Juhua Luo1, Lawrence Phillips1, Simin Liu1, Jean Wactawski-Wende1, Karen L Margolis1. 1. Department of Epidemiology and Biostatistics (J.L.), School of Public Health, Indiana University, Bloomington, Indiana 47405; Division of Endocrinology (L.P.), Emory University, Atlanta, Georgia 30322; School of Public Health (S.L.), The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island 02912; Department of Social and Preventive Medicine (J.W.-W.), University at Buffalo, Buffalo, New York 14214; and HealthPartners Institute for Education and Research (K.L.M.), Minneapolis, Minnesota 55440.
Abstract
OBJECTIVE: The objective of this study was to assess the relationships among diabetes, diabetes treatment and thyroid cancer risk using a large prospective cohort, the Women's Health Initiative. METHODS: A total of 147 934 women who were free of known cancer at baseline were followed prospectively. Diabetes status and diabetes treatment at baseline and during follow-up were ascertained. Incident cases of thyroid cancers were confirmed by physician review of central medical records and pathology reports. Time-dependent Cox proportional hazards regressions were used to estimate hazard ratios and 95% confidence intervals for thyroid cancer risk associated with diabetes status, diabetes treatment, and duration of diabetes. RESULTS: With a median follow-up time of 15.9 years, 391 incident thyroid cancers were identified. We found no significant associations between thyroid cancer and diabetes (hazard ratio = 1.09; 95% confidence interval, 0.79-1.52), diabetes treatment, or duration of diabetes. CONCLUSION: Our findings do not support the hypothesis that diabetes, or treatment of diabetes is associated with risk of thyroid cancer among postmenopausal women. Studies to investigate the specific effects of hyperinsulinemia and insulin resistance on thyroid cancer risk may provide additional information.
OBJECTIVE: The objective of this study was to assess the relationships among diabetes, diabetes treatment and thyroid cancer risk using a large prospective cohort, the Women's Health Initiative. METHODS: A total of 147 934 women who were free of known cancer at baseline were followed prospectively. Diabetes status and diabetes treatment at baseline and during follow-up were ascertained. Incident cases of thyroid cancers were confirmed by physician review of central medical records and pathology reports. Time-dependent Cox proportional hazards regressions were used to estimate hazard ratios and 95% confidence intervals for thyroid cancer risk associated with diabetes status, diabetes treatment, and duration of diabetes. RESULTS: With a median follow-up time of 15.9 years, 391 incident thyroid cancers were identified. We found no significant associations between thyroid cancer and diabetes (hazard ratio = 1.09; 95% confidence interval, 0.79-1.52), diabetes treatment, or duration of diabetes. CONCLUSION: Our findings do not support the hypothesis that diabetes, or treatment of diabetes is associated with risk of thyroid cancer among postmenopausal women. Studies to investigate the specific effects of hyperinsulinemia and insulin resistance on thyroid cancer risk may provide additional information.
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