New York State Cancer Registry, New York State Department of Health, Albany, New York, USA.
Thyroid. 2011 Nov;21(11):1255-61. doi: 10.1089/thy.2011.0091. Epub 2011 Aug 30.
Thyroid cancer incidence in New York State has increased rapidly in recent years, particularly in New York City and its surrounding metropolitan area. In 2007 among white non-Hispanics, incidence rates were about 40% higher in the New York City metropolitan area than in the rest of the state. Here we explore the extent to which living in neighborhoods with a high percentage of highly observant Jews may be associated with this pattern.
We identify neighborhoods with concentrations of highly observant Jewish persons based on the use of Yiddish among children and the location of Orthodox synagogues. Thyroid cancer risk is modeled as a function of living in such a neighborhood, adjusting for age, sex, and other factors. The model was repeated for small (<2 cm) and large (≥2 cm) tumors to assess the role of diagnostic improvements in driving the spatial-temporal patterns.
A moderate association with thyroid cancer was found among those living in Jewish neighborhoods and downstate New York. A lesser association was found among those who live in neighborhoods of high levels of people born in Russia, Belarus, or Ukraine. Similar elevated rate ratios were seen for small and large tumors in Jewish neighborhoods, providing evidence against differences in diagnostic practices in this group. Smaller tumors were more pronounced among women and persons diagnosed more recently.
The associations found do not seem to be diagnostically driven, but rather due to environmental, genetic, or cultural factors in the highly observant population of New York State.
近年来，纽约州的甲状腺癌发病率迅速上升，尤其是在纽约市及其周边大都市区。2007 年，在白人非西班牙裔人群中，纽约市大都市区的发病率比该州其他地区高出约 40%。在这里，我们探讨了居住在高度观察的犹太人聚居区的比例与这种模式之间的关系。
我们根据儿童使用意第绪语和正统犹太教堂的位置，确定了高度观察的犹太教徒聚居区。将甲状腺癌风险作为居住在这样的社区的函数进行建模，调整年龄、性别和其他因素。对小（<2cm）和大（≥2cm）肿瘤重复该模型，以评估诊断改进在驱动时空模式中的作用。
在居住在犹太社区和纽约州南部的人群中发现了与甲状腺癌中度相关的结果。在那些居住在俄罗斯、白俄罗斯或乌克兰出生的人比例较高的社区的人群中，关联度较小。在犹太社区中，大小肿瘤的比值比都较高，这表明该组人群的诊断实践差异不大。在女性和最近被诊断出的人群中，较小的肿瘤更为明显。
发现的关联似乎不是由诊断驱动的，而是由于纽约州高度观察人群的环境、遗传或文化因素。
