Thyroid cancer is the eighth most common cancer in women, and its incidence is increasing. No risk factors other than ionizing radiation have been identified for differentiated thyroid cancer. Studies of the relationship of thyroid cancer with cigarette smoking have been contradictory.
Most studies of alcohol consumption have found no association with thyroid cancer. The study assessed the association of smoking and alcohol intake with risk of thyroid cancer in a cohort of , women enrolled in the WHI. A self-administered questionnaire recorded smoking habits with regard to ever smoking, age at starting, whether a current smoker, age at quitting, and number of cigarettes smoked per day.
The number of alcoholic drinks per month, week, and day were also recorded. Boutros , Peter J. Campbell , David K. Chang , Susanna L. Cooke , Vikram Deshpande , Bishoy M. Faltas , William C. Grimmond , Syed Haider , Katherine A. Hoadley , Wei Jiao , Vera B. Lazar , Constance H. Li , David N. Nahal-Bose , G. Rubin , Colin A.
Semple , Dennis C. Stein , Miranda D. Stobbe , Ren X. Sun , Kevin Thai , Derek W. Boutros , Lauri A. Alvarez , Fernanda Amary , Samirkumar B. Todd Auman , Miriam R. Bailey , Peter J. Banks , Stefano Barbi , Andrew P. Bergmann , Erik N. Bergstrom , Benjamin P. Berman , Daniel M. Berney , Stephan H. Bhosle , Andrew V. Boutros , G. Steven Bova , David T. Bowen , Reanne Bowlby , David D. Brewer , Arie B. Brinkman , Robert G. Bristow , Russell R.
Broaddus , Jane E. Bruxner , Alicia L. Burns , John Busanovich , Carlos D. Bustamante , Adam P. Butler , Atul J. Butte , Niall J. Chandan , David K. Chang , Stephen J. Chanock , Lorraine A. Christ , Elizabeth L. Collins , Ashton A. Connor , Susanna L. Cooke , Colin S. Cordes , Stephen M.
Davidson , Helen Davies , Ian J. Davis , Brandi N. Davis-Dusenbery , Kevin J. Dawson , Francisco M. Demchok , Jonas Demeulemeester , German M. Dennis , Robert E. Denroche , Stefan C. Easton , Stuart Edmonds , Paul A. Edwards , Sandra E. Edwards , Rosalind A. Eyfjord , Bishoy M. Field , J. Fittall , Anna Fitzgerald , Rebecca C. Fitzgerald , Adrienne M. Flanagan , Neil E. Fleshner , Paul Flicek , John A.
Foekens , Kwun M. Fong , Nuno A. Fonseca , Christopher S. Foster , Natalie S. Fulton , Robert S. Fulton , Mayuko Furuta , P. Garsed , Nils Gehlenborg , Josep L. Gelpi , Joshy George , Daniela S. Gerhard , Clarissa Gerhauser , Jeffrey E. Giama , Richard A. Gibbs , Anthony J. Gill , Pelvender Gill , Dilip D. Giri , Dominik Glodzik , Vincent J. Graham , Robert C. Grant , Anthony R.
Grimmond , Robert L. Hamdy , Anne Hamilton , Mark P. Hamilton , Leng Han , George B. Hanna , Martin Hansmann , Nicholas J. Neil Hayes , Stephen J. Hayes , Nicholas K. Heath , Simon C. Heath , David Hedley , Apurva M. Hegde , David I. Heiman , Michael C. Heinold , Zachary Heins , Lawrence E. Holik , Michael A. Hollingsworth , Oliver Holmes , Robert A. Hong , Gerrit K. Hoyle , Ralph H. Hudson , Michael Hummel , Jillian A. Hung , David Huntsman , Ted R.
Hupp , Jason Huse , Matthew R. Huska , Barbara Hutter , Carolyn M. Jayaseelan , Reyka Jayasinghe , Stuart R. Jefferys , Karine Jegalian , Jennifer L. Johansson , Amber L. Jonasson , Corbin D. Jones , David R. Jones , David T. Jones , Nic Jones , Steven J.
Kay , Stephen H. Kazakoff , Marat D. Kefford , Manolis Kellis , James G. Kench , Catherine J. Kennedy , Jules N. Kim , Youngwook Kim , Tari A. Lai , Peter W. Laird , Sunil R. Lakhani , Christopher M. Lalansingh , Emilie Lalonde , Fabien C. Lau , Chris Lawerenz , Rita T.
Lawlor , Michael S. Lawrence , Alexander J. Leonard , Daniel A. Louis , Laurence B. Luxton , Andy G. Maglinte , Arindam Maitra , Partha P.
Mardis , Adam A. Margolin , Maximillian G. Marra , Luke Marsden , John W. Martens , Sancha Martin , Jose I. Maruvka , R. Jay Mashl , Charlie E.
Massie , Thomas J. McGillivray , Michael D. McLellan , John D. McPherson , John R. Endokrynol Pol. Combined effects of perchlorate, thiocyanate, and iodine on thyroid function in the National Health and Nutrition Examination Survey Environ Res.
Joint genetic susceptibility to type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms. Endocr Rev. Singh Balhara, Y. Impact of tobacco on thyroid function. Thyroid Res Prac. Smoking and alcohol consumption in relation to risk of thyroid cancer in postmenopausal women. Cancer Epidemiol. Nicotine Tob Res. Lung illnesses associated with use of vaping products.
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Smoking is causally associated with oral cavity, laryngeal, oropharyngeal, and hypopharyngeal cancer and increases the risk of leukemia, sinonasal, nasopharyngeal, and esophageal cancer International Agency for Research on Cancer Furthermore, cigarette smoking has been proved as a risk factor for developing cancer of the stomach and pancreas International Agency for Research on Cancer Interestingly, the risk for thyroid cancer has been frequently reported as decreased in both men and women smokers, in the two major histological groups papillary and follicular cancers from all geographic regions Mack et al.
Most procarcinogens in tobacco products require biotransformation and metabolic activation before they are able to react with DNA. This metabolic activation is generally initiated by phase I enzymes Levitz et al. Biotransformation involves two stages: phase I, mainly controlled by enzymatic activity from cytochrome P CYP family, and phase II, catalyzed by conjugation enzymes such as glutathione S-transferases GST and others.
Phase I enzymes promote the activation of procarcinogens for the genotoxic electrophilic intermediaries. Phase II enzymes generally act as inactivating enzymes catalyzing the binding of intermediary metabolites into more hydrophilic products, thus facilitating their elimination Vineis Therefore, the coordinated expression and regulation of both phases I and II enzymes and their metabolic equilibrium in the target organ cells can be important factors in determining the susceptibility to cancer as related to carcinogen exposure Kawajiri et al.
CYP1A1 gene encodes for the enzyme aryl hydrocarbon hydroxylase AHH , which plays a key role in phase I metabolism of estrogen and polycyclic aromatic hydrocarbons, such as those found in cigarette smoke, transforming them into carcinogens Trell et al. CYP1A1 gene is located in chromosome 15q22—24 and various patterns of restriction fragment length polymorphism RFLP for this gene have been described. The ensuing higher levels of the corresponding enzymes would result in an increased capacity to activate polycyclic aromatic hydrocarbons, producing highly reactive electrophilic intermediates that might damage DNA Kawajiri et al.
We hypothesized that the combination of increased metabolic activation and decreased detoxification, together with an impaired cellular apoptotic function could lead to a high risk of thyroid carcinogenesis. Hence, the inverse epidemiologic association observed in the literature between smoking and thyroid cancer could be related to the germline inheritance of these genotypes. Patients consecutively referred to our Teaching Hospital — Medical Sciences School of the State University of Campinas for thyroid nodule evaluation between the years and , were submitted to a careful clinical examination.
The study population was composed of 80 cases of benign thyroid lesions, including 67 multinodular goiters and 13 follicular adenomas, as well as cases of malignant thyroid tumors, including papillary carcinomas and 32 follicular carcinomas. Differentiation stage and grade of the tumors were obtained from surgical and pathological records.
Experienced pathologists of the Teaching Hospital confirmed all diagnoses. All cases were managed according to a standard protocol. All patients were submitted to total or near-total thyroidectomy. Patients with preoperatively or intraoperatively palpable neck node metastases underwent regional neck dissection.
Total body I scans were performed, 4—6 weeks after the operations. All patients received mCi I. Long-term levothyroxine suppressive doses were administered following total body scan, in order to keep serum thyrotropin thyroid-stimulating hormone; TSH at low normal levels. Individuals with history of previous thyroid disease, accidental or medical radiation exposure, and antecedents of other malignancies were excluded.
Cigarette smoking habit was recorded but, due to the limited reliable data obtained on the duration of smoking, age started smoking, quantity smoked, and years since stopped smoking, the patients were grouped in never-smokers and ever-smokers categories. This last group included individuals who consumed at least 20 packages 20 cigarettes per pack for 1 year in the last 5 years.
A control group of healthy individuals who were matched on the basis of gender, age, and ethnicity was selected from the general population of our region, considered to have a normal iodine intake. The history obtained from these subjects included demographic and ethnic background, diet routine, lifetime occupational history, smoking history, general health conditions, and previous diseases.
Individuals with history of previous thyroid disease, radiation exposure, specific environment or occupational exposure risks, and antecedents of malignancy were excluded.
Blood specimens were obtained from all patients and control individuals. Genomic DNA was extracted from frozen specimens and leukocytes were separated from whole blood using a standard proteinase K-phenol-chloroform protocol. The PCR fragments were visualized in ethidium bromide-stained gels. The wild-type allele has a single band representing the entire bp fragment and the variant allele results in two fragments of and bp.
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