Memon A, Varghese A, Suresh A
Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait.
Br J Cancer. 2002 Jun 5;86(11):1745-50. doi: 10.1038/sj.bjc.6600303.
We conducted a population-based study of 313 case-control pairs in Kuwait to examine the aetiology of thyroid cancer, the second most common neoplasm among women in this and several other countries in the Gulf region. Among the demographic variables, individuals with 12+ years of education had a significantly reduced risk of thyroid cancer (OR=0.6; 95% CI: 0.3-0.9). The average age at diagnosis (+/-s.d.) of thyroid cancer was 34.7+/-11 years in women and 39+/-13.4 years in men. History of thyroid nodule was reported only by cases (n=34; 10.9%; lower 95% CI: 12.0); and goitre by 21 cases and four controls (OR=5.3; 95% CI: 1.8-15.3). There was no significant increase in risk with history of hypothyroidism (OR=1.8) or hyperthyroidism (OR=1.7). For any benign thyroid disease, the OR was 6.4 (95% CI: 3.4-12.0); and the population attributable risk was about 26% (95% CI: 21.1-30.9). Stepwise regression analysis showed that high consumption of processed fish products (OR=2.2; 95% CI: 1.6-3.0) fresh fish (OR=0.5; 95% CI: 0.4-0.7) and chicken (OR=1.7; 95% CI: 1.2-2.3) were independently associated with thyroid cancer with significant dose-response relationships. Among the thyroid cancer patients who reported high consumption of fish products, a large majority also reported high consumption of fresh fish (98%) and shellfish (68%). No clear association emerged with consumption of cruciferous vegetables. These data support the hypothesis that hyperplastic thyroid disease is strongly related to thyroid cancer; and that habitual high consumption of various seafoods may be relevant to the aetiology of thyroid cancer. The association with chicken consumption requires further study.
我们在科威特对313例病例对照配对进行了一项基于人群的研究，以探究甲状腺癌的病因，甲状腺癌是该国及海湾地区其他几个国家女性中第二常见的肿瘤。在人口统计学变量中，接受12年及以上教育的个体患甲状腺癌的风险显著降低（比值比[OR]=0.6；95%置信区间[CI]：0.3 - 0.9）。甲状腺癌女性患者的平均诊断年龄（±标准差）为34.7±11岁，男性为39±13.4岁。仅病例报告有甲状腺结节病史（n = 34；10.9%；95%置信区间下限：12.0）；21例病例和4例对照报告有甲状腺肿（OR = 5.3；95% CI：1.8 - 15.3）。甲状腺功能减退病史（OR = 1.8）或甲状腺功能亢进病史（OR = 1.7）与风险增加无显著关联。对于任何良性甲状腺疾病，OR为6.4（95% CI：3.4 - 12.0）；人群归因风险约为26%（95% CI：21.1 - 30.9）。逐步回归分析表明，加工鱼类产品的高摄入量（OR = 2.2；95% CI：1.6 - 3.0）、新鲜鱼类（OR = 0.5；95% CI：0.4 - 0.7）和鸡肉（OR = 1.7；95% CI：1.2 - 2.3）与甲状腺癌独立相关，且存在显著的剂量反应关系。在报告鱼类产品高摄入量的甲状腺癌患者中，绝大多数还报告新鲜鱼类（98%）和贝类（68%）摄入量高。食用十字花科蔬菜未发现明显关联。这些数据支持以下假设：增生性甲状腺疾病与甲状腺癌密切相关；习惯性高摄入各种海鲜可能与甲状腺癌的病因有关。与鸡肉摄入量的关联需要进一步研究。
