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Risk of thyroid cancer among Caribbean Hispanic patients with familial adenomatous polyposis

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Abstract

Familial adenomatous polyposis (FAP) is an inherited form of colorectal cancer characterized by hundreds of adenomatous polyps in the colon and rectum. FAP is also associated with thyroid cancer (TC), but the lifetime risk is still unclear. This study reports the standardized incidence ratio (SIR) of TC in Hispanic FAP patients. TC incidence rates in patients with FAP between the periods of January 1, 2006 to December 31, 2013 were compared with the general population through direct database linkage from the Puerto Rico Central Cancer Registry (PRCCR) and the Puerto Rico Familial Colorectal Cancer Registry (PURIFICAR). The study population consisted of 51 Hispanic patients with FAP and 3239 with TC from the general population. The SIR was calculated using the Indirect Method, defined as observed TC incidence among patients with FAP in PURIFICAR’s cohort (2006–2013) divided by the expected TC incidence based on the PR population rates (2006–2010). SIR values were estimated by sex (male, female, and overall). This study received IRB approval (protocol #A2210207). In Hispanic patients with FAP, the SIR (95 % CI) for TC was 251.73 (51.91–735.65), with higher risk for females 461.18 (55.85–1665.94) than males 131.91 (3.34–734.95). Hispanic FAP patients are at a high risk for TC compared to the general population. Our incidence rates are higher than previous studies, suggesting that this community may be at a higher risk for TC than previously assumed. Implementation of clinical surveillance guidelines and regular ultrasound neck screening in Hispanic FAP patients is recommended.

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Abbreviations

FAP:

Familial adenomatous polyposis

CRC:

Colorectal cancer

TC:

Thyroid cancer

PRCCR:

Puerto Rico Central Cancer Registry

PURIFICAR:

Puerto Rico Familial Colorectal Cancer Registry

SIR:

Standardized incidence ratio

PRH:

Puerto Rican Hispanic

CMV-PTC:

Cribriform–morular variant of papillary thyroid cancer

PR:

Puerto Rico

UPR:

University of Puerto Rico

ICD-O3:

International Classification of Disease for Oncology

IHC:

Immunohistochemistry

APC :

Adenomatous polyposis coli

US:

United States

CDC:

Centers for Disease Control and Prevention

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Acknowledgments

The authors are grateful to the Puerto Rico Central Cancer Registry, Drs. Guillermo Tortolero and Diego Zavala, the Puerto Rico Colorectal Cancer Coalition and Puerto Rico Gastroenterology Association.

Grant support

This study was supported by the following: National Institute on Minority & Health Disparities Award Numbers 8U54MD007587-03 and U54MD007587; National Cancer Institute Award Numbers R01CA134620, R21CA167220-01, 5R03CA130034-02, P50CA62924, and U54CA096297/CA096300; Center for Collaborative Research in Health Disparities RCMI Award Number G12MD007600.

Author contributions

N.C.C., Y.D.A., M.S.S., and M.C.C. developed the study concept, participated in the statistical analysis and interpretation of the data. N.C.C., Y.D.A., M.C.C., and M.G.P. were major contributors in the drafting of the manuscript. C.B.R., V.C.C. and S.R.Q. helped acquire subject clinical data and intellectual content. N.R.M., F.M.G., and J.P.M. performed critical revisions of the manuscript for important intellectual content.

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Authors and Affiliations

  1. University of Puerto Rico Comprehensive Cancer Center, PMB 711 Ave. 89 Ste. 105, San Juan, PR, 00927-6346, USA

    Nicolás Casellas-Cabrera, Yaritza Díaz-Algorri, María González-Pons, Natalia Rodríguez-Mañón, Julyann Pérez-Mayoral, Carlos Bertrán-Rodríguez & Marcia Cruz-Correa

  2. Puerto Rico Pathology, 1760 Calle Loíza Cond. Madrid Suite 206, San Juan, PR, 00911, USA

    Víctor J. Carlo-Chévere

  3. Department of Medicine, University of Puerto Rico, Medical Sciences Campus, PO BOX 365067, San Juan, PR, 00936-5067, USA

    Marcia Cruz-Correa

  4. Department of Biochemistry, University of Puerto Rico, Medical Sciences Campus, PO BOX 365067, San Juan, PR, 00936-5067, USA

    Marcia Cruz-Correa

  5. Department of Surgery, University of Puerto Rico, Medical Sciences Campus, PO BOX 365067, San Juan, PR, 00936-5067, USA

    Segundo Rodríguez-Quilichini & Marcia Cruz-Correa

  6. UPR/MDACC Partnership for Excellence in Cancer Research Program, University of Puerto Rico, Medical Sciences Campus, PMB 371 PO BOX 70344, San Juan, PR, 00936-8344, USA

    María González-Pons, Natalia Rodríguez-Mañón, Marievelisse Soto-Salgado & Marcia Cruz-Correa

  7. Doctoral Program in Public Health with Specialty in Social Determinants of Health, Department of Social Sciences, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, PO BOX 365067, San Juan, PR, 00936-5067, USA

    Marievelisse Soto-Salgado

  8. Division of Gastroenterology, Department of Medicine, Johns Hopkins University, 600 N. Wolfe Street Sheikh Zayed Tower, Baltimore, MD, 21287, USA

    Francis M. Giardiello & Marcia Cruz-Correa

Authors
  1. Nicolás Casellas-Cabrera
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  2. Yaritza Díaz-Algorri
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  3. Víctor J. Carlo-Chévere
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  4. María González-Pons
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  5. Natalia Rodríguez-Mañón
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  6. Julyann Pérez-Mayoral
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  7. Carlos Bertrán-Rodríguez
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  8. Marievelisse Soto-Salgado
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  9. Francis M. Giardiello
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  10. Segundo Rodríguez-Quilichini
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  11. Marcia Cruz-Correa
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Corresponding author

Correspondence to Marcia Cruz-Correa.

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The authors have no potential conflicts to disclose. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Casellas-Cabrera, N., Díaz-Algorri, Y., Carlo-Chévere, V.J. et al. Risk of thyroid cancer among Caribbean Hispanic patients with familial adenomatous polyposis. Familial Cancer 15, 267–274 (2016). https://doi.org/10.1007/s10689-015-9862-4

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  • DOI: https://doi.org/10.1007/s10689-015-9862-4

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