Cancer Causes & Control

, Volume 10, Issue 6, pp 583–595

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


  • Silvia Franceschi
    • Servizio di EpidemiologiaCentro di Riferimento Oncologico
  • Susan Preston-Martin
    • Department of Preventive MedicineUniversity of Southern California
  • Luigino Dal Maso
    • Servizio di EpidemiologiaCentro di Riferimento Oncologico
  • Eva Negri
    • Istituto di Ricerche Farmacologiche “Mario Negri”
  • Carlo La Vecchia
    • Istituto di Ricerche Farmacologiche “Mario Negri”
    • Istituto di Statistica Medica e BiometriaUniversità degli Studi di Milano
  • Wendy J. Mack
    • Department of Preventive MedicineUniversity of Southern California
  • Anne McTiernan
    • Fred Hutchinson Cancer Research Center
  • Laurence Kolonel
    • Cancer Research Center of HawaiiUniversity of Hawaii at Manoa
  • Steven D. Mark
    • Division of Cancer Epidemiology and GeneticsNational Cancer Institute
  • Kiyohiko Mabuchi
    • Radiation Effects Research Foundation
  • Fan Jin
    • Shanghai Cancer Institute
  • Gun Wingren
    • Department of Health and Environment, Division of Occupational and Environmental MedicineLinköping University
  • Rosaria Galanti
    • Centrum för Tobakprevention
  • Arne Hallquist
    • Stockholm Sjukhem
  • Eystein Glattre
    • Cancer Registry of Norway
  • Eiliv Lund
    • Institute of Community MedicineUniversity of Tromsø
  • Fabio Levi
    • Registre Vaudois des Tumeurs
  • Dimitrios Linos
    • Radiation Epidemiology BranchNational Cancer Institute
  • Elaine Ron
    • Epidemiology BranchNational Cancer Institute

DOI: 10.1023/A:1008907227706

Cite this article as:
Franceschi, S., Preston-Martin, S., Maso, L.D. et al. Cancer Causes Control (1999) 10: 583. doi:10.1023/A:1008907227706


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.

goiterhyperthyroidismhypothyroidismthyroid adenomathyroid cancer
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© Kluwer Academic Publishers 1999