title: Cigarette smoking, alcohol intake, and thyroid cancer risk: a pooled analysis of five prospective studies in the United States.
abstract: OBJECTIVE
  We examined the associations between cigarette smoking, alcohol intake, and thyroid cancer risk in a pooled analysis of five prospective studies.
  
  
  METHODS
  Data from five prospective U.S. studies were standardized and then combined into one aggregate dataset (384,433 men and 361,664 women). Pooled hazard ratios (HR) and 95 % confidence intervals (CI) for thyroid cancer were estimated from mutually adjusted models of cigarette smoking and alcohol intake, which were additionally adjusted for age, sex, education, race, marital status, body mass index, and cohort.
  
  
  RESULTS
  Over follow-up, 1,003 incident thyroid cancer cases (335 men and 668 women) were identified. Compared to never smokers, current smoking was associated with reduced risk of thyroid cancer (HR = 0.68, 95 % CI 0.55-0.85); this association was slightly stronger among non-drinkers (HR = 0.46, 95 % CI 0.29-0.74). No reduction in risk was observed for former, compared to never, smokers. Greater smoking intensity, duration, and pack-years were associated with further reductions in risk among former and current smokers. Alcohol intake was also inversely associated with thyroid cancer risk (≥7 drinks/week versus 0, HR = 0.72, 95 % CI 0.58-0.90, p trend = 0.002). Inverse associations with smoking and alcohol were more pronounced for papillary versus follicular tumors.
  
  
  CONCLUSIONS
  The results of this pooled analysis suggest that both cigarette smoking and alcohol consumption are associated with reduced risks of papillary thyroid cancer and, possibly, follicular thyroid cancer.
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, EPS 7056, 6120 Executive Blvd, Rockville, MD 20852, USA. kitaharac@mail.nih.gov
authors: Cari M
authors: CM
authors: Kitahara
authors: Martha S
authors: MS
authors: Linet
authors: Laura E
authors: LE
authors: Beane Freeman
authors: David P
authors: DP
authors: Check
authors: Timothy R
authors: TR
authors: Church
authors: Yikyung
authors: Y
authors: Park
authors: Mark P
authors: MP
authors: Purdue
authors: Catherine
authors: C
authors: Schairer
authors: Amy
authors: A
authors: Berrington de González
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology; D002291:Carcinoma, Papillary; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology