Impact of Overweight and Obesity on US Papillary Thyroid Cancer Incidence Trends (1995–2015)

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/obesity during 1995-2015. Methods NIH-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 HRs and annual overweight/obesity prevalence estimates from the National Health Interview Survey. PAF estimates were combined with Surveillance, Epidemiology, and End Results (SEER)-13 data to calculate annual percent changes (APC) in PTC incidence rates attributable (and unrelated) to overweight/obesity. Results Overweight (25.0-29.0 kg/m2) and obesity (≥30.0 kg/m2) were associated with 1.26-fold (95% CI 1.05-1.52) and 1.30-fold (95% CI 1.05-1.62) increased risks of PTC, respectively, and nearly 3-fold (HR = 2.93, 95% CI 1.25-6.87) and >5-fold (HR = 5.42, 95% CI 2.24-13.1) increased risks of large (>4 cm) PTCs, compared to normal-weight (18.5-24.9 kg/m2). During 1995-2015, PAF estimates for overweight/obesity increased from 11.4 to 16.2% for all PTCs and 51.4 to 63.2% for large PTCs. Overweight/obesity accounted for 13.6% and 57.8% of the APCs in total (5.9%/year) and large (4.5%/year) PTC incidence rates, respectively, during 1995-2015. Conclusion Overweight/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, including nearly two-thirds of large PTCs, were attributable to overweight/obesity.

Obesity Is Associated withBRAFV600E-Mutated Thyroid Cancer

“…Several studies have examined the relationship between obesity (measured by body mass index [BMI]) and thyroid cancer risk. Most (4)(5)(6)(7)(8)(9), but not all (10,11), suggest that obesity is associated with increased thyroid cancer risk in both women and men. However, it is possible that the observed association does not reflect a biological relationship between obesity and thyroid cancer but instead could reflect more frequent use of health care services by people who are overweight or obese (12,13), with consequent increased opportunity for ascertainment of indolent thyroid lesions.…”

Understanding the ever-changing incidence of thyroid cancer

“…Please note the 10-fold difference in scale of the y axes. Adapted with permission from reF 10 ,. Oxford University Press.…”

“…For example, studies have shown that obesity might be more strongly associated with the risk of PTC characterized by suspicious or aggressive tumour features than PTC lacking these features 9 . Combining information from cohort, survey and cancer registry data, our research team estimated that about 16% of all PTCs (63% of large PTCs) diagnosed in 2013–2015 in the USA were attributable to overweight and obesity 10 . In the absence of overweight and obesity, PTC incidence trends would have been attenuated by about 14% (58% for large PTCs) (Fig.…”

Epidemiología del cáncer de tiroides en un Instituto Oncológico. Efecto de las nuevas recomendaciones clínicas

“…Es importante establecer que factores de riesgo explican la alta y creciente incidencia de CT en nuestro país. En los últimos años se han asociado con mayor riesgo de CT, además de la exposición a radiación, la obesidad, el sedentarismo y la diabetes mellitus 2 [19][20][21] , contaminantes químicos como bisfenol A y cadmio 21,22 , la baja ingesta de yodo y la ingesta excesiva de nitritos 24,25 y factores reproductivos en la mujer 26 .…”