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American Journal of Epidemiology Advance Access published online on November 30, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp354
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American Journal of Epidemiology Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2009.

Original Contribution

Nonradiation Risk Factors for Thyroid Cancer in the US Radiologic Technologists Study

Cari L. Meinhold*, Elaine Ron, Sara J. Schonfeld, Bruce H. Alexander, D. Michal Freedman, Martha S. Linet and Amy Berrington de González

* Correspondence to Cari L. Meinhold, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Rockville, MD 20852 (e-mail: meinholdc{at}mail.nih.gov).

Received for publication June 19, 2009. Accepted for publication September 29, 2009.

The incidence of thyroid cancer has been rapidly increasing in the United States, but few risk factors have been established. The authors prospectively examined the associations of self-reported medical history, anthropometric factors, and behavioral factors with thyroid cancer risk among 90,713 US radiologic technologists (69,506 women and 21,207 men) followed from 1983 through 2006. Incident thyroid cancers in 242 women and 40 men were reported. Elevated risks were observed for women with benign thyroid conditions (hazard ratio (HR) = 2.35, 95% confidence interval (CI): 1.73, 3.20), benign breast disease (HR = 1.56, 95% CI: 1.08, 2.26), asthma (HR = 1.68, 95% CI: 1.00, 2.83), and body mass index ≥35.0 versus 18.5–24.9 kg/m2 (HR = 1.74, 95% CI: 1.03, 2.94; P-trend = 0.04). Current smoking was inversely associated with thyroid cancer risk (HR = 0.54). No clear associations emerged for reproductive factors, other medical conditions, alcohol intake, or physical activity. Despite few thyroid cancers in men, men with benign thyroid conditions had a significantly increased risk of thyroid cancer (HR = 4.65, 95% CI: 1.62, 13.34), and results for other risk factors were similar to those for women. Consistent with prior studies, obesity and benign thyroid conditions increased and current smoking decreased the risk of thyroid cancer. The novel findings for benign breast disease and asthma warrant further investigation.

body mass index; hormones; motor activity; prospective studies; reproduction; smoking; thyroid diseases; thyroid neoplasms

Abbreviations: BMI, body mass index; CI, confidence interval; HR, hazard ratio; TSH, thyroid-stimulating hormone


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