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Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study
Yawei Zhang1, Yingtai Chen, Huang Huang
1aDepartment of Environmental Health Sciences, Yale School of Public Health bYale School of Medicine cDepartment of Biostatistics, Yale School of Public Health dDepartment of Surgery, Yale Cancer Center, Yale New Haven Hospital, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut, USA eCancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Diagnostic radiography, including computed tomography (CT) scans and nuclear medicine exams, is linked to an increased risk of thyroid microcarcinomas. This association was not observed for larger thyroid tumors, suggesting specific risks for smaller growths.
Area of Science:
- Radiology
- Oncology
- Epidemiology
Background:
- Thyroid cancer incidence has risen, coinciding with increased use of diagnostic radiography like computed tomography (CT) and nuclear medicine.
- Limited epidemiologic studies have directly investigated the association between diagnostic radiography and thyroid cancer risk.
Purpose of the Study:
- To investigate the association between diagnostic radiography exposures and the risk of developing thyroid cancer.
- To identify specific imaging modalities that may be linked to increased thyroid cancer risk.
Main Methods:
- A population-based case-control study was conducted in Connecticut (2010-2011) with 462 thyroid cancer cases and 498 controls.
- Multivariate unconditional logistic regression models were employed to assess the relationship between diagnostic radiography and thyroid cancer risk, controlling for confounders.
Main Results:
- Exposure to diagnostic radiography was associated with an increased risk of well-differentiated thyroid microcarcinoma (≤10 mm).
- Nuclear medicine examinations showed the highest risk increase (OR=5.47), followed by chest CT (OR=4.30) and head/neck CT (OR=3.88).
- No significant associations were found between these imaging modalities and thyroid tumors larger than 10 mm.
Conclusions:
- This study provides direct evidence linking computed tomography (CT) scanning and nuclear medicine examinations to an increased risk of thyroid cancer.
- The association between various diagnostic radiography procedures and thyroid microcarcinomas warrants further investigation.
