Anthropometry, diet and risk of differentiated thyroid cancer in the Pacific Islands

La Polynésie française et la Nouvelle-Calédonie, îles du Pacifique, ont l’un des taux de cancer de la thyroïde les plus élevés au monde. A l’exception des rayonnements ionisants, aucun autre facteur de risque n’est clairement établi pour ce cancer. Deux études cas-témoins sur le cancer de la thyroïde ont été réalisées en Polynésie française et Nouvelle-Calédonie afin d’étudier les facteurs de risque qui sont encore peu connus. L'objectif de ce travail de thèse est d’étudier le rôle des facteurs anthropométriques et de l’alimentation sur le risque de cancer de la thyroïde dans les îles du Pacifique.En Polynésie française, 229 cas de cancer de la thyroïde diagnostiqués entre 1979 et 2004 et 371 témoins appariés sur l’âge et le sexe ont été inclus. En Nouvelle-Calédonie, 331 cas de cancer de la thyroïde diagnostiqués entre 1993 et 1999 et 412 témoins appariés également sur l’âge et le sexe ont été inclus.Dans l’analyse poolée des deux études cas-témoins, un peu plus de la moitié des Polynésiens et Néo-calédoniens étaient en surpoids ou obèses. Une augmentation du risque de cancer thyroïdien a été mise en évidence avec une taille, un poids, un indice de masse corporelle, et une surface corporelle élevés. Parmi ces facteurs anthropométriques, la surface corporelle joue un rôle dominant dans le risque de cancer de la thyroïde, en particulier à l’âge de 18 ans.Ensuite, nous nous sommes intéressés à l’alimentation des Polynésiens uniquement. Nous avons identifié deux régimes (ou patterns) alimentaires : l’un occidental et l’autre polynésien traditionnel. Le régime « occidental » n’était pas associé à un risque de cancer thyroïdien, alors que le régime « polynésien traditionnel » était faiblement associé à une diminution du risque. Par ailleurs, les résultats ont montré que les Polynésiens avaient une alimentation carencée en iode. Une consommation élevée de poissons et fruits de mer, ainsi qu’un apport alimentaire en iode élevé étaient associés à une diminution du risque de cancer de la thyroïde. Enfin, une consommation élevée de manioc, aliment goitrigène, diminuait le risque de cancer thyroïdien.French Polynesia and New Caledonia, Pacific Islands, have one of the world’s highest thyroid cancer incidence rates. Except ionizing radiation, no other risk factor is clearly established for this cancer. Two case-control studies on thyroid cancer were conducted in French Polynesia and New Caledonia to investigate the risk factors not still understood. The objective of this thesis is to study the role of anthropometric and dietary factors in the risk of thyroid cancer in the Pacific Islands.In French Polynesia, 229 cases of thyroid cancer diagnosed between 1979 and 2004 and 371 controls matched on age and sex were included. In New Caledonia, 331 cases of thyroid cancer diagnosed between 1993 and 1999 and 412 controls matched also on age and sex were included.In the pooled analysis of the two case-control studies, half of Polynesians and Melanesians were overweighed or obese. An increased risk of thyroid cancer was shown with a high height, weight, body mass index, and body surface area. Among anthropometric factors, BSA plays a dominant role in thyroid cancer risk, in particular at 18 years old.Then, we are interested in the diet only of Polynesians. We have identified two dietary patterns: Western and traditional Polynesian. The pattern “Western" was not associated with a risk of thyroid cancer, while the pattern "traditional Polynesian" was weakly associated with a decreased risk. Moreover, results showed that Polynesians had a diet deficient in iodine. A higher consumption of fish and shellfish, and a higher dietary iodine intake are significantly associated with a decreased risk of thyroid cancer. Lastly, high cassava consumption decreased the thyroid cancer risk

Anthropometry, diet and risk of differentiated thyroid cancer in the Pacific Islands

La Polynésie française et la Nouvelle-Calédonie, îles du Pacifique, ont l’un des taux de cancer de la thyroïde les plus élevés au monde. A l’exception des rayonnements ionisants, aucun autre facteur de risque n’est clairement établi pour ce cancer. Deux études cas-témoins sur le cancer de la thyroïde ont été réalisées en Polynésie française et Nouvelle-Calédonie afin d’étudier les facteurs de risque qui sont encore peu connus. L'objectif de ce travail de thèse est d’étudier le rôle des facteurs anthropométriques et de l’alimentation sur le risque de cancer de la thyroïde dans les îles du Pacifique.En Polynésie française, 229 cas de cancer de la thyroïde diagnostiqués entre 1979 et 2004 et 371 témoins appariés sur l’âge et le sexe ont été inclus. En Nouvelle-Calédonie, 331 cas de cancer de la thyroïde diagnostiqués entre 1993 et 1999 et 412 témoins appariés également sur l’âge et le sexe ont été inclus.Dans l’analyse poolée des deux études cas-témoins, un peu plus de la moitié des Polynésiens et Néo-calédoniens étaient en surpoids ou obèses. Une augmentation du risque de cancer thyroïdien a été mise en évidence avec une taille, un poids, un indice de masse corporelle, et une surface corporelle élevés. Parmi ces facteurs anthropométriques, la surface corporelle joue un rôle dominant dans le risque de cancer de la thyroïde, en particulier à l’âge de 18 ans.Ensuite, nous nous sommes intéressés à l’alimentation des Polynésiens uniquement. Nous avons identifié deux régimes (ou patterns) alimentaires : l’un occidental et l’autre polynésien traditionnel. Le régime « occidental » n’était pas associé à un risque de cancer thyroïdien, alors que le régime « polynésien traditionnel » était faiblement associé à une diminution du risque. Par ailleurs, les résultats ont montré que les Polynésiens avaient une alimentation carencée en iode. Une consommation élevée de poissons et fruits de mer, ainsi qu’un apport alimentaire en iode élevé étaient associés à une diminution du risque de cancer de la thyroïde. Enfin, une consommation élevée de manioc, aliment goitrigène, diminuait le risque de cancer thyroïdien.French Polynesia and New Caledonia, Pacific Islands, have one of the world’s highest thyroid cancer incidence rates. Except ionizing radiation, no other risk factor is clearly established for this cancer. Two case-control studies on thyroid cancer were conducted in French Polynesia and New Caledonia to investigate the risk factors not still understood. The objective of this thesis is to study the role of anthropometric and dietary factors in the risk of thyroid cancer in the Pacific Islands.In French Polynesia, 229 cases of thyroid cancer diagnosed between 1979 and 2004 and 371 controls matched on age and sex were included. In New Caledonia, 331 cases of thyroid cancer diagnosed between 1993 and 1999 and 412 controls matched also on age and sex were included.In the pooled analysis of the two case-control studies, half of Polynesians and Melanesians were overweighed or obese. An increased risk of thyroid cancer was shown with a high height, weight, body mass index, and body surface area. Among anthropometric factors, BSA plays a dominant role in thyroid cancer risk, in particular at 18 years old.Then, we are interested in the diet only of Polynesians. We have identified two dietary patterns: Western and traditional Polynesian. The pattern “Western" was not associated with a risk of thyroid cancer, while the pattern "traditional Polynesian" was weakly associated with a decreased risk. Moreover, results showed that Polynesians had a diet deficient in iodine. A higher consumption of fish and shellfish, and a higher dietary iodine intake are significantly associated with a decreased risk of thyroid cancer. Lastly, high cassava consumption decreased the thyroid cancer risk

Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers

International audienceObjectives The French nuclear worker cohort allows for the assessment of cancer risk associated with occupational radiation exposure. But workers are also exposed to medical and environmental radiation which can be of the same order of magnitude. This study intends to examine the impact of non-occupational radiation exposures in the dose-risk analysis between occupational radiation exposure and cancer mortality.Methods The cohort includes workers employed before 1995 for at least one year by CEA, AREVA NC or EDF and badge-monitored for external radiation exposure. Monitoring results were used to calculate occupational individual doses. Scenarios of work-related X-ray and environmental exposures were simulated. Poisson regression was used to quantify associations between occupational exposure and cancer mortality adjusting on non-occupational radiation exposure.Results The mean cumulative dose of external occupational radiation was 18.4 mSv among 59,004 workers. Depending on the hypotheses made, the mean cumulative work-related X-ray dose varied between 3.1 and 9.2 mSv and the mean cumulative environmental dose was around 130 mSv. The unadjusted excess relative rate of cancer per Sievert (ERR/Sv) was 0.34 [90%CI: -0.44–1.24]. Adjusting on environmental radiation exposure did not modify substantially this risk coefficient, but it was attenuated by medical exposure (ERR/Sv point estimate between 0.15 and 0.23). Conclusions Occupational radiation risk estimates were lower when adjusted on work-related X-ray exposures. Environmental exposures had a very slight impact on the occupational exposure risk estimates. In any scenario of non-occupational exposure considered, a positive but not significant excess cancer risk associated to occupational exposure was observed

[Risk of second cancer after germinal cell testicular cancer: study from the data of Doubs cancer registry]

International audienceTesticular cancer, both seminoma and nonseminoma tumours, account for 1 to 1.5 % of male cancers. Many studies have shown that the risk of a second cancer after radiotherapy is dependent on the size of the exposure fields and the strength of delivered doses of radiotherapy. According to the literature, the relative risk of second cancer among patients treated by irradiation for seminoma limited to the testis varies from 1.5 to 1.9. We conducted a retrospective epidemiological study to measure the risk of second cancer in a population treated for both seminoma and nonseminoma tumours. The study period included patients who were diagnosed from 1978 to 2002. Data were provided by the Doubs cancer registry. Among these 291 cases of testicular cancer, we found 11 cases of second cancer after 157 seminomas (stomach, lungs, testis, ORL, kidney and oesophagus), and 3 cases after 134 nonseminomas (thyroid, kidney and testis). We found a high risk for second pulmonary and testicular cancers (standardised incidence ratio almost statistically significant). While our results are not conclusive regarding the etiology of these second cancers, they do form a useful, comparative basis for further study. They constitute the first step of a study that will be carried out on the risk related to radiation after orchidectomy

The risk of cancer attributable to diagnostic medical radiation: Estimation for France in 2015

International audienceAlthough medical ionizing radiation (IR) has clear clinical benefits, it is an established carcinogen. Our study estimates the number of new cancer cases in France in 2015 attributable to IR exposure from medical procedures. Exposures from external (X-rays, CT scans, interventional radiology) and internal (nuclear medicine) sources were considered. We used 2007 national frequencies of diagnostic examinations by sex and age to estimate the lifetime organ dose exposure adjusted for changes in the use of such procedures over time. The Biological Effects of Ionizing Radiation VII risk models were used to estimate the corresponding excess cancer risk, assuming an average latency period of 10 years. Additionally, we used cancer incidence data from the French Cancer Registries Network. Of the 346,000 estimated new cancer cases in adults in France in 2015, 2300 cases (940 among men and 1360 among women) were attributable to diagnostic IR, representing 0.7% of all new cancer cases (0.5% for men and 0.9% for women). The leading cancers attributable to medical IR were female breast (n = 560 cases), lung (n = 500 cases) and colon (n = 290 cases) cancers. Compared to other risk factors, the contribution of medical IR to the cancer burden is small, and the benefits largely outweigh its harms. However, some of these IR-associated cancer cases may be preventable through dose optimization of and enhanced justification for diagnostic examinations. © 2019 UIC

FOXE1 Polymorphism Interacts with Dietary Iodine Intake in Differentiated Thyroid Cancer Risk in the Cuban Population

International audienceBackground: The incidence of differentiated thyroid cancer (DTC) is low in Cuba, and the contribution of dietary factors to DTC in this population has not been investigated so far. The aim of this study was to evaluate the relationship between dietary iodine intake and DTC with regard to the interaction with environmental factors or some common single nucleotide polymorphisms (SNPs), based on a case-control study carried out in Cuba.Methods: A total of 203 cases and 212 controls from the general population were interviewed face-to-face using the dietary intake questionnaire and the photo booklet from the E3N cohort. A specific food composition table was constructed for this study. For each parameter studied, the odds ratio (OR) was stratified on age group and sex, and further adjusted for dietary energy, smoking status, ethnic group, level of education, number of pregnancies, and body surface area.Results: The risk of DTC was significantly reduced with increasing consumption of fish (p = 0.04), but no association between total dietary iodine intake and DTC risk was evident (p = 0.7). This lack of significant association was true whatever the age, the smoking status, the dietary selenium intake, and the ethnicity (p > 0.05). DTC risk was positively and strongly associated with the number of copies in the minor allele (A) for SNP rs965513 near FOXE1 among people who consumed less iodine than the median (p = 0.005).Conclusion: Overall, the majority of the studied population had an optimal dietary iodine intake. DTC risk was inversely associated with high fish consumption. Furthermore, DTC risk was positively associated with the number of copies in the minor allele (A) of rs965513 among people who consumed less iodine than the median. Because these findings are based on post-diagnostic measures, studies with pre-diagnostic dietary iodine are needed for confirmation

Risk of second bone sarcoma following childhood cancer:role of radiation therapy treatment

Bone sarcoma as a second malignancy is rare but highly fatal. The present knowledge about radiation-absorbed organ dose–response is insufficient to predict the risks induced by radiation therapy techniques. The objective of the present study was to assess the treatment-induced risk for bone sarcoma following a childhood cancer and particularly the related risk of radiotherapy. Therefore, a retrospective cohort of 4,171 survivors of a solid childhood cancer treated between 1942 and 1986 in France and Britain has been followed prospectively. We collected detailed information on treatments received during childhood cancer. Additionally, an innovative methodology has been developed to evaluate the dose–response relationship between bone sarcoma and radiation dose throughout this cohort. The median follow-up was 26 years, and 39 patients had developed bone sarcoma. It was found that the overall incidence was 45-fold higher [standardized incidence ratio 44.8, 95 % confidence interval (CI) 31.0–59.8] than expected from the general population, and the absolute excess risk was 35.1 per 100,000 person-years (95 % CI 24.0–47.1). The risk of bone sarcoma increased slowly up to a cumulative radiation organ absorbed dose of 15 Gy [hazard ratio (HR) = 8.2, 95 % CI 1.6–42.9] and then strongly increased for higher radiation doses (HR for 30 Gy or more 117.9, 95 % CI 36.5–380.6), compared with patients not treated with radiotherapy. A linear model with an excess relative risk per Gy of 1.77 (95 % CI 0.6213–5.935) provided a close fit to the data. These findings have important therapeutic implications: Lowering the radiation dose to the bones should reduce the incidence of secondary bone sarcomas. Other therapeutic solutions should be preferred to radiotherapy in bone sarcoma-sensitive areas