title: Parity and thyroid cancer risk: a meta-analysis of epidemiological studies.
abstract: Although observational studies have assessed the relationship between parity and thyroid cancer risk, the findings are inconsistent. To quantitatively assess the association, we conducted a systematic review and meta-analysis. PubMed and Embase were searched up to January 2015. Prospective or case-control studies that evaluated the association between parity and thyroid cancer risk were included. We used the fixed-effects model to pool risk estimates. After literature search, 10 prospective studies, 12 case-control studies and 1 pooled analysis of 14 case-control studies including 8860 patients were identified. The studies had fair methodological quality. Pooled analysis suggested that there was a significant association between parity and risk of thyroid cancer (RR for parous versus nulliparous: 1.09, 95% CI 1.03-1.15; I2=33.4%). The positive association persisted in almost all strata of subgroup analyses based on study design, location, study quality, type of controls, and confounder adjustment, although in some strata statistical significance was not detected. By evaluating the number of parity, we identified that both parity number of 2 versus nulliparous and parity number of 3 versus nulliparous demonstrated significant positive associations (RR=1.11, 95% CI 1.01-1.22; I2=31.1% and RR=1.16, 95% CI 1.01-1.33; I2=19.6% respectively). The dose-response analysis suggested neither a non-linear nor linear relationship between the number of parity and thyroid cancer risk. In conclusion, this meta-analysis suggests a potential association between parity and risk of thyroid cancer in females. However, the lack of detection of a dose-response relationship suggests that further studies are needed to better understand the relationship.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203.|Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, 55455.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, 523808, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, 213003, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Tu
authors.affiliation: Department of Hematology, the Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, 221000, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Li
authors.affiliation: Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, 213003, China.
authors.forename: Ke-Qing
authors.initials: KQ
authors.lastname: Qian
authors.affiliation: Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, 213003, China.
authors.forename: Tong-Bao
authors.initials: TB
authors.lastname: Feng
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, 70112.
authors.forename: Changwei
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Neurology, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei, 442000, China.
authors.forename: Guang Jian
authors.initials: GJ
authors.lastname: Liu
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203.
authors.forename: Lang
authors.initials: L
authors.lastname: Wu
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D017584:Reproductive History; D012306:Risk; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000209:etiology*
keywords: Epidemiology; meta-analysis; parity; risk; thyroid cancer