title: Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies.
abstract: Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality.
  
  
  
  This large pooled analysis of 22 prospective studies (833,176 men and 1,260,871 women) investigated thyroid cancer incidence associated with greater height, BMI at baseline and young adulthood, and adulthood BMI gain (difference between young-adult and baseline BMI), overall and separately by sex and histological subtype using multivariable Cox proportional hazards regression models. Associations with thyroid cancer mortality were investigated in a subset of cohorts (578,922 men and 774,373 women) that contributed cause of death information.
  
  
  
  During follow-up, 2996 incident thyroid cancers and 104 thyroid cancer deaths were identified. All anthropometric factors were positively associated with thyroid cancer incidence: hazard ratios (HR) [confidence intervals (CIs)] for height (per 5 cm) = 1.07 [1.04-1.10], BMI (per 5 kg/m2) = 1.06 [1.02-1.10], waist circumference (per 5 cm) = 1.03 [1.01-1.05], young-adult BMI (per 5 kg/m2) = 1.13 [1.02-1.25], and adulthood BMI gain (per 5 kg/m2) = 1.07 [1.00-1.15]. Associations for baseline BMI and waist circumference were attenuated after mutual adjustment. Baseline BMI was more strongly associated with risk in men compared with women (p = 0.04). Positive associations were observed for papillary, follicular, and anaplastic, but not medullary, thyroid carcinomas. Similar, but stronger, associations were observed for thyroid cancer mortality.
  
  
  
  The results suggest that greater height and excess adiposity throughout adulthood are associated with higher incidence of most major types of thyroid cancer, including the least common but most aggressive form, anaplastic carcinoma, and higher thyroid cancer mortality. Potential underlying biological mechanisms should be explored in future studies.
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.affiliation: 2 Epidemiology Research Program, American Cancer Society , Atlanta, Georgia .
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: McCullough
authors.affiliation: 3 International Agency for Research on Cancer , Lyon, France .
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.affiliation: 3 International Agency for Research on Cancer , Lyon, France .
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.affiliation: 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.affiliation: 5 Division of Cancer Control and Population Sciences; National Cancer Institute , Rockville, Maryland.
authors.forename: Gila
authors.initials: G
authors.lastname: Neta
authors.affiliation: 6 Department of Medical Epidemiology and Biostatistics; Karolinska Institutet , Stockholm, Sweden .|7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts.
authors.forename: Hans
authors.initials: H
authors.lastname: Olov Adami
authors.affiliation: 8 Division of Epidemiology and Community Health, School of Public Health; University of Minnesota , Minneapolis, Minnesota.|9 Masonic Cancer Center; University of Minnesota , Minneapolis, Minnesota.
authors.forename: Kristin
authors.initials: K
authors.lastname: Anderson
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Andreotti
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
authors.affiliation: 10 Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute , City of Hope, Duarte, California.
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.affiliation: 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts.|11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.affiliation: 12 Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France Paris South University , UMRS Inserm 1018 Team 9, Villejuif, France .
authors.forename: Francoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.affiliation: 13 Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway .|14 Epidemiology Branch, National Institute of Environmental Health Sciences , Research Triangle Park, North Carolina.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: De Roo
authors.affiliation: 15 Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.affiliation: 11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts.|16 Division of Aging; Brigham and Women's Hospital , Boston, Massachusetts.|17 Massachusetts Veteran's Epidemiology, Research, and Information Center, Geriatric Research Education and Clinical Center , VA Boston Healthcare System, Boston, Massachusetts.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.affiliation: 18 Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne, Australia .|19 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Carlton, Australia .
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.affiliation: 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden.
authors.forename: Niclas
authors.initials: N
authors.lastname: Håkansson
authors.affiliation: 20 Cancer Prevention Institute of California , Fremont, California.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Horn-Ross
authors.affiliation: 21 Prevention and Cancer Control, Cancer Care Ontario , Toronto, Canada .|22 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada .
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Kirsh
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: 18 Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne, Australia .|19 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Carlton, Australia .
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacInnis
authors.affiliation: 4 Division of Nutritional Epidemiology, Institute of Environmental Medicine; Karolinska Institutet , Stockholm, Sweden.
authors.forename: Nicola
authors.initials: N
authors.lastname: Orsini
authors.affiliation: 23 Division of Public Health Sciences, Washington University School of Medicine in St. Louis , St. Louis, Missouri.
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.affiliation: 2 Epidemiology Research Program, American Cancer Society , Atlanta, Georgia .
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
authors.affiliation: 24 Ontario Institute for Cancer Research , Toronto, Canada .
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
authors.affiliation: 25 Imperial School of Public Health, Imperial College London , London, United Kingdom .
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.affiliation: 26 Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University , Washington, DC.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Robien
authors.affiliation: 27 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, New York.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rohan
authors.affiliation: 14 Epidemiology Branch, National Institute of Environmental Health Sciences , Research Triangle Park, North Carolina.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Schairer
authors.affiliation: 28 Section of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago , Chicago, Illinois.
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Schneider
authors.affiliation: 7 Department of Epidemiology, Harvard School of Public Health , Boston, Massachusetts.|11 Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital , Boston, Massachusetts.|16 Division of Aging; Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.affiliation: 29 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.affiliation: 30 Center for Health Research, School of Public Health, Loma Linda University , Loma Linda, California.
authors.forename: Pramil N
authors.initials: PN
authors.lastname: Singh
authors.affiliation: 31 Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University , Maastricht, Netherlands .
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.affiliation: 32 Intramural Research, American Cancer Society , Atlanta, Georgia .
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ward
authors.affiliation: 6 Department of Medical Epidemiology and Biostatistics; Karolinska Institutet , Stockholm, Sweden .|33 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway , Tromsø, Norway .|34 Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research , Oslo, Norway .|35 Genetic Epidemiology Group, Folkälsan Research Center , Helsinki, Finland .
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: 36 Public Health Services Division, Fred Hutchinson Cancer Research Center , Seattle, Washington.|37 Department of Epidemiology, University of Washington , Seattle, Washington.
authors.forename: Emily
authors.initials: E
authors.lastname: White
authors.affiliation: 15 Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.affiliation: 38 Division of Epidemiology, Department of Population Health and NYU Cancer Institute, NYU School of Medicine , New York, New York.
authors.forename: Anne
authors.initials: A
authors.lastname: Zeleniuch-Jacquotte
authors.affiliation: 29 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.affiliation: 1 Division of Cancer Epidemiology and Genetics; National Cancer Institute , Rockville, Maryland.
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de González
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D055105:Waist Circumference