Cari M Kitahara1, Dagrun Slettebø Daltveit2, Anders Ekbom3, Anders Engeland4, Mika Gissler5, Ingrid Glimelius6, Tom Grotmol7, Ylva Trolle Lagerros3, Laura Madanat-Harjuoja8, Tuija Männistö9, Henrik Toft Sørensen10, Rebecca Troisi11, Tone Bjørge12. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA. Electronic address: kitaharac@mail.nih.gov. 2. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 3. Department of Medicine, Division of Clinical Epidemiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 4. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway. 5. Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. 6. Department of Medicine, Division of Clinical Epidemiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. 7. Cancer Registry of Norway, Oslo, Norway. 8. Cancer Society of Finland, Finnish Cancer Registry, Helsinki, Finland; Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 9. Northern Finland Laboratory Center NordLab, Oulu, Finland. 10. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 11. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA. 12. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Cancer Registry of Norway, Oslo, Norway.
Abstract
BACKGROUND: Thyroid cancer tends to be diagnosed at a younger age (median age 51 years) compared with most other malignancies (such as breast cancer [62 years] or lung cancer [71 years]). The incidence of thyroid cancer is higher in women than men diagnosed from early adolescence. However, few in-utero and early life risk exposures associated with increased risk of thyroid cancer have been identified. METHODS: In this population-based nested case-control study we used registry data from four Nordic countries to assess thyroid cancer risk in offspring in relation to maternal medical history, pregnancy complications, and birth characteristics. Patient with thyroid cancer (cases) were individuals born and subsequently diagnosed with first primary thyroid cancer from 1973 to 2013 in Denmark, 1987 to 2014 in Finland, 1967 to 2015 in Norway, or 1973 to 2014 in Sweden. Each case was matched with up to ten individuals without thyroid cancer (controls) based on birth year, sex, country, and county of birth. Cases and matched controls with a previous diagnosis of any cancer, other than non-melanoma skin cancer, at the time of thyroid cancer diagnosis were excluded. Cases and matched controls had to reside in the country of birth at the time of thyroid cancer diagnosis. Conditional logistic regression models were used to calculate odds ratios (ORs) with 95% CIs. RESULTS: Of the 2437 cases, 1967 (81·4%) had papillary carcinomas, 1880 (77·1%) were women, and 1384 (56·7%) were diagnosed before age 30 years (range 0-48). Higher birth weight (OR per kg 1·14 [95% CI 1·05-1·23]) and congenital hypothyroidism (4·55 [1·58-13·08]); maternal diabetes before pregnancy (OR 1·69 [0·98-2·93]) and postpartum haemorrhage (OR 1·28 [1·06-1·55]); and (from registry data in Denmark) maternal hypothyroidism (18·12 [10·52-31·20]), hyperthyroidism (11·91 [6·77-20·94]), goiter (67·36 [39·89-113·76]), and benign thyroid neoplasms (22·50 [6·93-73·06]) were each associated with an increased risk of thyroid cancer in offspring. INTERPRETATION: In-utero exposures, particularly those related to maternal thyroid disorders, might have a long-term influence on thyroid cancer risk in offspring. FUNDING: Intramural Research Program of the National Cancer Institute (National Institutes of Health).
BACKGROUND: Thyroid cancer tends to be diagnosed at a younger age (median age 51 years) compared with most other malignancies (such as breast cancer [62 years] or lung cancer [71 years]). The incidence of thyroid cancer is higher in women than men diagnosed from early adolescence. However, few in-utero and early life risk exposures associated with increased risk of thyroid cancer have been identified. METHODS: In this population-based nested case-control study we used registry data from four Nordic countries to assess thyroid cancer risk in offspring in relation to maternal medical history, pregnancy complications, and birth characteristics. Patient with thyroid cancer (cases) were individuals born and subsequently diagnosed with first primary thyroid cancer from 1973 to 2013 in Denmark, 1987 to 2014 in Finland, 1967 to 2015 in Norway, or 1973 to 2014 in Sweden. Each case was matched with up to ten individuals without thyroid cancer (controls) based on birth year, sex, country, and county of birth. Cases and matched controls with a previous diagnosis of any cancer, other than non-melanoma skin cancer, at the time of thyroid cancer diagnosis were excluded. Cases and matched controls had to reside in the country of birth at the time of thyroid cancer diagnosis. Conditional logistic regression models were used to calculate odds ratios (ORs) with 95% CIs. RESULTS: Of the 2437 cases, 1967 (81·4%) had papillary carcinomas, 1880 (77·1%) were women, and 1384 (56·7%) were diagnosed before age 30 years (range 0-48). Higher birth weight (OR per kg 1·14 [95% CI 1·05-1·23]) and congenital hypothyroidism (4·55 [1·58-13·08]); maternal diabetes before pregnancy (OR 1·69 [0·98-2·93]) and postpartum haemorrhage (OR 1·28 [1·06-1·55]); and (from registry data in Denmark) maternal hypothyroidism (18·12 [10·52-31·20]), hyperthyroidism (11·91 [6·77-20·94]), goiter (67·36 [39·89-113·76]), and benign thyroid neoplasms (22·50 [6·93-73·06]) were each associated with an increased risk of thyroid cancer in offspring. INTERPRETATION: In-utero exposures, particularly those related to maternal thyroid disorders, might have a long-term influence on thyroid cancer risk in offspring. FUNDING: Intramural Research Program of the National Cancer Institute (National Institutes of Health).
Authors: Jens Langhoff-Roos; Lone Krebs; Kari Klungsøyr; Ragnheidur I Bjarnadottir; Karin Källén; Anna-Maija Tapper; Maija Jakobsson; Per E Børdahl; Pelle G Lindqvist; Karin Gottvall; Lotte Berdiin Colmorn; Mika Gissler Journal: Acta Obstet Gynecol Scand Date: 2014-02 Impact factor: 3.636
Authors: Cari M Kitahara; Dóra K Rmendiné Farkas; Jens Otto L Jørgensen; Deirdre Cronin-Fenton; Henrik Toft Sørensen Journal: J Clin Endocrinol Metab Date: 2018-06-01 Impact factor: 5.958
Authors: Kathrine F Vandraas; Åse V Vikanes; Nathalie C Støer; Rebecca Troisi; Olof Stephansson; Henrik T Sørensen; Siri Vangen; Per Magnus; Andrej M Grjibovski; Tom Grotmol Journal: BMC Cancer Date: 2015-05-13 Impact factor: 4.430
Authors: Kyle Steenland; M K Schubauer-Berigan; R Vermeulen; R M Lunn; K Straif; S Zahm; P Stewart; W D Arroyave; S S Mehta; N Pearce Journal: Environ Health Perspect Date: 2020-09-14 Impact factor: 9.031
Authors: So Young Kim; Dae Myoung Yoo; Mi Jung Kwon; Ji Hee Kim; Joo-Hee Kim; Woo Jin Bang; Sung Kyun Kim; Hyo Geun Choi Journal: J Pers Med Date: 2022-05-27