O'Grady Thomas J, Rinaldi Sabina, Michels Kara A, Adami Hans-Olov, Buring Julie E, Chen Yu, Clendenen Tess V, D'Aloisio Aimee, DeHart Jessica Clague, Franceschi Silvia, Freedman Neal D, Gierach Gretchen L, Giles Graham G, Lacey James V, Lee I-Min, Liao Linda M, Linet Martha S, McCullough Marjorie L, Patel Alpa V, Prizment Anna, Robien Kim, Sandler Dale P, Stolzenberg-Solomon Rachael, Weiderpass Elisabete, White Emily, Wolk Alicja, Zheng Wei, Berrington de Gonzalez Amy, Kitahara Cari M
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY, USA.
Int J Epidemiol. 2024 Feb 1;53(1). doi: 10.1093/ije/dyad172.
BACKGROUND: The incidence of differentiated thyroid cancer (DTC) is higher in women than in men but whether sex steroid hormones contribute to this difference remains unclear. Studies of reproductive and hormonal factors and thyroid cancer risk have provided inconsistent results. METHODS: Original data from 1 252 907 women in 16 cohorts in North America, Europe, Australia and Asia were combined to evaluate associations of DTC risk with reproductive and hormonal factors. Multivariable-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS: During follow-up, 2142 women were diagnosed with DTC. Factors associated with higher risk of DTC included younger age at menarche (<10 vs 10-11 years; HR, 1.28; 95% CI, 1.00-1.64), younger (<40; HR, 1.31; 95% CI, 1.05-1.62) and older (≥55; HR, 1.33; 95% CI, 1.05-1.68) ages at menopause (vs 40-44 years), ever use of menopausal hormone therapy (HR, 1.16; 95% CI, 1.02-1.33) and previous hysterectomy (HR, 1.25; 95% CI, 1.13-1.39) or bilateral oophorectomy (HR, 1.14; 95% CI, 1.00-1.29). Factors associated with lower risk included longer-term use (≥5 vs <5 years) of oral contraceptives (HR, 0.86; 95% CI, 0.76-0.96) among those who ever used oral contraception and baseline post-menopausal status (HR, 0.82; 95% CI, 0.70-0.96). No associations were observed for parity, duration of menopausal hormone therapy use or lifetime number of reproductive years or ovulatory cycles. CONCLUSIONS: Our study provides some evidence linking reproductive and hormonal factors with risk of DTC. Results should be interpreted cautiously considering the modest strength of the associations and potential for exposure misclassification and detection bias. Prospective studies of pre-diagnostic circulating sex steroid hormone measurements and DTC risk may provide additional insight.
J Womens Health (Larchmt). 2024-9
Womens Health Issues. 2021
Cancer Prev Res (Phila). 2014-1-21
Am J Epidemiol. 1984-9
NPJ Womens Health. 2025
J Womens Health (Larchmt). 2024-9
Skin Res Technol. 2024-5