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Open AccessArticle

Uterine Fibroids Increase the Risk of Thyroid Cancer

by Li-Min Sun 1,2,†, Li-Min Chung 3,†, Cheng-Li Lin 4,5 and Chia-Hung Kao 6,7,8,9,*
1
Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung 81342, Taiwan
2
Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
3
Department of Medical Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung 81342, Taiwan
4
Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
5
College of Medicine, China Medical University, Taichung 404, Taiwan
6
Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404, Taiwan
7
Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404, Taiwan
8
Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
9
Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2020, 17(11), 3821; https://doi.org/10.3390/ijerph17113821
Received: 10 April 2020 / Revised: 22 May 2020 / Accepted: 26 May 2020 / Published: 28 May 2020
Objectives: The formation of uterine fibroids (UF) is potentially linked to the development of thyroid cancer through a common factor: female sex hormones. Methods: We conducted a nationwide population-based cohort study to determine whether Taiwanese women with UF have an increased risk of thyroid cancer. The data of both the UF and control groups were derived from the National Health Insurance Research Database (NHIRD) of Taiwan. Groups were matched by the year of UF diagnosis, age, income, urbanization level, occupation, and comorbidities. A Cox proportional hazard regression model was used to compare the incidence of thyroid cancer between the UF and control groups. In addition, the model was used to determine the hazard ratio of thyroid cancer in the UF group in comparison with the control group. Results: Women with UF had a statistically significantly increased risk of thyroid cancer compared with controls (adjusted hazard ratio (aHR): 1.64, 95% confidence interval (CI): 1.26–2.13). Stratified analyses showed that women with UF who had a significantly increased risk of thyroid cancer were more likely to be middle aged, have middle and higher income levels, and a medium follow-up period (1–5 years) of UF. No other UF patient characteristics and comorbidities showed association with the risk of thyroid cancer. In addition, UF patients had a significantly increased risk of thyroid cancer regardless of whether or not they underwent myomectomy. Conclusions: The results suggest that women with UF have an increased risk of subsequent thyroid cancer. Further research is needed to explore whether surveillance strategies for the early detection of thyroid cancer using ultrasonography should be implemented among patients with UF. View Full-Text
Keywords: uterine fibroids; thyroid cancer; population-based cohort study uterine fibroids; thyroid cancer; population-based cohort study
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Sun, L.-M.; Chung, L.-M.; Lin, C.-L.; Kao, C.-H. Uterine Fibroids Increase the Risk of Thyroid Cancer. Int. J. Environ. Res. Public Health 2020, 17, 3821.

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