Journal Article

Role of Goiter and of Menstrual and Reproductive Factors in Thyroid Cancer: A Population-based Case-Control Study in New Caledonia (South Pacific), a Very High Incidence Area

Thérèse Truong, Laurent Orsi, Dominique Dubourdieu, Yannick Rougier, Denis Hémon and Pascal Guénel

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 11, pages 1056-1065
Published in print June 2005 | ISSN: 0002-9262
Published online June 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi136
Role of Goiter and of Menstrual and Reproductive Factors in Thyroid Cancer: A Population-based Case-Control Study in New Caledonia (South Pacific), a Very High Incidence Area

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Exceptionally high incidence rates of thyroid cancer have been reported for Melanesian women in New Caledonia (South Pacific). To investigate the occurrence of thyroid cancer in that country and to clarify the role of goiter and hormonal factors in that disease in women, a countrywide population-based case-control study was conducted in 1993–1999. The study included 293 cases, identified through pathology registers and whose thyroid cancer was verified histologically, and 354 population controls. Thyroid cancer was associated with goiter, age at menarche, irregular menstruation, and hysterectomy. There was a dose-response trend with number of full-term pregnancies (p = 0.01), with an odds ratio of 2.2 (95% confidence interval: 1.1, 4.3) for women with eight or more pregnancies. Miscarriage, particularly as an outcome of the first pregnancy, was also indicated as a risk factor. The association between voluntary abortion and thyroid microcarcinoma could be explained by enhanced medical surveillance and improved cancer detection in women undergoing abortion. Oral contraceptives and hormone replacement therapy were unrelated to thyroid cancer. The very high birth rate among Melanesian women in New Caledonia, as well as late age at menarche, may explain, in part, their elevated incidence of thyroid cancer.

Keywords: case-control studies; goiter; menarche; menopause; New Caledonia; pregnancy; thyroid neoplasms; OR, odds ratio

Journal Article.  6179 words. 

Subjects: Public Health and Epidemiology

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