Environmental, Lifestyle, and Anthropometric Risk Factors for Differentiated Thyroid Cancer in Cuba: A Case-Control Study

Abstract

Background: The incidence of differentiated thyroid carcinoma (DTC) is low in people of African origin and higher in populations living on islands, but there is no well-established explanation for these differences. Cuba is a multiethnic nation with people of African and Spanish descent. Until now, no study on the risk factors of DTC has focused on the Cuban population. Our aim is to establish the role of environmental and lifestyle factors and to relate anthropometric measurements to the risk of developing DTC in Cuba. Methods: We performed a case-control study of 203 DTC patients treated in two hospitals in Havana and 212 controls living in the area covered by these hospitals (i.e. parts of Havana and the municipality of Jaruco). Risk factors were analyzed using conditional logistic regression. Results: As has been shown by other studies, we found that non-African ethnicity, never smoking, parity, and high body mass index are risk factors significantly associated with DTC, whereas a history of exposure to ionizing radiation and level of education were not significantly related with disease development. Being rhesus factor-positive, having a personal history of benign thyroid disorder, agricultural occupation, and consumption of artesian well water were also associated with a significantly increased risk of developing DTC. Conclusions: The original findings reported here concern the risk of DTC that was associated with non-African ethnicity, positive rhesus factor, farming, and drinking water from an artesian well.

Thyroid Volume and Its Relation to Anthropometric Measures in a Healthy Cuban Population

“…A recent case-control study on thyroid cancer risk factors, which has been performed in Cuba [12], has shown that thyroid cancer risk was lower in populations of African origin and increased with parity and BSA. Being rhesus factor positive, having a personal history of benign thyroid disorder, an agricultural occupation and an artesian well as the main source of drinking water were also factors associated with a significantly increased risk of developing DTC.…”

“…In women, irregular cycles and menopause status were associated with a higher risk of DTC. On the other hand, thyroid cancer risk was lower in current or former smokers than in nonsmokers [12]. …”

“…The aim of this study was to describe the volume of the thyroid gland in a control population and to determine its correlation with anthropometric measures and other selected parameters which have been found to be significantly associated with thyroid cancer risk in a case-control study [12]. …”

Factores Asociados a la Recurrencia Tumoral en Mujeres con Carcinoma Diferenciado de Tiroides

“…En un metaanálisis que incluyó 282,137 pacientes con cáncer, el incremento del IMC fue relacionado con ligeros incrementos en el riesgo de CDCFT. Los riesgos estimados van desde 1.0 hasta 7.4 en mujeres, según estudios publicados [34,50,53].…”

“…En un metaanálisis que incluyó 282,137 pacientes con cáncer, el incremento del IMC fue relacionado con ligeros incrementos en el riesgo de CDCFT. Los riesgos estimados van desde 1.0 hasta 7.4 en mujeres, según estudios publicados [34,50,53].En relación al efecto de la obesidad sobre la agresividad de la enfermedad maligna tiroidea, Kim y col.[45] encontraron fenotipos de carcinoma de tiroides más agresivos, relacionados con el IMC; pero otros autores no han podido demostrar la relación entre obesidad y tasa de recurrencia en el CDCFT [30,54].Los posibles mecanismos implicados en esta relación llevan a varias hipótesis que Pappa y Alevizaki [31] tratan de esclarecer en una revisión sobre el tema.Ellos incluyen por un lado, el efecto que tiene la obesidad sobre la disregulación de la vía mitogénica en presencia de resistencia a la insulina, inflamación y estrés oxidativo, como comunes denominadores; en especial cuando existe una distribución central de la grasa. Pero estos aún no son uniformes y en algunos casos, hasta contradictorios [55,56].…”