Unbound MEDLINE

Association between benign thyroid and endocrine disorders and subsequent risk of thyroid cancer among 4.5 million U.S. male veterans.

Abstract

CONTEXT
Risk factors for thyroid cancer (TC) in males are poorly understood. OBJECTIVES, SETTING, AND PARTICIPANTS: Our aim was to evaluate the relationship between history of benign thyroid and endocrine disorders and risk of TC among 4.5 million male veterans admitted to U.S. Veterans Affairs hospitals between July 1, 1969, and September 30, 1996.
DESIGN
We conducted a retrospective cohort study based on hospital discharge records with 1053 cases of TC.
MAIN OUTCOME MEASURES
We estimated relative risks (RR) and computed 95% confidence intervals (CI) for TC using time-dependent Poisson regression models. To evaluate potential ascertainment bias and/or delayed diagnosis of TC, we also analyzed RR by time between diagnosis of benign disorder and TC (<5 or ≥ 5 yr).
RESULTS
RR for TC were significantly elevated with many disorders and were often higher less than 5 yr compared with 5 yr or more before TC diagnosis. RR (95% CI) less than 5 yr/at least 5 yr were 67.9 (42.4-108.8)/28.9 (9.2-90.2) for thyroid adenoma, 77.8 (64.5-93.1)/25.9 (17.9-38.0) for nontoxic nodular goiter, 23.9 (13.8-41.3)/12.9 (4.8-34.4) for thyroiditis, 8.8 (6.9-11.3)/6.0 (3.8-9.6) for hypothyroidism, 6.4 (4.4-9.4)/ 2.0 (0.8-4.8) for thyrotoxicosis, and 1.2 (1.0-1.4)/1.1 (0.9-1.5) for diabetes. For some disorders, RR also significantly varied by attained age and race with younger patients and Blacks having higher RR than older patients and Whites.
CONCLUSIONS
We found strong associations for a history of thyroid adenoma, nodular goiter, thyroiditis, or hypothyroidism with TC in males allowing for increased surveillance/delayed diagnosis and evidence that some of these associations are modified by age and race.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • Publisher Full Text
  • Authors

    Balasubramaniam S, Ron E, Gridley G, Schneider AB, Brenner AV

    Source

    The Journal of clinical endocrinology and metabolism 97:8 2012 Aug pg 2661-9

    MeSH

    Cohort Studies
    Endocrine System Diseases
    Goiter, Nodular
    Humans
    Hypothyroidism
    Male
    Middle Aged
    Poisson Distribution
    Retrospective Studies
    Risk
    Thyroid Diseases
    Thyroid Neoplasms
    Thyroiditis
    Veterans

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    22569239