Cancer Causes & Control

, Volume 10, Issue 6, pp 583-595

First online:

A pooled analysis of case–control studies of thyroid cancer. IV. Benign thyroid diseases

  • Silvia FranceschiAffiliated withServizio di Epidemiologia, Centro di Riferimento Oncologico
  • , Susan Preston-MartinAffiliated withDepartment of Preventive Medicine, University of Southern California
  • , Luigino Dal MasoAffiliated withServizio di Epidemiologia, Centro di Riferimento Oncologico
  • , Eva NegriAffiliated withIstituto di Ricerche Farmacologiche “Mario Negri”
  • , Carlo La VecchiaAffiliated withIstituto di Ricerche Farmacologiche “Mario Negri”Istituto di Statistica Medica e Biometria, Università degli Studi di Milano
  • , Wendy J. MackAffiliated withDepartment of Preventive Medicine, University of Southern California
  • , Anne McTiernanAffiliated withFred Hutchinson Cancer Research Center
  • , Laurence KolonelAffiliated withCancer Research Center of Hawaii, University of Hawaii at Manoa
  • , Steven D. MarkAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute
    • , Kiyohiko MabuchiAffiliated withRadiation Effects Research Foundation
    • , Fan JinAffiliated withShanghai Cancer Institute
    • , Gun WingrenAffiliated withDepartment of Health and Environment, Division of Occupational and Environmental Medicine, Linköping University
    • , Rosaria GalantiAffiliated withCentrum för Tobakprevention
    • , Arne HallquistAffiliated withStockholm Sjukhem
    • , Eystein GlattreAffiliated withCancer Registry of Norway
    • , Eiliv LundAffiliated withInstitute of Community Medicine, University of Tromsø
    • , Fabio LeviAffiliated withRegistre Vaudois des Tumeurs
    • , Dimitrios LinosAffiliated withRadiation Epidemiology Branch, National Cancer Institute
    • , Elaine RonAffiliated withEpidemiology Branch, National Cancer Institute

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Objective: To obtain more precise estimates of the association between thyroid cancer and benign thyroid diseases and to elucidate the role of potential confounders or effect modifiers.

Methods: The original data from 12 case–control studies from the United States, Asia, and Europe were pooled. Based on 2094 women and 425 men with cancer of the thyroid and, respectively, 3248 and 928 control subjects, odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were obtained by conditional regression models, conditioning on study and age at diagnosis, and adjusting for age and radiotherapy.

Results: A history of hypothyroidism was not associated with cancer risk (pooled ORs = 0.9, 95% confidence interval, CI: 0.7–1.3 in women and 1.7, 95% CI: 0.3–11.7 in men). ORs for hyperthyroidism were 1.4 (95% CI: 1.0–2.1) in women and 3.1 (95% CI: 1.0–9.8) in men. In women, however, risk was lower in the absence of or after allowance for history of goiter. Pooled ORs for a history of goiter were 5.9 (95% CI: 4.2–8.1) in women and 38.3 (95% CI: 5.0–291.2) in men. Risk for a history of benign nodules/adenomas was especially high (OR = 29.9, 95% CI: 14.5–62.0, in women; 18 cases versus 0 controls in men). The excess risk for goiter and benign nodules/adenomas was greatest within 2–4 years prior to thyroid cancer diagnosis, but an elevated OR was present 10 years or more before cancer.

Conclusions: Goiter and benign nodules/adenomas are the strongest risk factors for thyroid cancer, apart from radiation in childhood.

goiter hyperthyroidism hypothyroidism thyroid adenoma thyroid cancer