Nativity and papillary thyroid cancer incidence rates among Hispanic women in California

Abstract Context Thyroid cancer incidence increased with the greatest change in adults aged ≥65 years. Objective To determine the relationship between area-level use of imaging and thyroid cancer incidence over time. Design, Setting and Participants Longitudinal imaging patterns in Medicare patients aged ≥65 years residing in Surveillance, Epidemiology, and End Results (SEER) regions were assessed in relationship to differentiated thyroid cancer diagnosis in patients aged ≥65 years included in SEER-Medicare. Linear mixed-effects modeling was used to determine factors associated with thyroid cancer incidence over time. Multivariable logistic regression was used to determine patient characteristics associated with receipt of thyroid ultrasound as initial imaging. Main Outcome Measure Thyroid cancer incidence. Results Between 2002 and 2013, thyroid ultrasound use as initial imaging increased (P < 0.001). Controlling for time and demographics, use of thyroid ultrasound was associated with thyroid cancer incidence (P < 0.001). Findings persisted when cohort was restricted to papillary thyroid cancer (P < 0.001), localized papillary thyroid cancer (P = 0.004), and localized papillary thyroid cancer with tumor size ≤1 cm (P = 0.01). Based on our model, from 2003 to 2013, at least 6594 patients aged ≥65 years were diagnosed with thyroid cancer in the United States due to increased use of thyroid ultrasound. Thyroid ultrasound as initial imaging was associated with female sex and comorbidities. Conclusion Greater thyroid ultrasound use led to increased diagnosis of low-risk thyroid cancer, emphasizing the need to reduce harms through reduction in inappropriate ultrasound use and adoption of nodule risk stratification tools.

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Association between Uranium Exposure and Thyroid Health: A National Health and Nutrition Examination Survey Analysis and Ecological Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17030712 ◽

2020 ◽

Vol 17 (3) ◽

pp. 712 ◽

Cited By ~ 1

Author(s):

Maaike van Gerwen ◽

Naomi Alpert ◽

Wil Lieberman-Cribbin ◽

Peter Cooke ◽

Kimia Ziadkhanpour ◽

...

Keyword(s):

Thyroid Cancer ◽

National Health ◽

Cancer Incidence ◽

Ecological Study ◽

Incidence Rates ◽

Thyroid Peroxidase ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Thyroid Cancer Incidence ◽

Cancer Incidence Rates

Besides specific, incidental radiation exposure, which has been associated with increased thyroid cancer risk, the effects of exposure to background radiation from uranium, a naturally occurring, radioactive, and ubiquitous element, on the thyroid gland has not been widely studied. We therefore investigated the association between uranium exposure and thyroid health in the US. Using the National Health and Nutrition Examination Survey (NHANES), we assessed the association between urinary uranium levels and thyroid-related antibodies, including thyroglobulin antibodies (TgAb) and anti-thyroid peroxidase (anti-TPO), in the general population. Secondly, we performed an ecological study of age-adjusted thyroid cancer incidence rates per state and sources of uranium exposure. We included 3125 eligible participants from the NHANES and found a significant association between increased TgAb and increased urinary uranium levels when analyzed as quartiles (p = 0.0105), while no association was found with anti-TPO. In addition, although no significant correlation was found in the ecological study, certain states had high age-adjusted thyroid cancer incidence rates and a high number of uranium activity locations and high uranium concentrations in water. The present study suggests that uranium exposure may affect thyroid health, which warrants increased sampling of soil and water in high-risk states.

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