Cancer Prevention Research, pages OF1-OF13

Reproductive and Hormonal Factors and Thyroid Cancer Risk: Pooled Analysis of Prospective Cohort Studies in the Asia Cohort Consortium

Sayada Zartasha Kazmi 1, 2
, 
Aesun Shin 1, 2, 3, 4, 5
, 
Sarah K. Abe 6, 7
, 
Md Rashedul Islam 7, 8, 9
, 
Md Shafiur Rahman 7, 10, 11
, 
Eiko Saito 12, 13
, 
Sooyoung Cho 1, 5
, 
Ryoko Katagiri 14, 15, 16
, 
Melissa J. Merritt 17, 18
, 
Ji He Choi 1, 19
, 
蔡 辉 Cai Hui 20, 21
, 
N. Sawada 6, 15
, 
Akiko Tamakoshi 22, 23
, 
R. Sakata 24, 25
, 
Atsushi Hozawa 26, 27
, 
Seiki Kanemura 27, 28
, 
Jeongseon Kim 29, 30
, 
Yumi Sugawara 27, 28
, 
Sue Youn Park 1, 2, 3, 4
, 
Hui Cai 20, 21
, 
Shoichiro Tsugane 15, 31, 32
, 
Takashi Kimura 23, 33
, 
Habibul Ahsan 34, 35
, 
Paolo Boffetta 36, 37, 38
, 
Kee Seng Chia 39, 40
, 
K. Matsuo 41, 42, 43
, 
Y. Qiao 44, 45
, 
Nathaniel Rothman 46, 47
, 
Wei Zheng 20, 21
, 
Manami Inoue 6, 9
, 
Daehee Kang 1, 2, 4
Show full list: 31 authors
1
 
2
 
1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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4
 
3Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
5
 
4Medical Research Center, Genomic Medicine Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
6
 
National Cancer Centre, Tokyo, Japan | 
7
 
5Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
8
 
National Cancer Centre, Japan | 
9
 
6Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
10
 
National Cancer Center Japan, Tokyo, Japan | 
11
 
7Research Center for Child Mental Development, Hamamatsu University School of Medicine, Shizuoka, Japan.
12
 
13
 
8Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan.
14
 
National Cancer Center Institute for Cancer Control, Tokyo, Japan | 
15
 
9Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
16
 
10National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
17
 
18
 
11The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, Australia.
19
 
12Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
20
 
21
 
13Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
22
 
23
 
14Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
24
 
Radiation Effects Research Foundation, Hiroshima, Japan | 
25
 
15Radiation Effects Research Foundation, Hiroshima, Japan.
26
 
27
 
16Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
28
 
29
 
National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Korea (South), Republic of
30
 
17Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea.
31
 
National Cancer Centre, Tokyo, Tokyo, Japan | 
32
 
18Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan.
33
 
34
 
35
 
19Department of Public Health Sciences, University of Chicago, Chicago, Illinois.
36
 
37
 
20Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York.
38
 
21Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
39
 
40
 
22Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
41
 
42
 
23Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
43
 
24Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
44
 
45
 
25School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
46
 
47
 
26Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Publication type: Journal Article
Publication date: 2025-02-11
scimago Q1
SJR: 1.239
CiteScore: 6.0
Impact factor: 2.9
ISSN: 19406207, 19406215
Abstract

Given the female predominance of thyroid cancer, particularly in the reproductive age range, female sex hormones have been proposed as an etiology; however, previous epidemiological studies have shown conflicting results. We conducted a pooled analysis using individual data from nine prospective cohorts in the Asia Cohort Consortium to explore the association between 10 female reproductive and hormonal factors and thyroid cancer risk. Using Cox proportional hazards models, cohort-specific hazard ratios (HR) and 95% confidence intervals (CI) were estimated and then pooled using a random-effects model. Analyses were stratified by country, birth years, smoking status, and body mass index, and thyroid cancer risk based on age of diagnosis was also examined. Among 259,649 women followed up for a mean of 17.2 years, 1,353 incident thyroid cancer cases were identified, with 88% (n = 1,140) being papillary thyroid cancer. Older age at first delivery (≥26 vs. 21–25 years) was associated with increased thyroid cancer risk (P-trend = 0.003; HR = 1.16; 95% CI, 1.03–1.31), particularly when diagnosed later in life (≥55 vs. < 55 years; P-trend = 0.003; HR = 1.19; 95% CI, 1.02–1.39). Among younger birth cohorts, women with more number of deliveries showed an increased thyroid cancer risk [P-trend = 0.0001, HR = 2.40; 95% CI, 1.12–5.18 (≥5 vs. 1–2 children)], and there was no substantial trend in older cohorts. Distinct patterns were observed for the number of deliveries and thyroid cancer risk across countries, with a significant positive association for Korea [P-trend = 0.0008, HR = 1.89; 95% CI, 1.21–2.94 (≥5 vs. 1–2 children)] and nonsignificant inverse associations for China and Japan. Contextual and macrosocial changes in reproductive factors in Asian countries may influence thyroid cancer risk.

Prevention Relevance: This analysis of prospective cohort studies across three Asian countries highlights that older age at first birth is linked to increased thyroid cancer risk. As women delay motherhood, understanding these trends is vital for public health strategies addressing reproductive factors influencing thyroid cancer risk in these populations.

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