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. 2016 Feb;26(2):306-18.
doi: 10.1089/thy.2015.0319.

Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies

Cari M Kitahara  1 , Marjorie L McCullough  2 , Silvia Franceschi  3 , Sabina Rinaldi  3 , Alicja Wolk  4 , Gila Neta  5 , Hans Olov Adami  6   7 , Kristin Anderson  8   9 , Gabriella Andreotti  1 , Laura E Beane Freeman  1 , Leslie Bernstein  10 , Julie E Buring  7   11 , Francoise Clavel-Chapelon  12 , Lisa A De Roo  13   14 , Yu-Tang Gao  15 , J Michael Gaziano  11   16   17 , Graham G Giles  18   19 , Niclas Håkansson  4 , Pamela L Horn-Ross  20 , Vicki A Kirsh  21   22 , Martha S Linet  1 , Robert J MacInnis  18   19 , Nicola Orsini  4 , Yikyung Park  23 , Alpa V Patel  2 , Mark P Purdue  24 , Elio Riboli  25 , Kimberly Robien  26 , Thomas Rohan  27 , Dale P Sandler  14 , Catherine Schairer  1 , Arthur B Schneider  28 , Howard D Sesso  7   11   16 , Xiao-Ou Shu  29 , Pramil N Singh  30 , Piet A van den Brandt  31 , Elizabeth Ward  32 , Elisabete Weiderpass  6   33   34   35 , Emily White  36   37 , Yong-Bing Xiang  15 , Anne Zeleniuch-Jacquotte  38 , Wei Zheng  29 , Patricia Hartge  1 , Amy Berrington de González  1
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Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies

Cari M Kitahara et al. Thyroid. 2016 Feb.

Abstract

Background: Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality.

Methods: This large pooled analysis of 22 prospective studies (833,176 men and 1,260,871 women) investigated thyroid cancer incidence associated with greater height, BMI at baseline and young adulthood, and adulthood BMI gain (difference between young-adult and baseline BMI), overall and separately by sex and histological subtype using multivariable Cox proportional hazards regression models. Associations with thyroid cancer mortality were investigated in a subset of cohorts (578,922 men and 774,373 women) that contributed cause of death information.

Results: During follow-up, 2996 incident thyroid cancers and 104 thyroid cancer deaths were identified. All anthropometric factors were positively associated with thyroid cancer incidence: hazard ratios (HR) [confidence intervals (CIs)] for height (per 5 cm) = 1.07 [1.04-1.10], BMI (per 5 kg/m2) = 1.06 [1.02-1.10], waist circumference (per 5 cm) = 1.03 [1.01-1.05], young-adult BMI (per 5 kg/m2) = 1.13 [1.02-1.25], and adulthood BMI gain (per 5 kg/m2) = 1.07 [1.00-1.15]. Associations for baseline BMI and waist circumference were attenuated after mutual adjustment. Baseline BMI was more strongly associated with risk in men compared with women (p = 0.04). Positive associations were observed for papillary, follicular, and anaplastic, but not medullary, thyroid carcinomas. Similar, but stronger, associations were observed for thyroid cancer mortality.

Conclusion: The results suggest that greater height and excess adiposity throughout adulthood are associated with higher incidence of most major types of thyroid cancer, including the least common but most aggressive form, anaplastic carcinoma, and higher thyroid cancer mortality. Potential underlying biological mechanisms should be explored in future studies.

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