Opposing effects of thyroid hormones on cancer risk: a population-based study
Autor: | Shmuel Giveon, Osnat Ashur-Fabian, Barbara Silverman, Eilon Krashin, Offer Fabian, David M. Steinberg, Aleck Hercbergs, Martin Ellis, Paul J. Davis, Daniel Yekutieli |
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Rok vydání: | 2020 |
Předmět: |
Oncology
Adult Male medicine.medical_specialty Thyroid Hormones Colorectal cancer Endocrinology Diabetes and Metabolism Thyrotropin 030209 endocrinology & metabolism Hyperthyroidism 03 medical and health sciences Prostate cancer 0302 clinical medicine Endocrinology Median follow-up Uterine cancer Internal medicine medicine Humans Israel Lung cancer Thyroid cancer Melanoma Proportional Hazards Models business.industry Cancer Prostatic Neoplasms General Medicine Middle Aged medicine.disease Cancer registry 030220 oncology & carcinogenesis Uterine Neoplasms Female business |
Zdroj: | European journal of endocrinology. 184(3) |
ISSN: | 1479-683X |
Popis: | Objective The association between dysregulated thyroid hormone function and cancer risk is inconclusive, especially among different age groups and uncommon malignancies. We sought to determine the relation of TSH and free T4 levels with overall cancer risk as well as risk of specific cancer types. Design and methods Data on thyroid hormone profile was collected from 375 635 Israeli patients with no prior history of cancer. Cancer cases were identified via the Israel National Cancer Registry. Cox proportional hazards model was used to assess hazard ratios for overall cancer as well as 20 cancer subgroups. Results In this study, 23 808 cases of cancer were detected over median follow up of 10.9 years. Among patients younger than 50 at inclusion, TSH in the hyperthyroid range, elevated free T4 and subclinical hyperthyroidism were associated with increased cancer risk (HR: 1.3, 1.28 and 1.31, respectively). In contrast, patients 50 or older with clinical hyperthyroidism were at lower cancer risk (HR: 0.64). Elevated TSH was associated with decreased risk of prostate cancer (HR: 0.67). Log-TSH elevation was associated with decreased risk of thyroid cancer (HR: 0.82) and increased risk of melanoma (HR: 1.11) and uterine cancer (HR: 1.27). Elevated free T4 was associated with increased lung cancer risk (HR: 1.54), while free T4 levels above the normal range and clinical hyperthyroidism were related to lower colorectal cancer risk (HR: 0.59 and 0.08, respectively). Conclusions Thyroid hormones display opposing effects on cancer risk, based on patient age and cancer type. |
Databáze: | OpenAIRE |
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