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Association of benign thyroid diseases with thyroid cancer risk: a meta-analysis of prospective observational studies

Authors
  • Liang, L.1
  • Zheng, X.-C.2
  • Hu, M.-J.1
  • Zhang, Q.1
  • Wang, S.-Y.2
  • Huang, F.1, 3
  • 1 Anhui Medical University, Department of Epidemiology and Biostatistics, School of Public Health, No. 81 Meishan Road, Shushan District, Hefei, Anhui, 230032, China , Hefei (China)
  • 2 Anhui Provincial Cancer Hospital (West Branch of The First Affiliated Hospital of University of Science and Technology of China), Department of Head and Neck, Breast Surgery, No. 107 East Huanhu Road, Shushan Districts, Hefei, Anhui, 230088, China , Hefei (China)
  • 3 Anhui Medical University, Central Laboratory of Preventive Medicine, School of Public Health, No. 81 Meishan Road, Shushan District, Hefei, Anhui, 230032, China , Hefei (China)
Type
Published Article
Journal
Journal of Endocrinological Investigation
Publisher
Springer-Verlag
Publication Date
Nov 01, 2018
Volume
42
Issue
6
Pages
673–685
Identifiers
DOI: 10.1007/s40618-018-0968-z
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeEvidence showed that benign thyroid disease was one of the risk factors for thyroid cancer. However, the results of some studies were inconsistent and were previously meta-analyses of case–control studies. Therefore, we performed a meta-analysis of prospective studies to investigate the relationship between benign thyroid diseases and thyroid cancer risk.MethodsAll eligible studies were identified via systematic searches of multiple literature databases. The combined RR (relative risk)/HR (hazard ratio) or SIR (standardized incidence ratio) with 95% confidence interval was calculated. Heterogeneity was assessed with the I2 test. Publication bias and subgroup analyses were also performed.ResultsTwelve studies were eligible for inclusion in the meta-analysis. The pooled RR/HR of thyroid carcinoma in benign thyroid diseases was 4.39 (95% CI 3.22–5.55). The pooled SIR of thyroid carcinoma in benign thyroid diseases was 5.98 (95% CI 4.09–7.86). Subgroup analysis was performed using the type of benign thyroid diseases. Effect value was RR/HR: hyperthyroidism (RR/HR = 3.89, 95% CI = 1.69–6.08), hypothyroidism (RR/HR = 2.72, 95% CI = 1.04–4.41), and goiter (RR/HR = 22.18, 95% CI = 12.09–32.28). Effect value was SIR: hyperthyroidism (RR/HR = 5.96, 95% CI = 1.88–10.03), goiter (RR/HR = 7.65, 95% CI = 6.94–8.37), and thyroiditis (RR/HR = 3.25, 95% CI = 1.62–4.89).ConclusionsOur study has shown that benign thyroid diseases might be associated with increased risk of thyroid cancer, especially in hyperthyroidism, hypothyroidism, and goiter. However, further investigation is needed to better understand the underlying biological mechanisms.

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