TY - JOUR
T1 - Predictors for thyroid carcinoma in Israel
T2 - A national cohort of 1,624,310 adolescents followed for up to 40 years
AU - Farfel, Alon
AU - Kark, Jeremy D.
AU - Derazne, Estela
AU - Tzur, Dorit
AU - Barchana, Micha
AU - Lazar, Liora
AU - Afek, Arnon
AU - Shamiss, Ari
PY - 2014/6/1
Y1 - 2014/6/1
N2 - Introduction: Data on adolescent precursors of thyroid cancer in adulthood are scant. Methods: In order to evaluate potential risk factors for thyroid cancer, we linked two national data sources: the military recruitment health examinations and the Israel National Cancer Register. The study population (1,624,310 participants) included 1,145,865 Jewish males aged 16-19 years when examined between 1967 and 2005, and 478,445 Jewish females aged 16-19 years when examined between 1989 and 2005. The cancer follow-up extended up to 2006. Multivariable Cox proportional hazards modeling was used. Results: During 24,389,502 person years of follow-up, 760 incidence cases of thyroid cancer were identified. The mean age at diagnosis was 25.2 ± 4.2 years for women and 37.2 ± 10.0 years for men. Women had a substantially higher incidence (birth cohort-adjusted hazard ratio (HR) = 5.70 [95% CI 4.45-7.31]; p 0.001). Height predicted incidence in both sexes, with birth cohort-adjusted HRs of 1.03 ( p 0.001) in males and 1.04 ( p 0.001) in females, per 1 cm increment in height. In males, but not in females, there was a graded association between education, as measured by years of schooling, and incidence of thyroid cancer. Body mass index was not associated with incidence. In a multivariable analysis of 617,613 males and 469,185 females examined from 1989 onwards, which included sex, birth year, height, and education, the excess risk in females persisted strongly (HR = 5.67 [CI 4.30-7.13]), as did the association with height. Conclusions: Female sex, measured height in adolescence, and later birth cohorts were independent predictors of thyroid cancer in young and middle-aged adults in Israel. Further study is needed to unravel the mechanisms whereby height is associated with thyroid cancer.
AB - Introduction: Data on adolescent precursors of thyroid cancer in adulthood are scant. Methods: In order to evaluate potential risk factors for thyroid cancer, we linked two national data sources: the military recruitment health examinations and the Israel National Cancer Register. The study population (1,624,310 participants) included 1,145,865 Jewish males aged 16-19 years when examined between 1967 and 2005, and 478,445 Jewish females aged 16-19 years when examined between 1989 and 2005. The cancer follow-up extended up to 2006. Multivariable Cox proportional hazards modeling was used. Results: During 24,389,502 person years of follow-up, 760 incidence cases of thyroid cancer were identified. The mean age at diagnosis was 25.2 ± 4.2 years for women and 37.2 ± 10.0 years for men. Women had a substantially higher incidence (birth cohort-adjusted hazard ratio (HR) = 5.70 [95% CI 4.45-7.31]; p 0.001). Height predicted incidence in both sexes, with birth cohort-adjusted HRs of 1.03 ( p 0.001) in males and 1.04 ( p 0.001) in females, per 1 cm increment in height. In males, but not in females, there was a graded association between education, as measured by years of schooling, and incidence of thyroid cancer. Body mass index was not associated with incidence. In a multivariable analysis of 617,613 males and 469,185 females examined from 1989 onwards, which included sex, birth year, height, and education, the excess risk in females persisted strongly (HR = 5.67 [CI 4.30-7.13]), as did the association with height. Conclusions: Female sex, measured height in adolescence, and later birth cohorts were independent predictors of thyroid cancer in young and middle-aged adults in Israel. Further study is needed to unravel the mechanisms whereby height is associated with thyroid cancer.
UR - http://www.scopus.com/inward/record.url?scp=84902130117&partnerID=8YFLogxK
U2 - 10.1089/thy.2013.0173
DO - 10.1089/thy.2013.0173
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C2 - 24483833
AN - SCOPUS:84902130117
SN - 1050-7256
VL - 24
SP - 987
EP - 993
JO - Thyroid
JF - Thyroid
IS - 6
ER -