Cancer Prevention Fellowship Program and Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20902, USA.
J Clin Endocrinol Metab. 2012 Aug;97(8):2661-9. doi: 10.1210/jc.2011-2996. Epub 2012 May 8.
Risk factors for thyroid cancer (TC) in males are poorly understood. OBJECTIVES, SETTING, AND PARTICIPANTS: Our aim was to evaluate the relationship between history of benign thyroid and endocrine disorders and risk of TC among 4.5 million male veterans admitted to U.S. Veterans Affairs hospitals between July 1, 1969, and September 30, 1996.
We conducted a retrospective cohort study based on hospital discharge records with 1053 cases of TC.
We estimated relative risks (RR) and computed 95% confidence intervals (CI) for TC using time-dependent Poisson regression models. To evaluate potential ascertainment bias and/or delayed diagnosis of TC, we also analyzed RR by time between diagnosis of benign disorder and TC (<5 or ≥ 5 yr).
RR for TC were significantly elevated with many disorders and were often higher less than 5 yr compared with 5 yr or more before TC diagnosis. RR (95% CI) less than 5 yr/at least 5 yr were 67.9 (42.4-108.8)/28.9 (9.2-90.2) for thyroid adenoma, 77.8 (64.5-93.1)/25.9 (17.9-38.0) for nontoxic nodular goiter, 23.9 (13.8-41.3)/12.9 (4.8-34.4) for thyroiditis, 8.8 (6.9-11.3)/6.0 (3.8-9.6) for hypothyroidism, 6.4 (4.4-9.4)/ 2.0 (0.8-4.8) for thyrotoxicosis, and 1.2 (1.0-1.4)/1.1 (0.9-1.5) for diabetes. For some disorders, RR also significantly varied by attained age and race with younger patients and Blacks having higher RR than older patients and Whites.
We found strong associations for a history of thyroid adenoma, nodular goiter, thyroiditis, or hypothyroidism with TC in males allowing for increased surveillance/delayed diagnosis and evidence that some of these associations are modified by age and race.
男性甲状腺癌（TC）的风险因素知之甚少。
目的、背景和参与者：我们的目的是评估美国退伍军人事务部医院 1969 年 7 月 1 日至 1996 年 9 月 30 日期间收治的 450 万男性退伍军人中良性甲状腺和内分泌疾病史与 TC 风险之间的关系。
我们根据住院记录进行了回顾性队列研究，其中包括 1053 例 TC 病例。
我们使用时间依赖性泊松回归模型估计 TC 的相对风险（RR）和计算 95%置信区间（CI）。为了评估潜在的确认偏倚和/或 TC 的延迟诊断，我们还按良性疾病与 TC 诊断之间的时间（<5 年或≥5 年）分析 RR。
许多疾病的 TC RR 显著升高，与 TC 诊断前 5 年相比，<5 年的 RR 往往更高。<5 年/至少 5 年的 RR（95%CI）分别为甲状腺腺瘤 67.9（42.4-108.8）/28.9（9.2-90.2）、非毒性结节性甲状腺肿 77.8（64.5-93.1）/25.9（17.9-38.0）、甲状腺炎 23.9（13.8-41.3）/12.9（4.8-34.4）、甲状腺功能减退症 8.8（6.9-11.3）/6.0（3.8-9.6）、甲状腺毒症 6.4（4.4-9.4）/2.0（0.8-4.8）和糖尿病 1.2（1.0-1.4）/1.1（0.9-1.5）。对于某些疾病，RR 也因年龄和种族而显著不同，年轻患者和黑人的 RR 高于老年患者和白人。
我们发现男性甲状腺腺瘤、结节性甲状腺肿、甲状腺炎或甲状腺功能减退症的病史与 TC 有很强的关联，这使得监测/延迟诊断的可能性增加，并证明这些关联中的一些受到年龄和种族的影响。
