Impact of overweight and obesity on U.S. papillary thyroid cancer incidence trends (1995-2015)
Menée aux Etats-Unis à partir de données portant sur 457 337 personnes (âge : 50-71 ans), cette étude de cohorte estime, pour la période 1995-2015, la part des cancers papillaires de la thyroïde attribuable au surpoids ou à l'obésité (604 cas)
Since the early 1980s, papillary thyroid cancer (PTC) incidence rates and the prevalence of obesity, a risk factor for PTC, have increased substantially in the United States. We estimated the proportion of PTC incidence in the United States attributable to overweight/obesity during 1995-2015.NIH-AARP Diet and Health Study cohort data (n = 457,331 participants, 50-71 years and cancer-free at baseline) were used to estimate multivariable-adjusted hazard ratios (HRs) for PTC across body mass index categories. Population attributable fractions (PAFs) were calculated using estimated HRs and annual overweight/obesity prevalence estimates from the National Health Interview Survey. PAF estimates were combined with Surveillance, Epidemiology, and End Results (SEER)-13 data to calculate annual percent changes (APC) in PTC incidence rates attributable (and unrelated) to overweight/obesity.Overweight (25.0-29.0 kg/m2) and obesity (≥30.0 kg/m2) were associated with 1.26-fold (95% CI 1.05-1.52) and 1.30-fold (95% CI 1.05-1.62) increased risks of PTC, respectively, and nearly 3-fold (HR = 2.93, 95% CI 1.25-6.87) and >5-fold (HR = 5.42, 95% CI 2.24-13.1) increased risks of large (>4 cm) PTCs, compared to normal-weight (18.5-24.9 kg/m2). During 1995-2015, PAF estimates for overweight/obesity increased from 11.4 to 16.2% for all PTCs and 51.4 to 63.2% for large PTCs. Overweight/obesity accounted for 13.6% and 57.8% of the APCs in total (5.9%/year) and large (4.5%/year) PTC incidence rates, respectively, during 1995-2015.Overweight/obesity may have contributed importantly to the rapid rise in PTC incidence during 1995-2015. By 2015, we estimate that one of every six PTCs diagnosed among adults ≥60 years, including nearly two-thirds of large PTCs, were attributable to overweight/obesity.