title: Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: the EPIC study.
abstract: Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for ≤ 5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for ≥ 9 vs. ≤ 1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR = 1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR = 1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.
authors.affiliation: International Agency for Research on Cancer (IARC), Lyon, France.
authors.forename: Raul
authors.initials: R
authors.lastname: Zamora-Ros
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.forename: Carine
authors.initials: C
authors.lastname: Biessy
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Jytte
authors.initials: J
authors.lastname: Halkjaer
authors.forename: Agnes
authors.initials: A
authors.lastname: Fournier
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Sylvie
authors.initials: S
authors.lastname: Mesrine
authors.forename: Kaja
authors.initials: K
authors.lastname: Tikk
authors.forename: Reneé T
authors.initials: RT
authors.lastname: Fortner
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Jana
authors.initials: J
authors.lastname: Förster
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Eleni-Maria
authors.initials: EM
authors.lastname: Papatesta
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tagliabue
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Silvia
authors.initials: S
authors.lastname: Polidoro
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Marcial
authors.initials: M
authors.lastname: Argüelles
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
authors.forename: Maria
authors.initials: M
authors.lastname: Sandström
authors.forename: Joakim
authors.initials: J
authors.lastname: Hennings
authors.forename: Konstantinos K
authors.initials: KK
authors.lastname: Tsilidis
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schmidt
authors.forename: Kay-Thee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Graham
authors.initials: G
authors.lastname: Byrnes
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gunter
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000328:Adult; D002454:Cell Differentiation; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008593:Menopause; D008598:Menstruation; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D017584:Reproductive History; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal
keywords: EPIC; differentiated thyroid carcinoma; hormone use; menstrual factors; reproductive factors