Document Type

Capstone Experience

Graduation Date

12-2018

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Christine M. Arcari

Second Committee Member

Jiangtao Luo

Third Committee Member

Paraskevi A. Farazi

Fourth Committee Member

Whitney S. Goldner

Abstract

Introduction: The incidence of thyroid cancer in the United States has rising on average 3.1% each year over the last 10 years. Much of this increase is attributed to increased detection using ultrasound. Dietary habits can be an important modifiable risk factors for different types of cancer, but the association between dietary factors and thyroid cancer has not been well studied. The goals of this capstone were to: 1) review the literature for the association between dietary factors and thyroid cancer, 2) describe demographic and behavioral characteristics of patients with thyroid nodules and cancer in a hospital-based registry, and 3) conduct a case-control study comparing dietary habits of patients with thyroid cancer or thyroid nodules to a control (cancer-free) population.

Methods: A case-control study was conducted with 368 thyroid cancer cases and 475 thyroid nodule cases identified from the Thyroid Tumor and Cancer Collaborative Registry (TCCR), and 223 controls identified from the Great Plains Health Informatics Database (GPHID). Dietary habits of cancer cases and thyroid nodule cases were compared to the control group. Crude odds ratios (ORs), adjusted ORs, and 95% Cis were estimated using multivariable logistic regression.

Results: Thyroid cancer cases more likely to consume deli meat (OR=1.69 95%CI 1.03, 2.78), high sugar, low fiber cereals (OR=2.57 95%CI 1.46, 4.53) and mayonnaise (OR=1.65 95%CI 1.14, 2.39). Thyroid cancer cases were less likely to consume fried or scrambled eggs (OR=0.46, 95%CI 0.24, 0.90). Smoking and alcohol assumption did not impact the association between dietary habits and thyroid cancer.

Conclusion: Deli meat, high sugar/low fiber cereals and mayonnaise were more likely to be consume by thyroid cancer cases compared to the controls. These potential risk factors for thyroid cancer need to be explored further. The mechanism is not clear, but if these foods are found to increase risk it could lead to prevention opportunities.

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