open access

Vol 70, No 2 (2019)
Review article
Published online: 2019-04-30
Submitted: 2018-09-20
Accepted: 2018-09-27
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Effects of thyroid hormone imbalance on colorectal cancer carcinogenesis and risk — a systematic review

Olga Rostkowska, Piotr Spychalski, Małgorzata Dobrzycka, Maciej Wilczyński, Andrzej J. Łachiński, Łukasz Obołończyk, Krzysztof Sworczak, Jarek Kobiela
DOI: 10.5603/EP.a2019.0007
·
Pubmed: 31039272
·
Endokrynologia Polska 2019;70(2):190-197.

open access

Vol 70, No 2 (2019)
Review article
Published online: 2019-04-30
Submitted: 2018-09-20
Accepted: 2018-09-27

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer-related death. The prevalence of colorectal neoplasm is increasing. Many studies have shown that thyroid dysfunction may be connected with the higher risk of pancreatic and breast cancer, but only a few described the role of thyroid dysfunction and thyroid hormone (TH) replacement in the development and risk of CRC. The aim of this study is to summarise all findings and potentially elucidate the connection between TH imbalance and colorectal cancer. The systematic review was conducted according to PICO and PRISMA guidelines. We searched MEDLINE, ClinicalTrials.gov, www.clinicaltrialsregister.eu, and Cochrane Library databases using the following keywords: “((((thyroid OR hypothyroidism OR hyperthyroidism OR levothyroxine OR hashimoto OR graves OR thyroidectomy)) AND (colon OR colorectal OR CRC)) NOT hashimoto[Author]) NOT graves[Author])”. No filters were used. Of total of 3054 articles identified by the search strategy, 11 met PICO criteria and were included into the review. Four of those were on cell lines and seven were human studies. Analysis of the included studies revealed an elevated risk of CRC in patients with hypothyroidism with aORs ranging from 1.16 (95% CI: 1.08–1.24, p < 0.001) to 1.69 (95% CI: 1.21–2.36, p = 0.002). Moreover, TH replacement therapy has a protective effect for CRC risk with aOR ranging from 0.60 (95% CI: 0.44–0.81, p = 0.001) to 0.92 (95% CI: 0.86–0.98, p = 0.009). THs seem to play a role in colorectal carcinogenesis. Further studies are warranted to define the exact role of thyroid hormone imbalance in prevention and treatment of CRC.

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer-related death. The prevalence of colorectal neoplasm is increasing. Many studies have shown that thyroid dysfunction may be connected with the higher risk of pancreatic and breast cancer, but only a few described the role of thyroid dysfunction and thyroid hormone (TH) replacement in the development and risk of CRC. The aim of this study is to summarise all findings and potentially elucidate the connection between TH imbalance and colorectal cancer. The systematic review was conducted according to PICO and PRISMA guidelines. We searched MEDLINE, ClinicalTrials.gov, www.clinicaltrialsregister.eu, and Cochrane Library databases using the following keywords: “((((thyroid OR hypothyroidism OR hyperthyroidism OR levothyroxine OR hashimoto OR graves OR thyroidectomy)) AND (colon OR colorectal OR CRC)) NOT hashimoto[Author]) NOT graves[Author])”. No filters were used. Of total of 3054 articles identified by the search strategy, 11 met PICO criteria and were included into the review. Four of those were on cell lines and seven were human studies. Analysis of the included studies revealed an elevated risk of CRC in patients with hypothyroidism with aORs ranging from 1.16 (95% CI: 1.08–1.24, p < 0.001) to 1.69 (95% CI: 1.21–2.36, p = 0.002). Moreover, TH replacement therapy has a protective effect for CRC risk with aOR ranging from 0.60 (95% CI: 0.44–0.81, p = 0.001) to 0.92 (95% CI: 0.86–0.98, p = 0.009). THs seem to play a role in colorectal carcinogenesis. Further studies are warranted to define the exact role of thyroid hormone imbalance in prevention and treatment of CRC.

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Keywords

colorectal cancer; cancer risk; hypothyroidism; thyroid hormones; levothyroxine

About this article
Title

Effects of thyroid hormone imbalance on colorectal cancer carcinogenesis and risk — a systematic review

Journal

Endokrynologia Polska

Issue

Vol 70, No 2 (2019)

Pages

190-197

Published online

2019-04-30

DOI

10.5603/EP.a2019.0007

Pubmed

31039272

Bibliographic record

Endokrynologia Polska 2019;70(2):190-197.

Keywords

colorectal cancer
cancer risk
hypothyroidism
thyroid hormones
levothyroxine

Authors

Olga Rostkowska
Piotr Spychalski
Małgorzata Dobrzycka
Maciej Wilczyński
Andrzej J. Łachiński
Łukasz Obołończyk
Krzysztof Sworczak
Jarek Kobiela

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