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Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study
Author(s) -
ZamoraRos Raul,
Rinaldi Sabina,
Biessy Carine,
Tjønneland Anne,
Halkjær Jytte,
Fournier Agnes,
BoutronRuault MarieChristine,
Mesrine Sylvie,
Tikk Kaja,
Fortner Reneé T.,
Boeing Heiner,
Förster Jana,
Trichopoulou Antonia,
Trichopoulos Dimitrios,
Papatesta EleniMaria,
Masala Giovanna,
Tagliabue Giovanna,
Panico Salvatore,
Tumino Rosario,
Polidoro Silvia,
Peeters Petra H.M.,
BuenodeMesquita H.Bas,
Weiderpass Elisabete,
Lund Eiliv,
Argüelles Marcial,
Agudo Antonio,
MolinaMontes Esther,
Navarro Carmen,
Barricarte Aurelio,
Larrañaga Nerea,
Manjer Jonas,
Almquist Martin,
Sandström Maria,
Hennings Joakim,
Tsilidis Konstantinos K.,
Schmidt Julie A.,
Khaw KayThee,
Wareham Nicholas J.,
Romieu Isabelle,
Byrnes Graham,
Gunter Marc J.,
Riboli Elio,
Franceschi Silvia
Publication year - 2014
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.29067
Subject(s) - medicine , hazard ratio , menarche , proportional hazards model , menopause , gynecology , prospective cohort study , breast cancer , cohort study , etiology , infertility , european prospective investigation into cancer and nutrition , confidence interval , obstetrics , pregnancy , cancer , biology , genetics
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.