Relationship of modifiable risk factors with the incidence of thyroid cancer: a worldwide study

Cancer research · Thyroid cancer

This ecological study demonstrates that tobacco use, secondhand smoke exposure, higher BMI, and low physical activity are positively associated with the age‑standardized incidence rate of thyroid cancer worldwide.

Background: Thyroid cancer is among the most common endocrine malignancies, with rising incidence worldwide and many cases lacking symptoms. Modifiable risk factors such as smoking, second‑hand smoke (SHS), alcohol, body mass index (BMI), and physical activity may influence this trend, yet their global association remains unclear. Methods: An ecological study was conducted using data from 204 countries and territories (1990‑2019) obtained from the Global Burden of Disease database. Pearson correlation coefficients and generalized additive models (GAM) were applied to evaluate the relationship between the age‑standardized incidence rate (ASIR) of thyroid cancer and modifiable risk factors. Results: ASIR showed a statistically significant positive correlation with tobacco use (r = 0.33, P ≤ 0.0001), SHS (r = 0.53, P ≤ 0.0001), mean BMI (r = 0.39, P ≤ 0.0001), and low physical activity (r = 0.70, P ≤ 0.0001); whereas cigarette smoking alone exhibited a weak negative correlation (r = –0.06). GAM analysis indicated that women have an 8.9‑fold higher risk compared to men, and each unit increase in smoking, alcohol, SHS, BMI, or reduced physical activity raised thyroid cancer risk by factors ranging from 1.01 to 1.12. Conclusion: Modifiable risk factors—tobacco use, SHS exposure, obesity, and sedentary lifestyle—are positively associated with thyroid cancer incidence worldwide, warranting targeted public‑health interventions.

Identifying modifiable risk factors for thyroid cancer incidence is critical for developing prevention strategies and guiding public health policies. This study highlights the global influence of tobacco use, SHS exposure, obesity, and reduced physical activity, which may inform screening recommendations, lifestyle interventions, and resource allocation to reduce the burden of thyroid cancer.

Evidence level: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.

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