title: Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies.
abstract: BACKGROUND
  Several studies have evaluated the association between obesity and thyroid cancer risk. However, the results remain uncertain. In this study, we conducted a meta-analysis to assess the association between obesity and thyroid cancer risk.
  
  
  METHODS
  Published literature from PubMed, EMBASE, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) were retrieved before 10 August 2014. We included all studies that reported adjusted risk ratios (RRs), hazard ratios (HRs) or odds ratios (ORs), and 95% confidence intervals (CIs) of thyroid cancer risk.
  
  
  RESULTS
  Thirty-two studies (n=12 620 676) were included in this meta-analysis. Obesity was associated with a significantly increased risk of thyroid cancer (adjusted RR=1.33; 95% CI, 1.24-1.42; I2=25%). In the subgroup analysis by study type, increased risk of thyroid cancer was found in cohort studies and case-control studies. In subgroup analysis by sex, both obese men and women were at significantly greater risk of thyroid cancer than non-obese subjects. When stratified by ethnicity, significantly elevated risk was observed in Caucasians and in Asians. In the age subgroup analysis, both young and old populations showed increased thyroid cancer risk. Subgroup analysis on smoking status showed that increased thyroid cancer risks were found in smokers and in non-smokers. In the histology subgroup analyses, increased risks of papillary thyroid cancer, follicular thyroid cancer, and anaplastic thyroid cancer were observed. However, obesity was associated with decreased risk of medullary thyroid cancer.
  
  
  CONCLUSIONS
  Our results indicate that obesity is associated with an increased thyroid cancer risk, except medullary thyroid cancer.
authors.affiliation: Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland).
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Scientific Research and Education, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland).
authors.forename: Min
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland).
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland).
authors.forename: Wei
authors.initials: W
authors.lastname: Ye
authors.affiliation: Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland).
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.affiliation: Department of Stomatology, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland).
authors.forename: Hanmin
authors.initials: H
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D064887:Observational Studies as Topic; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000208:ethnology; D055815:Young Adult