Diabetes mellitus and risk of thyroid cancer: a meta-analysis

Yohwan Yeo, Seung-Hyun Ma, Yunji Hwang, Pamela L Horn-Ross, Ann Hsing, Kyu-Eun Lee, Young Joo Park, Do-Joon Park, Keun-Young Yoo, Sue K Park, Yohwan Yeo, Seung-Hyun Ma, Yunji Hwang, Pamela L Horn-Ross, Ann Hsing, Kyu-Eun Lee, Young Joo Park, Do-Joon Park, Keun-Young Yoo, Sue K Park

Abstract

Introduction: Diabetes mellitus (DM) is an important risk factor for endocrine cancers; however, the association with thyroid cancer is not clear. We performed a systematic review and meta-analysis to clarify the association between thyroid cancer and DM.

Methods: We searched MEDLINE, PUBMED and EMBASE databases through July 2012, using search terms related to diabetes mellitus, cancer, and thyroid cancer. We conducted a meta-analysis of the risk of incidence of thyroid cancer from pre-existing diabetes. Of 2,123 titles initially identified, sixteen articles met our inclusion criteria. An additional article was identified from a bibliography. Totally, 14 cohort and 3 case-control studies were selected for the meta-analysis. The risks were estimated using random-effects model and sensitivity test for the studies which reported risk estimates and used different definition of DM.

Results: Compared with individuals without DM, the patients with DM were at 1.34-fold higher risk for thyroid cancer (95% CI 1.11-1.63). However, there was heterogeneity in the results (p<0.0001). Sensitivity tests and studies judged to be high quality did not show heterogeneity and DM was associated with higher risk for thyroid cancer in these sub-analyses (both of RRs = 1.18, 95% CIs 1.08-1.28). DM was associated with a 1.38-fold increased risk of thyroid cancer in women (95% CI 1.13-1.67) after sensitivity test. Risk of thyroid cancer in men did not remain significant (RR 1.11, 95% CI 0.80-1.53).

Conclusions: Compared with their non-diabetic counterparts, women with pre-existing DM have an increased risk of thyroid cancer.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Literature search algorithm.
Figure 1. Literature search algorithm.
Figure 2. Meta-analysis of the association between…
Figure 2. Meta-analysis of the association between diabetes mellitus and thyroid cancer in men and women: (a) all studies, (b) high quality studies (c) cohort studies and (d) case-control studies.
Figure 3. Meta-analysis of the association between…
Figure 3. Meta-analysis of the association between diabetes mellitus and thyroid cancer in men: (a) all studies and (b) high quality studies.
Figure 4. Meta-analysis of the association between…
Figure 4. Meta-analysis of the association between diabetes mellitus and thyroid cancer in women: (a) all studies and (b) high quality studies.

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