The Association between Selenium and Other Micronutrients and Thyroid Cancer Incidence in the NIH-AARP Diet and Health Study

<div><p>Background</p><p>Selenium is an essential trace element that is important for thyroid hormone metabolism and has antioxidant properties which protect the thyroid gland from oxidative stress. The association of selenium, as well as intake of other micronutrients, with thyroid cancer is unclear.</p><p>Methods</p><p>We evaluated associations of dietary selenium, beta-carotene, calcium, vitamin D, vitamin C, vitamin E, folate, magnesium, and zinc intake with thyroid cancer risk in the National Institutes of Health – American Association of Retired Persons Diet and Health Study, a large prospective cohort of 566,398 men and women aged 50–71 years in 1995–1996. Multivariable-adjusted Cox proportional hazards regression was used to examine associations between dietary intake of micronutrients, assessed using a food frequency questionnaire, and thyroid cancer cases, ascertained by linkage to state cancer registries and the National Death Index.</p><p>Results</p><p>With the exception of vitamin C, which was associated with an increased risk of thyroid cancer (HR_{Q5 vs Q1}, 1.34; 95% CI, 1.02–1.76; P_trend, <0.01), we observed no evidence of an association between quintile of selenium (HR_{Q5 vs Q1}, 1.23; 95% CI, 0.92–1.65; P_trend, 0.26) or other micronutrient intake and thyroid cancer.</p><p>Conclusion</p><p>Our study does not suggest strong evidence for an association between dietary intake of selenium or other micronutrients and thyroid cancer risk. More studies are needed to clarify the role of selenium and other micronutrients in thyroid carcinogenesis.</p></div

Hazard Ratios (HRs) and corresponding 95% confidence intervals (CIs) for total thyroid cancer by quintile of micronutrient intake in men and women combined in The NIH-AARP Diet and Health Study.

1<p>Adjusted for entry age.</p>2<p>Adjusted for entry age, sex (overall), calories, smoking status, race, education, BMI, and physical activity.</p>3<p>Additionally adjusted for vitamin C, vitamin E, beta-carotene, and folate.</p><p>Hazard Ratios (HRs) and corresponding 95% confidence intervals (CIs) for total thyroid cancer by quintile of micronutrient intake in men and women combined in The NIH-AARP Diet and Health Study.</p

Top Five Primary Dietary Sources for Micronutrients in NIH-AARP Diet and Health Study for Men and Women Combined.

+<p>Micronutrients measured as followed: Selenium (mcg/day), Betacarotene (mcg/day), Calcium (mg/day), Folate (mcg/day), Magnesium (mg/day), Vitamin C (mg/day), Vitamin D (mcg/day), Vitamin E (mg/day), Zinc (mg/day). Vitamin D food sources not available.</p><p>Top Five Primary Dietary Sources for Micronutrients in NIH-AARP Diet and Health Study for Men and Women Combined.</p

Baseline characteristics of the NIH-AARP Diet and Health Study cohort by quintiles of residual adjusted selenium intake.

<p>^*The same quintile cut points were used for men and women. In an analysis using sex-specific cut points, the results presented in the manuscript were unchanged.</p>+<p>Mean and (standard deviation).</p><p>Baseline characteristics of the NIH-AARP Diet and Health Study cohort by quintiles of residual adjusted selenium intake.</p

Total Thyroid Cancer and Papillary Thyroid Cancer Risk in NLST and PLCO by randomization group.

1<p>Adjusted for age, sex (overall).</p>2<p>Uses a time dependent variable with cut point at 3 years (NLST) & 6 years (PLCO).</p><p>Total Thyroid Cancer and Papillary Thyroid Cancer Risk in NLST and PLCO by randomization group.</p

Baseline characteristics of participants in the PLCO by randomization group.

1<p>Mean and standard deviation.</p>2<p>Values do not sum to 1 because of missing values.</p>3<p>Does not sum to 1 because of rounding.</p><p>Baseline characteristics of participants in the PLCO by randomization group.</p

Baseline characteristics of participants in NLST by randomization group.

1<p>Mean and standard deviation.</p>2<p>Values do not sum to 1 because of missing values.</p><p>Baseline characteristics of participants in NLST by randomization group.</p