학술논문
Risk of thyroid cancer following hysterectomy.
Document Type
Academic Journal
Author
Rahman ST; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh. Electronic address: sabbir.rahman@qimrberghofer.edu.au.; Pandeya N; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia. Electronic address: nirmala.pandeya@qimrberghofer.edu.au.; Neale RE; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia. Electronic address: rachel.neale@qimrberghofer.edu.au.; McLeod DSA; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. Electronic address: donald.mcleod@qimrberghofer.edu.au.; Baade PD; Cancer Council Queensland, Brisbane, QLD, Australia; Menzies Health Institute, Griffith University, Gold Coast, QLD, Australia. Electronic address: peterbaade@cancerqld.org.au.; Youl PH; Cancer Alliance Queensland, Metro South Hospital and Health Service, Woolloongabba, QLD, Australia. Electronic address: philippa.youl@health.gov.au.; Allison R; Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. Electronic address: rogerruthallison@gmail.com.; Leonard S; Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. Electronic address: awsbleonard@gmail.com.; Jordan SJ; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia. Electronic address: s.jordan@uq.edu.au.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101508793 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1877-783X (Electronic) Linking ISSN: 18777821 NLM ISO Abbreviation: Cancer Epidemiol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Hysterectomy has been associated with increased thyroid cancer risk but whether this reflects a biological link or increased diagnosis of indolent cancers due to greater medical contact remains unclear.
Methods: We recruited 730 women diagnosed with thyroid cancer and 785 age-matched population controls. Multivariable logistic regression was used to assess the association overall, and by tumour BRAF mutational status as a marker of potentially higher-risk cancers. We used causal mediation analysis to investigate potential mediation of the association by healthcare service use.
Results: Having had a hysterectomy was associated with an increased risk of thyroid cancer (odds ratio [OR] = 1.45, 95 % confidence interval [CI] 1.07-1.96). When stratified by indication for hysterectomy, the risk appeared stronger for those who had a hysterectomy for menstrual disorders (OR = 1.67, 95 % CI 1.17-2.37) but did not differ by tumour BRAF status. Approximately 20 % of the association between hysterectomy and thyroid cancer may be mediated by more frequent use of healthcare services.
Conclusions: The observed increased risk of thyroid cancer among those with hysterectomy may be driven, at least partly, by an altered sex steroid hormone milieu. More frequent healthcare service use by women with hysterectomy accounts for only a small proportion of the association.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Methods: We recruited 730 women diagnosed with thyroid cancer and 785 age-matched population controls. Multivariable logistic regression was used to assess the association overall, and by tumour BRAF mutational status as a marker of potentially higher-risk cancers. We used causal mediation analysis to investigate potential mediation of the association by healthcare service use.
Results: Having had a hysterectomy was associated with an increased risk of thyroid cancer (odds ratio [OR] = 1.45, 95 % confidence interval [CI] 1.07-1.96). When stratified by indication for hysterectomy, the risk appeared stronger for those who had a hysterectomy for menstrual disorders (OR = 1.67, 95 % CI 1.17-2.37) but did not differ by tumour BRAF status. Approximately 20 % of the association between hysterectomy and thyroid cancer may be mediated by more frequent use of healthcare services.
Conclusions: The observed increased risk of thyroid cancer among those with hysterectomy may be driven, at least partly, by an altered sex steroid hormone milieu. More frequent healthcare service use by women with hysterectomy accounts for only a small proportion of the association.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)