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American Journal of Epidemiology Advance Access originally published online on October 26, 2007
American Journal of Epidemiology 2008 167(2):219-229; doi:10.1093/aje/kwm288
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Menstrual and Reproductive Factors in the Risk of Differentiated Thyroid Carcinoma in Native Women in French Polynesia: A Population-based Case-Control Study

Pauline Brindel1,2,3, Françoise Doyon1,2,3, Frédérique Rachédi4, Jean-Louis Boissin5, Joseph Sebbag6, Larrys Shan5, Vaiana Chungue1,2,3, Laure Yen Kai Sun7, Frédérique Bost-Bezeaud4,8, Patrice Petitdidier8,9, John Paoaafaite9,10, Joseph Teuri9,10 and Florent de Vathaire1,2,3

1 Unit 605, INSERM, Villejuif, France
2 Department of Biostatistics and Epidemiology, Institut Gustave Roussy, Villejuif, France
3 University Paris XI, Villejuif, France
4 Department of Diabetology and Endocrinology, Territorial Hospital Mamao, Papeete, French Polynesia
5 Endocrinologists, Papeete, French Polynesia
6 Endocrinologist, Clinique Paofai, Papeete, French Polynesia
7 Cancer Registry of French Polynesia, Direction de la santé, Papeete, French Polynesia
8 Department of Biology, Territorial Hospital Mamao, Papeete, French Polynesia
9 Laboratory of Anatomy and Cytopathology Boz and Petitdidier, Papeete, French Polynesia
10 Institut de Recherche pour le Développement, Papeete, French Polynesia

Correspondence to Dr. Florent de Vathaire, INSERM Unit 605, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France (e-mail: fdv{at}igr.fr).

Received for publication May 31, 2006. Accepted for publication September 7, 2007.

French Polynesia has one of the world's highest incidence rates of thyroid cancer. A case-control study among native residents of French Polynesia included 201 women diagnosed with differentiated thyroid cancer before the age of 56 years, between 1981 and 2004, matched to 324 population controls on date of birth. Face-to-face interviews were conducted from 2002 to 2004. Odds ratios were calculated by using conditional logistic regression and were reported in the total group and by ethnic group ("Polynesian" vs. "mixed"). The risk of thyroid cancer increased with natural (odds ratio = 1.9) or artificial (odds ratio = 4.5) menopause compared with that associated with a premenopausal status and with number of births (p for trend = 0.03): odds ratios for one, two, three, four or five, six or seven, and eight or more births were, respectively, 0.90, 1.6, 2.3, 2.2, 2.7, and 1.7 compared with a nulliparous status. Similar results were observed for Polynesian women. No association was observed with irregular menstrual cycles, age at menopause, history of miscarriage or induced abortion, time since last birth, age at and outcome of first pregnancy, or breastfeeding. This study confirms the role of menstrual and reproductive factors in the risk of differentiated thyroid cancer in Pacific island populations.

case-control studies; menopause; menstruation; Polynesia; pregnancy; thyroid neoplasms; women

Abbreviations: CI, confidence interval; OR, odds ratio


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