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Background Various risk factors have been associated with the risk of thyroid cancer in observational studies. However, the causality of the risk factors is not clear given the susceptibility of confounding and reverse causation. A 2-sample Mendelian randomization approach was used to estimate the effect of potential risk factors on thyroid cancer risk. Methods Genetic instruments to proxy 55 risk factors were identified by genome-wide association studies (GWAS). Associations of these genetic variants with thyroid cancer risk were estimated in GWAS of the FinnGen Study (989 cases and 217,803 controls). A Bonferroni-corrected threshold of P=9.09×10 -4 was considered significant, and P<0.05 was considered to be suggestive of an association. Results Telomere length was significantly associated with increased thyroid cancer risk after correction for multiple testing (OR=4.68, 95%CI 2.35 to 9.31, P=1.12×10 -5). Suggestive associations with increased risk were noted for waist-to-hip ratio (OR=1.85, 95%CI 1.02 to 3.35, P=0.042) and diastolic blood pressure (OR=1.03, 95%CI 1.00 to 1.06, P=0.040). Suggestive associations were noted between hemoglobin A1c (HbA1c) (OR=0.20, 95%CI 0.05 to 0.82, P=0.025) and decreased risk of thyroid cancer. Risk of thyroid cancer was not associated with sex hormones and reproduction, developmental and growth, lipids, diet and lifestyle, or inflammatory factors (All P>0.05). Conclusion Our study identified several potential targets for primary prevention of thyroid cancer, including central obesity, diastolic blood pressure, HbA1c, as well as telomere length that should inform public health policy.

Background Metabolic syndrome (MetS) is now a common public health problem. Few researches have reported the relationship between MetS and the risk of renal cell cancer (RCC). To investigate the association of metabolic syndrome and its components with the risk of RCC in Chinese males, the study was performed in the Kailuan male cohort, a large prospective cohort study. Methods A total of 104,333 eligible males enrolled in the every 2-year health checkup were involved in the Kailuan male cohort study (2006-2015). Information on demographic and socioeconomic characteristics, lifestyle, medical history and laboratory tests at baseline entry was obtained. Univariable and multivariable Cox proportional hazards regression models were used to estimate the association between MetS and the RCC risk. Results During a median follow-up of 8.9 years, 131 RCC cases were verified over a total of 824,211.96 person-years. Among the 5 single MetS components, hypertension (Systolic/diastolic blood pressure≥130/85 mm Hg or antihypertensive drug treatment of previously hypertension) (HR = 2.35, 95%CI:1.48-3.72) and elevated triglyceride (TG) (≥1.7mmol/L) (HR = 1.78, 95%CI:1.23-2.56) showed significant risk for RCC. Multivariate analysis showed that compared to those who did not meet MetS diagnostic criteria (number of abnormal MetS components<3), HR of RCC risk for participants with MetS was 1.95 (95% CI 1.35-2.83). The number of abnormal MetS components was linearly associated with an increased risk of RCC (P trend<0.001), and the HRs of RCC risk for males with 1, 2 and ≥3 MetS components were 1.27 (0.56-2.90), 2.42 (1.12-5.20) and 3.32 (1.56-7.07), respectively, compared with subjects without MetS components. Conclusions MetS was inversely associated with of RCC risk in males. Key messages MetS might be one of the scientific and important predictors of RCC. Controlling metabolic syndrome may potentially have key scientific and clinical significance for RCC prevention.