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Birth Characteristics and Risk of Pediatric Thyroid Cancer: A Population-Based Record-Linkage Study in California
- Source :
- Thyroid, Thyroid : official journal of the American Thyroid Association, vol 31, iss 4
- Publication Year :
- 2021
- Publisher :
- Mary Ann Liebert, Inc., publishers, 2021.
-
Abstract
- Background: Incidence rates of thyroid cancer in children and young adults (age 0-19 years) have nearly doubled over a recent 15-year period in the United States. Children with thyroid cancer may require long-term therapy and surveillance and are at greater risk for second primary malignancies. High-dose exposure to ionizing radiation is the only known nongenetic risk factor; the vast majority of cases have an unknown etiology. Methods: We conducted a population-based nested case-control study to evaluate the relationship between a range of birth characteristics and the risk of pediatric thyroid cancer. Using linked birth records and cancer registry data from California, we included 1012 cases who were diagnosed with first primary thyroid cancer at the age of 0-19 years from 1988 to 2015 and 50,600 birth-year matched controls (1:50 case to control ratio). We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) by using multivariable logistic regression models applied to the full population and stratified by thyroid cancer subtypes (papillary and follicular), race/ethnicity (white and Hispanic), and age at diagnosis (0-14 and 15-19 years). Results: Hispanic ethnicity (OR: 1.20 [CI 1.01-1.42]), higher birth weight (OR: 1.11 [CI 1.04-1.18] per 500g), and higher maternal education (13-15 years OR: 1.35 [CI 1.09-1.68], 16+ years OR: 1.35 [CI 1.07-1.71]) were associated with an increased risk of pediatric thyroid cancer, while male sex (OR: 0.21 [CI 0.18-0.25]) and higher birth order (third or higher OR: 0.81 [CI 0.68-0.98]) were associated with a decreased risk. Some heterogeneity was observed across subtype, most notably an elevated OR with higher birth order for follicular thyroid cancer, in contrast to the reduced risk for this category among papillary thyroid cancer cases (p-value for interaction = 0.01). Hispanic ethnicity was a risk factor for papillary, but not follicular thyroid cancer (p-value for interaction = 0.07). Conclusions: In this population-based study of birth characteristics and pediatric thyroid cancer, we identified several important risk factors for pediatric thyroid cancer, including female sex, Hispanic ethnicity, higher birth weight, higher maternal educational attainment, and lower birth order. Our data provide new areas for replication and investigation of biological mechanisms for this poorly understood malignancy.
- Subjects :
- Male
Time Factors
endocrine system diseases
Endocrinology, Diabetes and Metabolism
pediatric thyroid cancer
California
0302 clinical medicine
Endocrinology
papillary
Risk Factors
follicular
Follicular phase
Epidemiology
Birth Weight
Registries
Aetiology
Young adult
Age of Onset
Child
Thyroid cancer
Cancer
Pediatric
Incidence
Hispanic or Latino
Race Factors
030220 oncology & carcinogenesis
Birth Certificates
Child, Preschool
Educational Status
epidemiology
Female
Adult
Pediatric Research Initiative
endocrine system
medicine.medical_specialty
Adolescent
Pediatric Cancer
Clinical Sciences
030209 endocrinology & metabolism
Population based
Risk Assessment
Endocrinology & Metabolism
03 medical and health sciences
Young Adult
Rare Diseases
Sex Factors
Clinical Research
medicine
Humans
Thyroid Neoplasms
Preschool
business.industry
Prevention
Infant, Newborn
Infant
Thyroid Cancer and Nodules
Newborn
medicine.disease
Birth characteristics
Case-Control Studies
Record Linkage Study
Birth Order
business
2.4 Surveillance and distribution
Demography
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Thyroid, Thyroid : official journal of the American Thyroid Association, vol 31, iss 4
- Accession number :
- edsair.doi.dedup.....574df23ddeb8af60fb7d4f2c39447431