effects of sex difference, gonadectomy, and estrogen on N-methyl-N-nitrosourea induced rat thyroid tumors. Cancer Res 50: 7662-7667.

    Google Scholar 

  14. 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 

  15. 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 

  16. Preston-Martin S, Jin F, Duda MJ, Mack WJ (1983) 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 

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

    Google Scholar 

  18. Glattre E, Kravdal Ø (1994) Male and female parity and risk of thyroid cancer. Int J Cancer 58: 616-617.

    Google Scholar 

  19. 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 

  20. 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 

  21. 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 

  22. 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 

  23. 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 

  24. Kravdal O, Glattre E, Haldorsen T (1991) Positive correlation between parity and incidence of thyroid cancer: new evidence based on complete Norwegian birth cohorts. Int J Cancer 49: 831-836.

    Google Scholar 

  25. Galanti MR, Lambe M, Ekbom A, Sparén P, Pettersson B (1995) Parity and risk of thyroid cancer: a nested case-control study of a nationwide Swedish cohort. Cancer Causes Control 6: 37-44.

    Google Scholar 

  26. 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 

  27. Paoff K, Preston-Martin S, Mack WJ, Monroe K (1995) A case-control study of maternal risk factors for thyroid cancer in young women (California, United States). Cancer Causes Control 6: 389-397.

    Google Scholar 

  28. 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.

  29. Galanti MR, Hansson L, Bergstrom R, et al. (1997) Diet and nutrients as risk factors for papillary and follicular thyroid carcinoma. Cancer Causes Control 8: 205-214.

    Google Scholar 

  30. 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 

  31. 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 

  32. 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 

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

    Google Scholar 

  34. Kelsey JL, Gammon MD, John EM (1993) Reproductive factors and breast cancer. Epidemiol Rev 15: 36-47.

    Google Scholar 

  35. Lipworth L (1995) Epidemiology of breast cancer. Eur J Cancer Prev 4: 7-30.

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  38. Ron E (1996) Epidemiology of thyroid cancer. In: Schottenfeld D, Fraumeni JR Jr. Cancer Epidemiology Prevention. Oxford: Oxford University Press, pp. 1000-1021.

    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 (

    Eva Negri, Carlo La Vecchia & Claudia Braga

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

    Luigino Dal Maso & Silvia Franceschi

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

    Carlo La Vecchia

  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. National Institute of Radiological Sciences, 263-0024, Chiba, Japan

    Yasuhiko Yoshimoto

  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, Örebro Medical Center, SE-701 85, Örebro, Sweden

    Lennart Hardell

  13. The Cancer Registry of Norway, Montebello, NO-3010, Oslo, Norway

    Eystein Glattre

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

    Eiliv Lund

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

    Fabio Levi

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

    Dimitrios Linos

Authors
  1. Eva Negri
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  2. Luigino Dal Maso
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  3. Elaine Ron
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  4. Carlo La Vecchia
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  5. Steven D. Mark
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  6. Susan Preston-Martin
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  7. Anne McTiernan
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  8. Laurence Kolonel
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  9. Yasuhiko Yoshimoto
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  10. Fan Jin
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  11. Gun Wingren
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  12. Maria Rosaria Galanti
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  13. Lennart Hardell
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  14. Eystein Glattre
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  15. Eiliv Lund
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  16. Fabio Levi
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  17. Dimitrios Linos
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  18. Claudia Braga
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  19. Silvia Franceschi
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Correspondence to Eva Negri.

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Negri, E., Maso, L.D., Ron, E. et al. A pooled analysis of case-control studies of thyroid cancer ¶II. Menstrual and reproductive factors. Cancer Causes Control 10, 143–155 (1999). https://doi.org/10.1023/A:1008880429862

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