Aug 2026· The American surgeon· pp.
31348261480818
· 0 citations· 14 references
Medicine
TL;DR
There was an increased risk of developing TC in all groups, and Black patients had the highest HR highlighting an area that warrants further investigation, and Black patients had the highest HR highlighting an area that warrants further investigation.
Abstract
BackgroundSmoking is a known carcinogen and its relationship with the development of thyroid cancer (TC) is not well established and prior evidence shows a possible protective relationship. We aim to evaluate the impact of smoking on the development of TC.MethodsThis is a retrospective cohort study of adult patients who were diagnosed with a thyroid nodule(s) between 2005 and 2025. Cohorts were developed based on smoking status. Patients with the diagnosis of multiple endocrine neoplasia syndrome or who had known TC were excluded. Propensity score matching (PSM) was performed. The primary outcome was diagnosis of TC. Hazard ratios (HRs) and 95% confidence intervals were calculated. Cohorts were then divided into subgroups based on sex and racial groups with the same analysis.ResultsThere were 404,811 individuals identified who were smokers and had thyroid nodules. Average age was 60 +/- 15 years, with 69% of the cohort being female and 70% white. TC developed in 3.4% of smokers with nodules compared to 1.2% of nonsmokers (HR = 2.60). Subgroup analysis revealed an increased risk across all sex and racial groups. Female smokers had a HR than males at 2.62. Across racial groups, Black patients had the highest HR at 2.91. All groups had confidence intervals that did not cross one.DiscussionIn this retrospective cohort study, smoking was significantly associated with an increased risk of developing TC. There was an increased risk of developing TC in all groups, and Black patients had the highest HR highlighting an area that warrants further investigation.
ABSTRACT Thyroid function has been suggested to be associated with breast cancer risk, but not much is known about thyroid hormones as a potential prognostic factor for breast cancer. This study investigated the relation between thyroid hormones in breast cancer patients and mortality. A total of 2000 breast cancer patients from the Swedish SCAN‐B cohort were followed for 9 years. Blood samples were collected at the time of diagnosis, before surgery, and analysed for free and total T3 and T4. All‐cause mortality and recurrent disease were compared between quartiles (Q) using Cox proportional hazard analysis adjusted for prognostic factors, yielding hazard ratios (HR) with 95% confidence intervals (CIs). During follow‐up, 310 deaths and 167 recurrences occurred. Free T3 was associated with a lower mortality; the combined group Q2 to Q4 had an adjusted HR of 0.73 (0.58–0.93) as compared to Q1. Moreover, a high ratio of free T3/T4 was associated with a low mortality in Q2, Q3 and Q4, respectively. High levels of free and total T4 were associated with a high risk of all‐cause mortality; the crude HR for free T4 Q4 vs. Q1 was 1.53 (1.14–2.07) and the corresponding HR for total T4 was 1.63 (1.20–2.22). These results did not remain in the adjusted analysis. No clear associations were found regarding recurrent disease. We conclude that high levels of free T3, and a high free T3/T4 ratio were associated with a lower risk of all‐cause mortality and may be a marker of a favourable prognosis.
Annie Brange, Ylva Heyman, Kamil Demircan et al.· Cancer Medicine· 0 citations
OBJECTIVES
The incidence of thyroid carcinoma in patients with Graves' disease (GD) has increased, with reported rates ranging from 1% to 21%. While thyroid nodules are a well-established risk factor, the role of body mass index (BMI) in predicting malignancy in GD remains unclear. This study aimed to evaluate the prevalence of thyroid cancer in GD and identify independent predictors to improve preoperative risk stratification.
METHODS
We retrospectively analyzed 206 consecutive patients who underwent thyroidectomy for GD between 2016 and 2024. Demographic characteristics, preoperative biochemical parameters, and postoperative histopathological findings were reviewed. Patients were classified as malignant (n = 42) or benign (n = 164). All malignancies were papillary thyroid carcinoma.
RESULTS
The mean age was 42.3 ± 13.2 years, and 74.8% were female. Age was not associated with malignancy. Female sex was more prevalent in the malignant group (88.1% vs. 71.3%; p = 0.026). Patients with malignancy had significantly higher BMI (28.1 ± 4.2 vs. 25.5 ± 4.3 kg/m2; p = 0.001) and a higher rate of thyroid nodules (66.7% vs. 31.1%; p < 0.001). Biochemical parameters were not predictive. Multivariable analysis identified female sex (OR = 2.90, p = 0.045), thyroid nodules (OR = 3.27, p = 0.002), and BMI (OR = 1.13 per kg/m2, p = 0.005) as independent predictors. BMI alone showed moderate discrimination (AUC = 0.67).
CONCLUSION
Higher BMI is independently associated with thyroid malignancy in GD and may serve as a clinically relevant adjunctive risk marker. When combined with thyroid nodules and sex, BMI may enhance preoperative risk stratification and support more individualized surgical decision-making in patients with GD.
LEVEL OF EVIDENCE: 3
O. Çalişkan, M. T. Unlu, I. Çetinoğlu et al.· The Laryngoscope· 0 citations
Introduction: Differentiated thyroid cancer (DTC) accounts for the most common types of thyroid cancer. The aim of the present study was to investigate the factors associated with recurrence and mortality after thyroidectomy in patients with diagnose of DTC in Hamadan, Iran. Materials and Methods: In this retrospective cohort study, 350 patients over 18 years old who underwent total thyroidectomy and ablation with radioactive iodine (RAI) and had DTC based on pathology and followed up for ten years were studied. The univariate and multivariate logistic regression was used for determining the risk factors of recurrence and mortality of DTC at a significance level of 0.05. SPSS software (Version 26) was applied to analyze the data. Results: In the present study, 16.6% of the participants were male and 83.4% were female with a mean age of 40.7 ±14.7 years. Recurrence and mortality rates were obtained to be 26.9% and 4.9 %, respectively. Overall, the risk of recurrence and death was significantly higher in older age, men, smokers, tumors larger than 4 cm and regional lymph node (p<0.05). For each additional year of life, the risk of recurrence and death increased by 4% and 9%, respectively (P =0.001 and p<0.001). Recurrence in men were 5.111 times more likely than women (p<0.001). A 6.002-fold increase in the risk of death was associated with smoking (P=0.008). Conclusion: Due to the high prevalence of DTC and on the other hand the good prognosis of this type of cancer, timely diagnosis and identification of risk factors of recurrence and death are very important.
Background Family history of cancer is an established risk factor for lung cancer, but its association with the probability of malignancy among patients evaluated for pulmonary nodules—rather than with population-level lung cancer incidence—remains poorly characterized in Chinese populations. Methods We conducted a retrospective cohort study of 3,850 consecutive patients evaluated for pulmonary nodules at a tertiary teaching hospital between January 2018 and December 2021, of whom 1,257 (32.6%) underwent surgical resection or biopsy. Family history of lung and non-lung cancer in first- and second-degree relatives was self-reported at admission. Lung cancer was confirmed histopathologically. Sequential multivariable logistic regression was performed: Model 1 included clinical variables only, and Model 2 additionally included radiological features. Results Among 3,850 patients, 1,158 (30.1%) had pathology-confirmed lung cancer (95.3% adenocarcinoma; 92.2% stage IA). The 2,692 controls comprised 99 patients with pathology-confirmed benign lesions and 2,593 patients managed with imaging surveillance in whom no malignant pathology was recorded. First-degree family history of lung cancer (present in 32.3% of the cohort) was not associated with malignancy in univariate analysis (OR 0.94, 95% CI 0.81–1.09, p = 0.432) but showed an inverse association after adjustment (Model 2: aOR 0.72, 95% CI 0.57–0.90, p = 0.005); family history of non-lung cancer showed a similar pattern (univariate OR 0.79, 95% CI 0.69–0.91; Model 2: aOR 0.59, 95% CI 0.48–0.74, p < 0.001). Radiological features dominated risk prediction (Model 2 AUC 0.807 versus 0.566 for clinical variables alone): nodule size (aOR 1.21 per mm, 95% CI 1.18–1.24), lobulation (aOR 2.32), spiculation (aOR 2.08), and vacuole sign (aOR 1.80) were the strongest predictors. Female sex was independently associated with malignancy (aOR 1.62, 95% CI 1.31–2.01), whereas smoking was not (aOR 1.16, 95% CI 0.90–1.49). Patients with family history were not diagnosed earlier or at an earlier stage than those without. Conclusion In this selected cohort of patients evaluated for pulmonary nodules, family history was not positively associated with malignancy, and the inverse adjusted associations are most plausibly explained by referral- and surveillance-related selection rather than biological protection. Radiological assessment should remain the primary basis for pulmonary nodule management. Family history may be considered during nodule evaluation, but its independent contribution should be validated in prospective cohorts with standardized screening and referral procedures.
Hong-Jun Song, Xin-Lu Men, Jun Cheng et al.· Frontiers in Medicine· 0 citations
Smoking exposure, occupational hazards, unhealthy indoor environments, and chronic pulmonary diseases are important determinants of lung cancer in North Sumatra and public health strategies focusing on tobacco control, improved workplace safety, and reduction of indoor air pollution may substantially reduce lung cancer burden.
Putri Aulia Anwar, Noni Novisari Soeroso, Setia Putra Tarigan et al.· Experimental oncology· 0 citations
This nomogram provides a population-level estimate of DSS in advanced FTC and may support preliminary risk stratification using readily available registry variables, but its clinical interpretation should consider the absence of key biologic and treatment-response factors not captured in SEER, including vascular invasion, molecular alterations, and systemic therapy data.
A. Şanlı, Isa Karaca, Bilal Turan et al.· The American surgeon· 0 citations
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