Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Rockville, MD 20852, USA.
Am J Epidemiol. 2010 Jan 15;171(2):242-52. doi: 10.1093/aje/kwp354. Epub 2009 Nov 30.
The incidence of thyroid cancer has been rapidly increasing in the United States, but few risk factors have been established. The authors prospectively examined the associations of self-reported medical history, anthropometric factors, and behavioral factors with thyroid cancer risk among 90,713 US radiologic technologists (69,506 women and 21,207 men) followed from 1983 through 2006. Incident thyroid cancers in 242 women and 40 men were reported. Elevated risks were observed for women with benign thyroid conditions (hazard ratio (HR) = 2.35, 95% confidence interval (CI): 1.73, 3.20), benign breast disease (HR = 1.56, 95% CI: 1.08, 2.26), asthma (HR = 1.68, 95% CI: 1.00, 2.83), and body mass index > or =35.0 versus 18.5-24.9 kg/m(2) (HR = 1.74, 95% CI: 1.03, 2.94; P-trend = 0.04). Current smoking was inversely associated with thyroid cancer risk (HR = 0.54). No clear associations emerged for reproductive factors, other medical conditions, alcohol intake, or physical activity. Despite few thyroid cancers in men, men with benign thyroid conditions had a significantly increased risk of thyroid cancer (HR = 4.65, 95% CI: 1.62, 13.34), and results for other risk factors were similar to those for women. Consistent with prior studies, obesity and benign thyroid conditions increased and current smoking decreased the risk of thyroid cancer. The novel findings for benign breast disease and asthma warrant further investigation.
在美国，甲状腺癌的发病率一直在迅速上升，但很少有确定的风险因素。作者前瞻性地研究了自我报告的病史、人体测量因素和行为因素与 90713 名美国放射技师（69506 名女性和 21207 名男性）患甲状腺癌风险的相关性，这些人从 1983 年到 2006 年被随访。报告了 242 名女性和 40 名男性的甲状腺癌新发病例。观察到女性患有良性甲状腺疾病（危险比（HR）=2.35，95%置信区间（CI）：1.73，3.20）、良性乳腺疾病（HR=1.56，95%CI：1.08，2.26）、哮喘（HR=1.68，95%CI：1.00，2.83）和体重指数（BMI）≥35.0 与 18.5-24.9kg/m²（HR=1.74，95%CI：1.03，2.94；P 趋势=0.04）的风险增加。目前吸烟与甲状腺癌风险呈负相关（HR=0.54）。生殖因素、其他疾病、饮酒或体力活动与甲状腺癌风险无明显关联。尽管男性甲状腺癌病例较少，但患有良性甲状腺疾病的男性甲状腺癌风险显著增加（HR=4.65，95%CI：1.62，13.34），其他风险因素的结果与女性相似。与先前的研究一致，肥胖和良性甲状腺疾病增加，而目前吸烟则降低了甲状腺癌的风险。良性乳腺疾病和哮喘的新发现值得进一步研究。
