1. Role of goiter and of menstrual and reproductive factors in thyroid cancer: a population-based case-control study in New Caledonia (South Pacific), a very high incidence area.: Thyroid cancer in New Caledonia
- Author
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Truong, Thérèse, Orsi, Laurent, Dubourdieu, Dominique, Rougier, Yannick, Hémon, Denis, Guénel, Pascal, Recherches épidémiologiques et statistiques sur l'environnement et la santé., Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Anatomie et Cytopathologie [CHT Gaston-Bourret], Laboratoire d'Anatomie et Cytopathologie, Institut Pasteur de Nouvelle-Calédonie, Réseau International des Instituts Pasteur (RIIP), This study was supported by Fondation de France, Association pour la Recherche contre le Cancer (ARC), Ministère de l'Environnement (Programme Environnement Santé), and Ministère des DOM-TOM (CORDET).
- Subjects
endocrine system ,endocrine system diseases ,MESH: Abortion, Spontaneous ,case-control study ,MESH: Age of Onset ,menopause ,MESH: Goiter ,MESH: Research Support, Non-U.S. Gov't ,New Caledonia ,MESH: Risk Factors ,MESH: Menstruation Disturbances ,MESH: Incidence ,MESH: Aged ,goiter ,MESH: Middle Aged ,MESH: Humans ,thyroid neoplasms ,menarche ,MESH: Parity ,MESH: Adult ,MESH: New Caledonia ,MESH: Case-Control Studies ,MESH: Menarche ,MESH: Thyroid Neoplasms ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,pregnancy ,MESH: Female ,MESH: Abortion - Abstract
International audience; Exceptionally high incidence rates of thyroid cancer have been reported for Melanesian women in New Caledonia (South Pacific). To investigate the occurrence of thyroid cancer in that country and to clarify the role of goiter and hormonal factors in that disease in women, a countrywide population-based case-control study was conducted in 1993-1999. The study included 293 cases, identified through pathology registers and whose thyroid cancer was verified histologically, and 354 population controls. Thyroid cancer was associated with goiter, age at menarche, irregular menstruation, and hysterectomy. There was a dose-response trend with number of full-term pregnancies (p = 0.01), with an odds ratio of 2.2 (95% confidence interval: 1.1, 4.3) for women with eight or more pregnancies. Miscarriage, particularly as an outcome of the first pregnancy, was also indicated as a risk factor. The association between voluntary abortion and thyroid microcarcinoma could be explained by enhanced medical surveillance and improved cancer detection in women undergoing abortion. Oral contraceptives and hormone replacement therapy were unrelated to thyroid cancer. The very high birth rate among Melanesian women in New Caledonia, as well as late age at menarche, may explain, in part, their elevated incidence of thyroid cancer.
- Published
- 2005