Cancer Causes & Control

, Volume 23, Issue 10, pp 1615–1624 | Cite as

Cigarette smoking, alcohol intake, and thyroid cancer risk: a pooled analysis of five prospective studies in the United States

  • Cari M. Kitahara
  • Martha S. Linet
  • Laura E. Beane Freeman
  • David P. Check
  • Timothy R. Church
  • Yikyung Park
  • Mark P. Purdue
  • Catherine Schairer
  • Amy Berrington de González
Original paper



We examined the associations between cigarette smoking, alcohol intake, and thyroid cancer risk in a pooled analysis of five prospective studies.


Data from five prospective U.S. studies were standardized and then combined into one aggregate dataset (384,433 men and 361,664 women). Pooled hazard ratios (HR) and 95 % confidence intervals (CI) for thyroid cancer were estimated from mutually adjusted models of cigarette smoking and alcohol intake, which were additionally adjusted for age, sex, education, race, marital status, body mass index, and cohort.


Over follow-up, 1,003 incident thyroid cancer cases (335 men and 668 women) were identified. Compared to never smokers, current smoking was associated with reduced risk of thyroid cancer (HR = 0.68, 95 % CI 0.55–0.85); this association was slightly stronger among non-drinkers (HR = 0.46, 95 % CI 0.29–0.74). No reduction in risk was observed for former, compared to never, smokers. Greater smoking intensity, duration, and pack-years were associated with further reductions in risk among former and current smokers. Alcohol intake was also inversely associated with thyroid cancer risk (≥7 drinks/week versus 0, HR = 0.72, 95 % CI 0.58–0.90, p trend = 0.002). Inverse associations with smoking and alcohol were more pronounced for papillary versus follicular tumors.


The results of this pooled analysis suggest that both cigarette smoking and alcohol consumption are associated with reduced risks of papillary thyroid cancer and, possibly, follicular thyroid cancer.


Thyroid neoplasms Cigarette smoking Alcohol intake Prospective study Epidemiology 

Supplementary material

10552_2012_39_MOESM1_ESM.docx (26 kb)
Supplementary material 1 (DOCX 26 kb)


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Copyright information

© Springer Science+Business Media B.V. (outside the USA)  2012

Authors and Affiliations

  • Cari M. Kitahara
    • 1
  • Martha S. Linet
    • 2
  • Laura E. Beane Freeman
    • 2
  • David P. Check
    • 2
  • Timothy R. Church
    • 3
  • Yikyung Park
    • 2
  • Mark P. Purdue
    • 2
  • Catherine Schairer
    • 2
  • Amy Berrington de González
    • 2
  1. 1.Division of Cancer Epidemiology and Genetics, National Cancer InstituteNational Institutes of HealthRockvilleUSA
  2. 2.Division of Cancer Epidemiology and Genetics, National Cancer InstituteNational Institutes of HealthRockvilleUSA
  3. 3.Division of Environmental Health SciencesUniversity of Minnesota School of Public HealthMinneapolisUSA

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