Case-control Study On The Association Of Female Reproductive Factors With Risks Of Differentiated Thyroid Cancer And Nodular Goiter

ObjectiveTo explore the association of female reproductive factors with risks of thyroid cancer and nodular goiter by collecting new cases of thyroid cancer and nodular goiter in Anhui Province.And to provide further epidemiological evidence for primary prevention and control of thyroid diseases.MethodsParticipants were recruited from Anhui Tumor Hospital,the First Affiliated Hospital of Anhui Medical University and the Second Affiliated Hospital of Anhui Medical University from July 2017 to December 2018.The control was matched with cases by age ±5 years.The questionnaire survey was carried out by self-compiled questionnaire.The demographic characteristics,lifestyle habits,history of radiation exposure before three years,family history,female reproductive factors,personal disease history and current diseases were included in the questionnaire.Additionally,the serum levels of free triiodothyroxine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH)were measured.Goodman-Kruskal Gamma test was applied to examine the association between the categorical reproductive variables and the levels of thyroid hormone levels.After adjusting for factors that are significant in the univariate analysis,female reproductive factors and thyroid hormone levels,logistic regression analysis was applied to explore the relationship between female reproductive factors and the risks of thyroid cancer as well as nodular goiter,respectively.ResultsA total of 224 cases of thyroid cancer and 167 cases of nodular goiter were matched with control according to age matching.The results of univariate analysis on the thyroid cancer and control group indicated that factors including the age of menarche,menopausal status,the number of fetus in term and history of breast disease were related to thyroid cancer.Multivariate regression analysis indicated that irregular menstrual cycles were associated with increased risk of thyroid cancer(OR=3.00,95%CI=1.26~7.18).The early age of menarche was associated with an increased risk of thyroid cancer incidence.Compared to women with age of menarche at 13 to 18 years old,the odds ratio of thyroid cancer risk was 3.63(95%CI = 1.13~11.66)in women with age of menarche less than 12 years old.After additionally correcting for thyroid hormone levels,the number of abortions and history of breast diseases were statistically significant in addition to the menstrual cycle and the age of menarche.Compared with women with no history of abortion,the odds ratio of thyroid cancer risk was 2.08(95%CI = 1.02~4.25)in women with history of once abortion.Women without history of breast diseases was related to lower thyroid cancer risk(OR = 0.21,95%CI = 0.06~0.79).The results of univariate analysis on the nodular goiter and control group indicated that history of breast disease was associated with nodular goiter.Multivariate regression analysis indicated that the number of abortion is related to the risk of nodular goiter.Specifically,compared with women without history of abortion,the odds ratio value of nodular goiter risk was 2.11(95%CI=0.89~4.96)in women with history of once abortion,the odds ratio value of nodular goiter risk was 4.32(95%CI=1.62~11.54)in women with history of twice abortion.The history of abortion remains significant for risk of nodular goiter after additionally correcting for thyroid hormone levels.ConclusionFactors including irregular cycles,early age of menarche,history of abortion and breast diseases may be related to the increased risk of thyroid cancer.Having history of abortion for more than three times may increase the risk of nodule goiter.