Dietary factors and thyroid cancer risk: a meta-analysis of observational studies.

To better understand the relationship between dietary factors and thyroid cancer risk, we summarized the published evidence on relationship between dietary factors and thyroid cancer incidence. Searching several databases for relevant studies published by March 2014 included a total of 19 studies. We calculated summary odds ratios (ORs) for each risk factor. Based on the highest level of total consumption vs. the lowest level, the summary OR [95% (confidence interval) CI] of thyroid cancer was 0.79 (0.66, 0.94) for fish; 0.95 (0.74, 1.23) for salt water fish; 0.86 (0.63, 1.16) for fresh water fish; 0.76 (0.58, 1.00) for vegetables; 0.88 (0.72, 1.08) for shellfish; 0.93 (0.66, 1.29) for cruciferous vegetables; 0.97 (0.78, 1.21) for fruits; 0.96 (0.70, 1.34) for meat; and 1.11 (0.86, 1.42) for grains. Subgroup analysis showed that fish (OR 0.74, 95%CI: 0.59, 0.92) and shellfish (OR 0.46, 95%CI: 0.27, 0.75) consumption have a protective effect in iodine deficiency areas, whereas the ORs were not statistically significant in iodine-rich areas. Our findings indicated that fish and shellfish consumption may decrease the risk of thyroid cancer in iodine deficiency areas, although no such effect was observed in iodine-rich areas.