Thyroid最新文献

{"title":"Graves' Disease and the Risk of Type 2 Diabetes: A Korean Population-Based Study.","authors":"Yoon Young Cho, Bongseong Kim, Sang-Man Jin, Chan-Hee Jung, Ji Oh Mok, Sun Wook Kim, Jae Hoon Chung, Kyung-Do Han, Tae Hyuk Kim","doi":"10.1089/thy.2024.0270","DOIUrl":"10.1089/thy.2024.0270","url":null,"abstract":"<p><p><b><i>Background:</i></b> Several meta-analyses have found no association between Graves' disease (GD) and an increased risk of incident diabetes; however, the intricate relationship between thyroid dysfunction and diabetes remains underexplored. In this study, we aimed to evaluate the risk of incident type 2 diabetes (T2DM) in a population newly diagnosed with GD, focusing on different treatment methods and treatment duration. <b><i>Methods:</i></b> This was a retrospective population-based study utilizing data from the Korean National Health Insurance database. We included 36,243 patients with GD and 36,243 controls, matched with age and sex. We calculated the incidence of T2DM among patients and controls based on treatment methods, such as medical therapy, radioactive iodine therapy (RAIT), and surgery. We examined the cumulative dose and duration of antithyroid drug (ATD) use for each patient. <b><i>Results:</i></b> The majority of patients (34,867, 96.2%) were treated with ATDs, followed by RAIT (1093 patients, 3%), and surgery (283 patients, 0.8%). After adjusting for age; sex; income; comorbidities, including hypertension, dyslipidemia, and cancer; body mass index; smoking; drinking; and exercise, patients with GD exhibited a higher risk of developing diabetes (hazard ratio [HR] = 1.13 [95% confidence interval 1.06-1.21]) than controls (5.1% vs. 4.5%, respectively). While the risk was the highest within the first six months after GD diagnosis (HR = 3.21), it was significant between six months and two years (HR = 1.36) and was comparable with the controls two years after GD diagnosis (HR = 0.93). A longer duration of ATD treatment and a higher cumulative dose were associated with an increased risk of diabetes. However, the risks for T2DM did not differ according to treatment modality or clinical outcomes, which was probably related to the small number of patients in each subgroup. <b><i>Conclusions:</i></b> Our findings highlight the negative impact of GD on the development of T2DM. Patients newly diagnosed with GD can be considered for diabetes screening to facilitate early detection and intervention.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"60-68"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Hospital Safety-Net Burden on Outcomes for High-Volume Thyroid Cancer Surgeons.","authors":"Hattie H Huston-Paterson, Yifan V Mao, Chi-Hong Tseng, Jiyoon Kim, Debbie W Chen, James X Wu, Michael W Yeh","doi":"10.1089/thy.2024.0268","DOIUrl":"10.1089/thy.2024.0268","url":null,"abstract":"<p><p><b><i>Background:</i></b> Higher center and surgeon volume correspond to better outcomes for patients with thyroid cancer. This study aims to investigate how a hospital's safety-net burden, the proportion of a hospital's patients who are insured by state Medicaid plans or are uninsured, influences the outcomes of high-volume (HV) surgeons. <b><i>Methods:</i></b> We performed a retrospective cohort study of all patients who underwent surgery for thyroid cancer in California from 1999 to 2017. We stratified treating facilities by the proportion of Medicaid-type and indigent payors into safety-net burden quartiles. We compared the perioperative and oncologic outcomes of HV surgeons (annual case volume ≥10) for patients undergoing total thyroidectomy across safety-net burden quartiles. A mixed-effects regression model controlled for surgeon random effects and fixed effects of patient and tumor characteristics. <b><i>Results:</i></b> Our sample comprised 42,347 patients (78% female, median age 50), of whom 13,848 (32%) were treated by HV surgeons (<i>n</i> = 276). Compared to patients of lower-volume surgeons, patients of HV surgeons were more likely to be White, from the upper quartiles of socioeconomic status and well insured (all <i>p</i> < 0.001). HV surgeons in each hospital's safety-net burden quartile displayed similar case number distributions. Compared to patients treated by HV surgeons at Q1 (lowest safety-net burden) hospitals, those treated by HV surgeons at Q4 (highest safety-net burden) hospitals had higher absolute risks of endocrine complications (+7%, <i>p</i> = 0.007), airway complications (+6%, <i>p</i> = 0.004), disease-specific mortality (+1.3%, <i>p</i> = 0.046), and all-cause mortality during the study period (+3%, <i>p</i> = 0.046) in multivariable analysis. <b><i>Conclusion:</i></b> The performance of HV thyroid cancer surgeons differs by a hospital's safety-net burden, with patients treated at high safety-net burden hospitals experiencing higher rates of operative complications, disease-specific mortality, and all-cause mortality. Having a HV surgeon alone may be insufficient to provide optimal short- and long-term outcomes for patients with thyroid cancer.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"50-59"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Fine-Needle Aspiration Is Safe and Well-Tolerated in Children.","authors":"Sara Mazzantini, Christine E Cherella, Cynthia Graziano, Ann Damian, Bethany Furlong, Jean C Solodiuk, Danielle M Richman, Jessica R Smith, Ari J Wassner","doi":"10.1089/thy.2024.0549","DOIUrl":"10.1089/thy.2024.0549","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"111-114"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the Incidence, Organization of Care, and Surgical Treatment of Medullary Thyroid Cancer: A Population-Based Study.","authors":"Eline C Jager, Madelon J H Metman, Inger A C Timmenga, Wouter T Zandee, Liesbeth Jansen, Bettien M van Hemel, Lutske Lodewijk, Menno R Vriens, Medard F M van den Broek, Anton F Engelsman, Koen M A Dreijerink, Romana T Netea-Maier, Tessa M van Ginhoven, Robin P Peeters, Eline de Heus, Thera P Links, Schelto Kruijff","doi":"10.1089/thy.2024.0433","DOIUrl":"10.1089/thy.2024.0433","url":null,"abstract":"<p><p><b><i>Background:</i></b> Medullary thyroid cancer (MTC) is a rare cancer with variable disease course. To enable optimal care, centralization and consensus guidelines are essential. This study describes trends in the incidence, organization of care, surgical treatment, and outcomes of MTC over 30 years in the Netherlands. <b><i>Methods:</i></b> All patients with a histological MTC diagnosis between 1989 and 2018 were identified from the Netherlands Cancer Registry and linked to the Dutch Pathology register (PALGA). Incidence rates, relative to the Dutch population, were assessed throughout time. Clinicopathological parameters and extent of lymph node (LN) surgery were extracted from PALGA pathology reports. Period A (1989-1998), period B (1999-2008), and period C (2009-2018) were compared. <b><i>Results:</i></b> Throughout 30 years, the population-adjusted incidence remained stable with 0.17 ± 0.04 diagnoses per 100,000 people per year (<i>p</i> = 0.247). Of all 795 patients, 54% were female and 63% were treated in an academic hospital, at a median age of 48 years (interquartile range [IQR] 34-61). Age at diagnosis increased over time from 42 years (IQR 25-61) in period A to 52 years (IQR 42-63) in period C (<i>p</i> < 0.001). The proportion of treatments occurring in an academic hospital increased from 41% of patients in period A to 58% and 86% in period B and C, respectively (both <i>p</i> < 0.001). At primary treatment, a LN dissection was performed in 582 (73%) patients. Of these patients, 88%, 36%, and 20% underwent a central neck dissection (CND), unilateral neck dissection, and bilateral neck dissection, respectively. CND was performed more frequently in period C (93%) than in period A (77%) or B (87%) (<i>p</i> = 0.009, <i>p</i> = 0.027, respectively). Overall survival improved from period A (55%) to C (88%) and B (65%) to C (<i>p</i> = 0.022, <i>p</i> = 0.007, respectively). Locoregional recurrence rates remained stable. <b><i>Conclusions:</i></b> This study shows a stable incidence and improved survival of MTC in the Dutch population over the last three decades. In addition, these data indicate a transition of treatment to academic hospitals, likely due to centralization, and a higher rate of CNDs, following the introduction of recommendation guidelines.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"87-96"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"35th Anniversary of Thyroid-Journal of the American Thyroid Association.","authors":"Anna M Sawka","doi":"10.1089/thy.2024.0739","DOIUrl":"10.1089/thy.2024.0739","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1-2"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild Gestational Hypothyroidism in Mice Has Transient Developmental Effects and Long-Term Consequences on Neuroendocrine Systems.","authors":"Clarisse Quignon, Annika Backer, Jessica Kearney, Hannah Bow, Susan Wray","doi":"10.1089/thy.2024.0512","DOIUrl":"10.1089/thy.2024.0512","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyroid hormones (TH) play a key role in fetal brain development. While severe thyroid dysfunction, has been shown to cause neurodevelopmental and reproductive disorders, the rising levels of TH-disruptors in the environment in the past few decades have increased the need to assess effects of subclinical (mild) TH insufficiency during gestation. Since embryos do not produce their own TH before mid-gestation, early development processes rely on maternal production. Notably, the reproductive network governed by gonadotropin-releasing hormone (GnRH) neurons develops during this critical period. <b><i>Methods:</i></b> The risk of mild maternal hypothyroidism on the development of GnRH neurons and long-term effect on neuroendocrine function in the offspring was investigated using a mouse model of gestational hypothyroidism induced by methimazole (MMI) treatment. <b><i>Results:</i></b> MMI treatment during gestation led to reduced litter size, consistent with increased miscarriages due to hypothyroidism. E12/13 embryos, collected from MMI-treated dams, had a decreased number of GnRH neurons, but the migration of the remaining GnRH neurons was normal. Cell proliferation was reduced in the vomeronasal organ (VNO), correlating with the reduced number of GnRH neurons detected in this region. Using a GnRH cell line confirmed attenuated proliferation in the absence of T3. Pups born from hypothyroid mothers had normal postweaning growth and estrus cycles, yet adult offspring had significantly more cells expressing estrogen receptor alpha in the arcuate nucleus. Notably, by adulthood, GnRH cell number and distribution was comparable with nontreated controls indicating that compensatory mechanisms occurred after E13. <b><i>Conclusion:</i></b> Overall, our work shows that mild TH disruption during gestation transiently affects proliferation of the pool of GnRH neurons within the VNO and has a long-term impact on neuroendocrine systems.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"97-110"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Extraocular Muscle Enlargement in Graves' Orbitopathy and Acromegaly.","authors":"Chris Zajner, Nikhil Patil, Rachel McInnis, Stan Van Uum, Alexander Fraser, Pavlo Ohorodnyk, Lulu L C D Bursztyn","doi":"10.1089/thy.2024.0438","DOIUrl":"https://doi.org/10.1089/thy.2024.0438","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Extraocular muscle (EOM) enlargement occurs in both acromegaly and Graves' disease, but the degree and pattern of enlargement have not been directly compared in these patient groups. This study investigated whether acromegaly and Graves' orbitopathy (GO) are associated with different patterns of EOM enlargement at the time of diagnosis. <b><i>Study Design:</i></b> Retrospective cohort. <b><i>Methods:</i></b> All new patients with a diagnosis of acromegaly or GO who presented to St Joseph's Health Care in London, Ontario, between January 1, 2015, and July 1, 2020, and who underwent computed tomography (CT) scanning with adequate orbital imaging were considered for inclusion. We included age- and sex-matched control patients with pituitary macroadenomas without thyroid or growth hormone abnormalities. Orbital CT scans were analyzed by a single neuroradiologist, who measured the maximum diameter and cross-sectional area of each EOM. The relative likelihood of involvement of each rectus EOM was analyzed separately using an analysis of variance test. <b><i>Results:</i></b> We included 16 patients with GO, 17 with acromegaly, and 18 controls. Ages (mean ± standard deviation) of groups were 55.6 ± 18.0, 50.2 ± 15.7, and 49.3 ± 14.0 years. The mean maximum diameter of EOMs in GO, acromegaly, and controls was inferior rectus (IR) = 4.77 ± 1.53, 4.66 ± 0.61, and 3.68 ± 0.61 mm; medial rectus (MR) = 5.35 ± 2.23, 4.84 ± 0.81, and 3.65 ± 0.42 mm; superior rectus (SR) = 4.94 ± 1.84, 4.88 ± 0.91, and 3.68 ± 0.61 mm; and lateral rectus (LR) = 3.91 ± 1.59, 4.55 ± 0.60, and 3.20 ± 0.43 mm. The IR, MR, and SR muscles were significantly larger in the GO group compared with controls (IR, <i>p</i> = 0.020; SR, <i>p</i> = 0.004; MR, <i>p</i> < 0.001; and LR, <i>p</i> = 0.166), and all four EOMs were larger in acromegaly compared with controls (IR, <i>p</i> = 0.039; SR, <i>p</i> = 0.006; MR, <i>p</i> = 0.006; and LR, <i>p</i> = 0.001). There was no significant difference between the GO and acromegaly groups (IR, <i>p</i> = 0.959; SR, <i>p</i> = 0.987; MR, <i>p</i> = 0.408; and LR, <i>p</i> = 0.250). <b><i>Conclusions:</i></b> GO and acromegaly groups demonstrated the enlargement of the IR, MR, and SR muscles when compared with controls. The GO group did not show significantly larger EOM sizes compared with the acromegaly group. In the GO group, the IR, MR, and SR were similarly affected and did not follow previously described patterns of enlargement in GO.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Ultrasound Rates Mirror Sex Disparities in Thyroid Cancer.","authors":"Sara Fernandes-Taylor, Erin J Aiello Bowles, Manasa Venkatesh, Rachael Doud, Craig Krebsbach, Natalia Arroyo, Bret Hanlon, Amy Y Chen, Louise Davies, David O Francis","doi":"10.1089/thy.2024.0344","DOIUrl":"10.1089/thy.2024.0344","url":null,"abstract":"<p><p><b><i>Background:</i></b> Expanding ultrasound use has increased the detection of thyroid cancer. Incidence has always been higher among females, a disparity that has grown over time. The sex difference in thyroid cancer is understudied in the context of diagnostic testing, particularly among privately insured adults in whom thyroid cancer is most common. We evaluated the association between thyroid ultrasound, fine needle aspiration biopsy (FNAB), and cancer incidence by sex in a large, integrated health system. <b><i>Methods:</i></b> This longitudinal retrospective cohort study included Kaiser Permanente of Washington enrollees aged 18 and over who underwent thyroid ultrasound from 1997 to 2019. Data included electronic billing claims for patients linked to tumor registry diagnoses. We estimated (1) annual overall ultrasound, FNAB, and cancer incidence rates; (2) the proportion of ultrasound requiring FNAB; and (3) cancer diagnoses per FNAB. A Poisson model with offset determined the relationship between sex and the proportion of ultrasound requiring FNAB adjusting for patient and sociodemographic characteristics. <b><i>Results:</i></b> A total of 33,589 patients underwent ultrasound (78% females; mean age 56). Ultrasound rates per 100,000 covered lives, defined as insured individuals per year, increased five-fold among males (111.11-490.97) and >four-fold among females (382.27-1331.14) between 1997 and 2019. FNAB rates also increased over time (rates per 100,000: 174.09-430.37 in females vs. 58.38-189.13 in men). Overall, FNAB rates per ultrasound changed little over time, and FNAB per ultrasound was greater in males compared with females (Adj rate ratio = 1.06 [confidence interval 1.01-1.11]). Cancer incidence was higher in females over the study period, but cancer incidence per FNAB was similar between sexes (both 0.06, <i>p</i> = 0.4). <b><i>Conclusions:</i></b> Sex disparities in thyroid ultrasound rates are stark and are a likely driver of sex disparities in thyroid cancer incidence. Interestingly, ultrasound-triggered FNAB was more common in males and changed little over time, challenging the prevailing understanding that females have much higher rates of thyroid cancer. Although the population-based differences between sexes for FNAB and cancer were large, the differences among people who had ultrasound were small.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1531-1539"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Temporal Patterns of Differentiated Thyroid Carcinoma in Children and Adolescents in Germany: A Pooled Analysis Based on Data from the German Malignant Endocrine Tumor Registry and the German Childhood Cancer Registry.","authors":"Michaela Kuhlen, Maike Wellbrock, Marina Kunstreich, Claudia Trübenbach, Cecile Ronckers, Antje Redlich, Friederike Erdmann","doi":"10.1089/thy.2024.0534","DOIUrl":"10.1089/thy.2024.0534","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The increasing incidence of differentiated thyroid carcinoma (DTC) in children and adolescents has become a growing concern. This study provides the first extensive assessment of incidence patterns and temporal trends of pediatric DTC in Germany, using the best available data from the German Malignant Endocrine Tumor (MET) Registry and the German Childhood Cancer Registry (GCCR) covering a period of 25 years. <b><i>Patients and Methods:</i></b> We conducted a register-based incidence and time series analysis, identifying all children and adolescents diagnosed with DTC at ages 0-17 years between 1997 and 2021 in Germany, as recorded in the German MET Registry and/or the GCCR. Age-specific and age-standardized incidence rates (ASR) over time, average annual percentage changes (AAPC), and cross-tabulations were used to evaluate incidence and temporal patterns. <b><i>Results:</i></b> We identified 469 DTC cases, including 85.7% papillary thyroid cancer and 9.4% follicular thyroid cancer. The average ASR for the period 1997-2021 was 1.16 per million, with higher rates in females compared with males (1.64 vs. 0.72 per million, respectively). Incidence rates increased with increasing age. The overall ASR increased from 0.84 per million in 1997-2001 to 1.48 per million in 2017-2021, with an AAPC of 3.46% [confidence interval or CI: 2.12-4.83]. The increase was most pronounced in adolescents aged 15-17 years (AAPC: 6.79% [CI: 4.43-9.19]). The proportion of incidentalomas rose from 5% in 1997-2001 to 26% in 2017-2021, yet we observed no marked shift in tumor size between symptomatic and incidental cases. <b><i>Conclusions:</i></b> Our study revealed a significant increase in pediatric DTC incidence in Germany, most pronounced among adolescents. The observation of an increasing incidence mirrors global trends and presents a complex public health challenge. While improved detection likely contributes to this trend, the stable tumor size distribution suggests that other factors are also in play. The rising detection of incidentalomas suggests enhanced diagnostic practices unrelated to symptoms of thyroid neoplasia. These findings highlight the need to carefully evaluate diagnostic and screening practices in pediatric populations.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1540-1550"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Environmental Air Pollution and Thyroid Cancer and Nodules: A Systematic Review.","authors":"Varun Vohra, Lekha V Yesantharao, Rachel Stemme, Stella M Seal, Lilah F Morris-Wiseman, Mara McAdams-DeMarco, Leila J Mady, Nicole C Deziel, Shyam Biswal, Murugappan Ramanathan, Aarti Mathur","doi":"10.1089/thy.2024.0317","DOIUrl":"10.1089/thy.2024.0317","url":null,"abstract":"<p><p><b><i>Background:</i></b> The global incidence of thyroid cancer has increased over the past several decades. While this increase is partially due to increased detection, environmental pollutants have also emerged as a possible contributing factor. Our goal was to perform a systematic review to assess the relationship between environmental air pollution and thyroid cancer. <b><i>Methods:</i></b> Systematic literature search was performed using PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases for original articles published prior to March 2024, investigating outdoor air pollution and thyroid cancer/nodules (PROSPERO CRD42024517624). Inclusion criteria included quantitative reporting of pollutant levels and effect size. Specific pollutants included ozone (O₃), particulate matter less than 2.5 (PM_2.5) or 10 microns in diameter (PM₁₀), sulfur dioxide (SO₂), nitric oxides (NO_x), carbon monoxide (CO), and polyaromatic hydrocarbons (PAHs). Study design, sample size, pollution assessment method, covariates, and strength/direction of associations between pollutants and thyroid cancer/nodule detection were extracted, and descriptive synthesis was utilized to summarize pertinent findings. Risk of bias was assessed using the National Heart, Lung, and Blood Institute quality assessment tool. <b><i>Results:</i></b> Of 1294 identified studies, 11 met inclusion criteria. Over 6 million patients from diverse regions were represented across studies. Pollutants studied included O₃ in 5 studies; PM_2.5, PM₁₀, SO₂, and NO_x in 3 studies; unspecified PM and CO in 2 studies; and PAHs in 1 study. Primary outcome was thyroid cancer diagnosis among 9 studies and thyroid nodule detection in 2. All studies examining NO_x and O₃ reported increased risks ranging from 1.03 to 1.5-fold and 1.1 to 1.3-fold, respectively. Both studies assessing PM_2.5 reported 1.18 to 1.23-fold increased odds of thyroid cancer diagnosis, and the magnitude of association increased with increasing duration or concentration of PM_2.5 Inconsistent results were observed for levels of CO, PM₁₀, and SO₂. <b><i>Conclusion:</i></b> While an emerging body of literature suggests a potential association between air pollution and thyroid cancer, the quality of evidence is limited by study design constraints, variability in exposure assessment, and inconsistent adjustment for potential confounding factors. The heterogeneity in study designs and methodologies present challenges in interpreting results, underscoring the need for standardized approaches in future research.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1451-1464"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}