title: Obesity and the risk of papillary thyroid cancer: a pooled analysis of three case-control studies.
abstract: BACKGROUND
  There is a correlation between temporal trends of obesity prevalence and papillary thyroid cancer (PTC) incidence in the United States. Obesity is a well-recognized risk factor for many cancers, but there are few studies on the association between obesity and PTC risk. We investigated the association between anthropometric measurements and PTC risk using pooled individual data from three case-control populations.
  
  
  METHODS
  Height and weight information were obtained from three independent case-control studies, including 1917 patients with PTC (1360 women and 557 men) and 2127 cancer-free controls from the United States, Italy, and Germany. Body mass index (BMI), body fat percentage, and body surface area (BSA) were calculated. An unconditional logistic regression model was used to calculate odds ratios (ORs) and confidence intervals (CIs) with respect to risk of PTC, adjusted by age, sex, race/ethnicity, and study site.
  
  
  RESULTS
  In the pooled population, for both men and women, an increased risk of PTC was found to be associated with greater weight, BMI, body fat percentage, and BSA, whereas a reduced risk of PTC was associated with greater height, in the pooled population for both men and women. Compared with normal-weight subjects (BMI 18.5-24.9 kg/m2), the ORs for overweight (BMI 25-29.9 kg/m2) and obese (BMI≥30 kg/m2) subjects were 1.72 [CI 1.48-2.00] and 4.17 [CI 3.41-5.10] respectively. Compared with the lowest quartile of body fat percentage, the ORs for the highest quartile were 3.83 [CI 2.85-5.15] in women and 4.05 [CI 2.67-6.15] in men.
  
  
  CONCLUSIONS
  Anthropometric factors, especially BMI and body fat percentage, were significantly associated with increased risk of PTC. Future studies of anthropometric factors and PTC that incorporate intermediate factors, including adiposity and hormone biomarkers, are essential to help clarify potential mechanisms of the relationship.
authors.affiliation: 1 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Matthias
authors.initials: M
authors.lastname: Port
authors.forename: Stefano
authors.initials: S
authors.lastname: Landi
authors.forename: Federica
authors.initials: F
authors.lastname: Gemignani
authors.forename: Monica
authors.initials: M
authors.lastname: Cipollini
authors.forename: Rossella
authors.initials: R
authors.lastname: Elisei
authors.forename: Lilia
authors.initials: L
authors.lastname: Goudeva
authors.forename: Jörg Andreas
authors.initials: JA
authors.lastname: Müller
authors.forename: Kai
authors.initials: K
authors.lastname: Nerlich
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellegrini
authors.forename: Christoph
authors.initials: C
authors.lastname: Reiners
authors.forename: Cristina
authors.initials: C
authors.lastname: Romei
authors.forename: Robert
authors.initials: R
authors.lastname: Schwab
authors.forename: Michael
authors.initials: M
authors.lastname: Abend
authors.forename: Erich M
authors.initials: EM
authors.lastname: Sturgis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology*; D002291:Carcinoma, Papillary; D016022:Case-Control Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D012306:Risk; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology