Parity and risk of thyroid cancer: a nested case-control study of a nationwide Swedish cohort (original) (raw)

Abstract

The association between parity and risk of thyroid cancer was examined in a case-control study nested within a cohort of Swedish women born 1925–60. A total of 1,409 cases of thyroid cancer were compared with 7,019 agematched controls. Odds ratios (OR) and 95 percent confidence intervals (CI) were calculated as estimates of relative risk. A weak association was found between parity and risk of thyroid cancer (OR for ever-parous women cf nulliparous was 1.1, CI=1.0–1.3). For the subset of papillary cancers, there was a significantly increased risk (OR for ever-parous cf nulliparous = 1.3, CI=1.0–1.6), and among women diagnosed at the age of 50 or older, there was a positive linear trend with increasing number of livebirths. Women during the first year after a livebirth had an increased risk of thyroid cancer compared with women who delivered 10 or more years before; this association was most prominent among uniparous women (OR=2.5, CI=1.1–5.9). An increased risk was also apparent for age over 20 years at livebirth (among uniparous women) and age over 25 years at last livebirth (among multiparous women). A negligible effect of parity on thyroid cancer risk was seen, but each livebirth may have a short-term and age-dependent promoting effect.

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References

  1. Parkin DM, Muir CS, Whelan SL, Gao YT, Fenlay J, Powell J. Cancer Incidence in Five Continents Vol. VI. Lyon, France: International Agency for Research on Cancer, 1992; LARC Sci. Pub. No. 120.
    Google Scholar
  2. dos Santos Silva I, Swerdlow AJ. Sex differences in the risks of hormone-dependent cancers. Am J Epidemiol 1993; 138: 10–28.
    Google Scholar
  3. Franssila KO, Harach HR. Occult papillary carcinoma of the thyroid in children and young adults. A systemic autopsy study in Finland. Cancer 1986 58: 715–9.
    Google Scholar
  4. Martinez-Tello F, Cabruja-Martinez R, Fernandez-Martin J, Lasso-Oria C, Ballestrin-Carcavilla C. Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods. Cancer 1993; 71: 4022–9.
    Google Scholar
  5. Preston-Martin S, Bernstein L, Pike MC, Maldonado AA, Henderson BE. Thyroid cancer among young women related to prior thyroid disease and pregnancy history. Br J Cancer 1987; 55: 191–5.
    Google Scholar
  6. Ron E, Kleinermann RA, Boice JDJr, Li Volsi VA, Flannery JT, Fraumeni JFJr. A population-based case-control study of thyroid cancer. JNCI 1987; 79: 1–12.
    Google Scholar
  7. Franceschi S, Fassina A, Talamini R, et al. The influence of reproductive and hormonal factors on thyroid cancer in women. Rev Epidemiol Sante Publique 1990; 38: 27–34.
    Google Scholar
  8. Kravdal Ö, Glattre E, Haldorsen T. Positive correlation between parity and incidence of thyroid cancer: new evidence based on complete Norwegian birth cohorts. Int J Cancer 1991; 49: 831–6.
    Google Scholar
  9. Preston-Martin S, Jin F, Duda MJ, Mack WJ. A case-control study of thyroid cancer in women under age 55 in Shanghai (People's Republic of China). Cancer Causes Control 1993; 4: 431–40.
    Google Scholar
  10. Kolonel LN, Hankin JH, Wilkens LR, Fukunaga FH, Hinds MW. An epidemiologic study of thyroid cancer in Hawaii. Cancer Causes Control 1990; 1: 223–34.
    Google Scholar
  11. Akslen LA, Nilssen S, Kvåle G. Reproductive factors and risk of thyroid cancer. A prospective study of 63,090 women from Norway. Br J Cancer 1992; 65: 772–4.
    Google Scholar
  12. La Vecchia C, Negri E, Franceschi S, Parazzini F. Long term impact of reproductive factors in cancer risk. Int J Cancer 1993; 53: 215–9.
    Google Scholar
  13. The Cancer Registry. Cancer Incidence in Sweden, 1960. Stockholm, Sweden National Board of Health, 1963.
    Google Scholar
  14. World Health Organization. International Classification of Diseases, Seventh Revision, Geneva, Switzerland: WHO, 1957.
    Google Scholar
  15. Pettersson B, Adami HO, Wilander E, Coleman MP. Trends in thyroid cancer incidence in Sweden, 1958–1981, by histopathologic type. Int J Cancer 1991; 48: 28–33.
    Google Scholar
  16. Hedinger C, Williams ED, Sobin LH. Histological typing of thyroid tumours. In: World Health Organization. International Histological Classification of Tumors. Second Edition. Berlin, Germany: Springer-Verlag, 1988.
    Google Scholar
  17. Pearce N. What does the odds ratio estimate in a case-control study? Int J Epidemiol 1993; 22: 1189–92.
    Google Scholar
  18. Breslow NE, Day NE. Statistical Methods in Cancer Research Vol. 1. The Analysis of Case-control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.
    Google Scholar
  19. Levi F, Franceschi S, Gulie C, Negri E, La Vecchia C. Female thyroid cancer: the role of reproductive and hormonal factors in Switzerland. Oncology 1993; 50: 309–15.
    Google Scholar
  20. McTiernan AM, Weiss NS, Daling JR. Incidence of thyroid cancer in women in relation to reproductive and hormonal factors. Am J Epidemiol 1984; 120: 423–35.
    Google Scholar
  21. Sjöberg K-H, Sundlöf G. Strumasjukdomen före och efter jodprofylaxen. Lakartidningen 1971; 68: 980–4.
    Google Scholar
  22. Panagiotopoulou K, Katsouyanni K, Petridou E, Garas Y, Tzonou A, Trichopoulos D. Maternal age, parity, and pregnancy estrogens. Cancer Causes Control 1990; 1: 119–24.
    Google Scholar
  23. Cruikshank DP, Hays PM. Maternal physiology in pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics. Normal and Problem Pregnancies. New York, Edinburgh, London, Melbourne: Churchill Livingstone, 1986: 151–2.
    Google Scholar
  24. Glinoer D, Fernandez Soto M, Bourdoux P, et al. Pregnancy in patients with mild thyroid abnormalities: maternal and neonatal repercussions. J Clin Endocrinol Metab 1991; 73: 421–7.
    Google Scholar
  25. Haas JF. Pregnancy in association with a newly diagnosed cancer: a population-based epidemiologic assessment. Int J Cancer 1984; 34: 229–35.
    Google Scholar
  26. Pekonen F, Alfthan H, Stenman UH, Ylikorkala O. Human chorionic gonadotropin (hCG) and thyroid function in early human pregnancy: circadian variation and evidence for intrinsic thyrotropic activity of hCG. J Clin Endocrinol Metab 1988; 66: 853–6.
    Google Scholar
  27. Glinoer D, De Nayer P, Bourdoux P, et al. Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab 1990; 71: 276–87.
    Google Scholar
  28. Mori M, Naito M, Watanabe H, Takeichi N, Kiyohiko D, Ito A. Effects of sex difference, gonadectomy, and estrogen on N-methyl-N-nitrosourea induced rat thyroid tumors. Cancer Res 1990; 50: 7662–7.
    Google Scholar
  29. Bernstein L, Depue RH, Ross RK, Judd HL, Pike MC, Henderson BE. Higher maternal levels of free estradiol in first compared to second pregnancy: early gestational differences. JNCI 1986; 76: 1035–9.
    Google Scholar
  30. Musey VC, Collins DC, Brogan DR, et al. Long term effects of a first pregnancy on the hormonal environment: estrogens and androgens. J Clin Endocrinol Metab 1987; 64: 111–8.
    Google Scholar

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Authors

  1. Maria Rosaria Galanti
  2. Mats Lambe
  3. Anders Ekbom
  4. Pär Sparén

Additional information

Authors are with the Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden (M.R. Galanti, M. Lambe, A. Ebbora, R. Sparda B. Pettersson): Department of Social Medicine, University Hospital, Uppsala, Sweden (M. Lambe); Department of Epidemiology, Harvard School of Public Health, Boston, USA (A. Ekbom). Address correspondence to Dr M. Rosaria Galanti, Department of Cancer Epidemiology, University Hospital, S-751 85 Uppsala, Sweden. This work was supported in part by grant n. 3136-B92-02XBB from the Swedish Cancer Society.

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Galanti, M.R., Lambe, M., Ekbom, A. et al. Parity and risk of thyroid cancer: a nested case-control study of a nationwide Swedish cohort.Cancer Causes Control 6, 37–44 (1995). https://doi.org/10.1007/BF00051679

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