Impact of Overweight and Obesity on US Papillary Thyroid Cancer Incidence Trends (1995-2015) - PubMed (original) (raw)

Cari M Kitahara et al. J Natl Cancer Inst. 2020.

Abstract

Background: Since the early 1980s, papillary thyroid cancer (PTC) incidence rates and the prevalence of obesity, a risk factor for PTC, have increased substantially in the United States. We estimated the proportion of PTC incidence in the United States attributable to overweight and obesity during 1995-2015.

Methods: National Institutes of Health-AARP Diet and Health Study cohort data (n = 457 331 participants, 50-71 years and cancer-free at baseline) were used to estimate multivariable-adjusted hazard ratios (HRs) for PTC across body mass index categories. Population attributable fractions (PAFs) were calculated using estimated hazard ratios and annual overweight and obesity prevalence estimates from the National Health Interview Survey. PAF estimates were combined with Surveillance, Epidemiology, and End Results-13 data to calculate annual percent changes in PTC incidence rates attributable (and unrelated) to overweight and obesity.

Results: Overweight (25.0-29.0 kg/m2) and obesity (≥30.0 kg/m2) were associated with 1.26-fold (95% confidence interval [CI] = 1.05- to 1.52-fold) and 1.30-fold (95% CI = 1.05- to 1.62-fold) increased risks of PTC, respectively, and nearly threefold (HR = 2.93, 95% CI = 1.25 to 6.87) and greater than fivefold (HR = 5.42, 95% CI = 2.24 to 13.1) increased risks of large (>4 cm) PTCs compared with normal weight (18.5-24.9 kg/m2). During 1995-2015, PAF estimates for overweight and obesity increased from 11.4% to 16.2% for all PTCs and from 51.4% to 63.2% for large PTCs. Overweight or obesity accounted for 13.6% and 57.8% of the annual percent changes in total (5.9%/y) and large (4.5%/y) PTC incidence rates, respectively, during 1995-2015.

Conclusions: Overweight and obesity may have contributed importantly to the rapid rise in PTC incidence during 1995-2015. By 2015, we estimate that one of every six PTCs diagnosed among adults 60 years or older, including nearly two-thirds of large PTCs, were attributable to overweight and obesity.

© The Author(s) 2019. Published by Oxford University Press.

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Figures

Figure 1.

Figure 1.

Prevalence of overweight and obesity among those 50 years and older in the United States from National Health Interview Survey, 1985–2005. Obesity and overweight prevalence estimates for 1986, 1989, and 1996 were estimated by averaging the surrounding prevalence estimates.

Figure 2.

Figure 2.

Age-standardized incidence rates of papillary thyroid cancer among those 60 years and older in Surveillance, Epidemiology, and End Results-13, 1995–2015. Rates presented overall and stratified by overweight- and obesity-attributable and overweight- and obesity-unrelated cases. Annual population attributable fractions are also presented. Please note the 10-fold difference in scale of the _y_-axis.

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