Introduction The incidence of thyroid carcinomas has been rapidly increasing over the last 20–30 years in many Westernized countries. Large part of the increase is due to diagnostic improvements, however other changes may be involved. The only well-established risk factors for differentiated thyroid carcinomas (TC) (the most common forms of TC) are history of benign thyroid disease, notably goiter and benign nodules, and exposure to ionizing radiations (especially during childhood). However, recent studies have shown consistent evidence that body mass, including height and weight, are also positively associated with differentiated TC risk. However, mechanisms that may explain this association are currently not known but can include sex hormones. We therefore investigated the role of sex steroids and sex hormones binding globulin (SHBG) in the etiology of differentiated thyroid cancer in a case-control study nested within the large European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods Within EPIC, during follow-up, we identified 329 primary incident cases of differentiated thyroid carcinoma (133 in pre-menopausal women, 118 in postmenopausal women, and 78 in men) among subjects who participated in the study and gave a blood sample at blood collection. To these cases, 710 controls, who did not develop any cancers, apart from non-melanoma skin cancer, at the time of the diagnosis of the case, were matched on study recruitment center, sex, age, date, time, fasting status at blood collection, duration of follow-up, and, in women, menopausal status and phase of the menstrual cycle. Women taking exogenous hormones at blood donation were excluded. Plasma concentrations of testosterone (T), androstenedione (D4), dehydroepiandrosterone (DHEA), estradiol, estrone and progesterone (in pre-menopausal women only) were performed by a highly sensitive high-resolution liquid chromatography/mass spectrometry (LC-HSMS/MS) method. SHBG concentrations were measured by a validated immunoassay. Odds ratios (ORs) of TC by levels of each biomarker were estimated using conditional logistic regression models adjusted for potential confounders (including height, waist circumference, physical activity, smoking status, alcohol consumption, education level, and for women, age at first full term pregnancy, number of full term pregnancies, and exogenous hormone use). Results In pre-menopausal women, controls had a lower BMI, a shorter waist circumference, and a higher alcohol intake than the cases (24.2 vs. 25.7 kg/m2 for BMI, 76.5 vs. 80.0 cm for waist, 3.2 vs. 1.8 g/day for alcohol intake, respectively). Preliminary conditional logistic regression analyses suggest positive associations of borderline statistical significance of differentiated thyroid cancer with the concentrations of T, D4 and DHEA in pre-menopausal women (ORT3vsT1: 1.83 (95% CI: 0.99–3.39) for T; 1.99 (95% CI: 1.02–3.87) for D4; 1.84 (95% CI: 0.95–3.56) for DHEA). No associations could be observed in postmenopausal women nor in men. No associations were found with estrogens or progesterone. Conclusions This study is the first prospective study conducted on sex steroids and differentiated TC risk and will provide insights on mechanisms relating overweight and obesity to TC risk. Our preliminary results suggest a possible positive association of differentiated TC risk with high androgen concentration in pre-menopausal women but no relationship with estrogens or progesterone.
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