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Published online: 2024-01-15
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Evaluation of the risk of thyroid cancer following hysterectomy through meta-analysis

Ozkan Balcin12, Ilker Ercan3, Arda Uzunoglu2
DOI: 10.5603/gpl.95791
·
Pubmed: 38334350
Affiliations
  1. Bursa City Hospital, Department of General Surgery, Dogankoy, Bursa, Türkiye
  2. Bursa Uludag University, Institute of Health Sciences, Department of Biostatistics, Gorukle, Bursa, Türkiye
  3. Department of Biostatistics, Uludag University, Faculty of Medicine, Bursa, Turkey

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Ahead of Print
REVIEW PAPERS Gynecology
Published online: 2024-01-15

Abstract

Objectives: Thyroid cancer is observed more frequently in women than men, possibly due to the influence of hormonal factors. This study aims to conduct a meta-analysis encompassing both prospective and retrospective observational studies to examine the risk of thyroid cancer in women who have undergone hysterectomy surgery.

Material and methods: The literature search identified 356 articles by May 2022, and eight reported hazard ratios for thyroid cancer in women who underwent hysterectomy surgery. After the eliminations, we performed three different meta-analyses with studies that included patients who underwent only total abdominal hysterectomy (TAH), total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO), and underwent hysterectomy with or without BSO. The reporting of this study has been conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the Methodological Quality of Systematic Reviews).

Results: Our study showcases a comprehensive meta-analysis that includes eight observational studies, both retrospective and prospective, exploring the link between hysterectomy and the likelihood of developing thyroid cancer. This analysis is based on data from more than 12 million individuals, encompassing over 24,000 cases. Women who had undergone TAH (HR = 1.586, 95% CI: 1.382–1.819, p < 0.001), women who had undergone TAH and BSO (HR = 1.420, 95% CI: 1.205–1.675, p < 0.001), and women who had undergone hysterectomy with or without BSO had an increased risk (HR = 1.623, 95% CI: 1.387–1.899, p < 0.001) of developing thyroid cancer later in life.

Conclusions: We found that hysterectomy had a statistically significant risk effect on the development of thyroid cancer. The limited number of previous studies, the low amount of information, the lack of homogeneous distribution of the patients in the studies, and the unknown characteristics of thyroid cancer developing after hysterectomy were the limitations of this study. Nevertheless, our findings can positively affect public health because of the potential to enlighten the etiological mechanisms leading to thyroid cancer. Future researches should first aim to explain the underlying mechanisms of developing thyroid cancer after hysterectomy.

Abstract

Objectives: Thyroid cancer is observed more frequently in women than men, possibly due to the influence of hormonal factors. This study aims to conduct a meta-analysis encompassing both prospective and retrospective observational studies to examine the risk of thyroid cancer in women who have undergone hysterectomy surgery.

Material and methods: The literature search identified 356 articles by May 2022, and eight reported hazard ratios for thyroid cancer in women who underwent hysterectomy surgery. After the eliminations, we performed three different meta-analyses with studies that included patients who underwent only total abdominal hysterectomy (TAH), total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO), and underwent hysterectomy with or without BSO. The reporting of this study has been conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the Methodological Quality of Systematic Reviews).

Results: Our study showcases a comprehensive meta-analysis that includes eight observational studies, both retrospective and prospective, exploring the link between hysterectomy and the likelihood of developing thyroid cancer. This analysis is based on data from more than 12 million individuals, encompassing over 24,000 cases. Women who had undergone TAH (HR = 1.586, 95% CI: 1.382–1.819, p < 0.001), women who had undergone TAH and BSO (HR = 1.420, 95% CI: 1.205–1.675, p < 0.001), and women who had undergone hysterectomy with or without BSO had an increased risk (HR = 1.623, 95% CI: 1.387–1.899, p < 0.001) of developing thyroid cancer later in life.

Conclusions: We found that hysterectomy had a statistically significant risk effect on the development of thyroid cancer. The limited number of previous studies, the low amount of information, the lack of homogeneous distribution of the patients in the studies, and the unknown characteristics of thyroid cancer developing after hysterectomy were the limitations of this study. Nevertheless, our findings can positively affect public health because of the potential to enlighten the etiological mechanisms leading to thyroid cancer. Future researches should first aim to explain the underlying mechanisms of developing thyroid cancer after hysterectomy.

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Keywords

thyroid cancer; hysterectomy; oophorectomy; artificial menopause; surgical menopause; meta-analysis

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About this article
Title

Evaluation of the risk of thyroid cancer following hysterectomy through meta-analysis

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Review paper

Published online

2024-01-15

Page views

166

Article views/downloads

158

DOI

10.5603/gpl.95791

Pubmed

38334350

Keywords

thyroid cancer
hysterectomy
oophorectomy
artificial menopause
surgical menopause
meta-analysis

Authors

Ozkan Balcin
Ilker Ercan
Arda Uzunoglu

References (54)
  1. Fitzmaurice C, Dicker D, Pain A, et al. Global Burden of Disease Cancer Collaboration. The global burden of cancer 2013. JAMA Oncol. 2015; 1(4): 505–527.
    CrossRefPubMed
  2. Lubitz CC, Kong CY, McMahon PM, et al. Annual financial impact of well-differentiated thyroid cancer care in the United States. Cancer. 2014; 120(9): 1345–1352.
    CrossRefPubMed
  3. Schneider DF, Chen H. New developments in the diagnosis and treatment of thyroid cancer. CA Cancer J Clin. 2013; 63(6): 374–394.
    CrossRefPubMed
  4. Colonna M, Uhry Z, Guizard AV, et al. FRANCIM network. Recent trends in incidence, geographical distribution, and survival of papillary thyroid cancer in France. Cancer Epidemiol. 2015; 39(4): 511–518.
    CrossRefPubMed
  5. Clavel-Chapelon F, Guillas G, Tondeur L, et al. Risk of differentiated thyroid cancer in relation to adult weight, height and body shape over life: the French E3N cohort. Int J Cancer. 2010; 126(12): 2984–2990.
    CrossRefPubMed
  6. Trésallet C, Seman M, Tissier F, et al. The incidence of papillary thyroid carcinoma and outcomes in operative patients according to their body mass indices. Surgery. 2014; 156(5): 1145–1152.
    CrossRefPubMed
  7. Rahbari R, Zhang L, Kebebew E. Thyroid cancer gender disparity. Future Oncol. 2010; 6(11): 1771–1779.
    CrossRefPubMed
  8. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136(5): E359–E386.
    CrossRefPubMed
  9. Moleti M, Sturniolo G, Di Mauro M, et al. Female Reproductive Factors and Differentiated Thyroid Cancer. Front Endocrinol (Lausanne). 2017; 8: 111.
    CrossRefPubMed
  10. Derwahl M, Nicula D. Estrogen and its role in thyroid cancer. Endocr Relat Cancer. 2014; 21(5): T273–T283.
    CrossRefPubMed
  11. Bayram C, Valenti L, Britt H. General practice encounters with men. Aust Fam Physician. 2016; 45(4): 171–174.
    PubMed
  12. Cordina-Duverger E, Leux C, Neri M, et al. Hormonal and reproductive risk factors of papillary thyroid cancer: A population-based case-control study in France. Cancer Epidemiol. 2017; 48: 78–84.
    CrossRefPubMed
  13. Zamora-Ros R, Rinaldi S, Biessy C, et al. Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: the EPIC study. Int J Cancer. 2015; 136(5): 1218–1227.
    CrossRefPubMed
  14. Xhaard C, Rubino C, Cléro E, et al. Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in young women in France: a population-based case-control study. Am J Epidemiol. 2014; 180(10): 1007–1017.
    CrossRefPubMed
  15. Manole D, Schildknecht B, Gosnell B, et al. Estrogen promotes growth of human thyroid tumor cells by different molecular mechanisms. J Clin Endocrinol Metab. 2001; 86(3): 1072–1077.
    CrossRefPubMed
  16. Rajoria S, Suriano R, Shanmugam A, et al. Metastatic phenotype is regulated by estrogen in thyroid cells. Thyroid. 2010; 20(1): 33–41.
    CrossRefPubMed
  17. Xu S, Chen G, Peng W, et al. Oestrogen action on thyroid progenitor cells: relevant for the pathogenesis of thyroid nodules? J Endocrinol. 2013; 218(1): 125–133.
    CrossRefPubMed
  18. Zane M, Parello C, Pennelli G, et al. Estrogen and thyroid cancer is a stem affair: A preliminary study. Biomed Pharmacother. 2017; 85: 399–411.
    CrossRefPubMed
  19. Luo J, Hendryx M, Manson JE, et al. Hysterectomy, oophorectomy, and risk of thyroid cancer. J Clin Endocrinol Metab. 2016; 101(10): 3812–3819.
    CrossRefPubMed
  20. Mack WJ, Preston-Martin S, Bernstein L, et al. Reproductive and hormonal risk factors for thyroid cancer in Los Angeles County females. Cancer Epidemiol Biomarkers Prev. 1999; 8(11): 991–997.
    PubMed
  21. Wu JM, Wechter ME, Geller EJ, et al. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007; 110(5): 1091–1095.
    CrossRefPubMed
  22. Tamhane N, Imudia AN, Mikhail E. Contemporary management of adnexa at the time of benign hysterectomy: a review of the literature. J Obstet Gynaecol. 2019; 39(7): 896–902.
    CrossRefPubMed
  23. Laughlin GA, Barrett-Connor E, Kritz-Silverstein D, et al. Hysterectomy, oophorectomy, and endogenous sex hormone levels in older women: the Rancho Bernardo Study. J Clin Endocrinol Metab. 2000; 85(2): 645–651.
    CrossRefPubMed
  24. Xiangying Hu, Lili H, Yifu S. The effect of hysterectomy on ovarian blood supply and endocrine function. Climacteric. 2006; 9(4): 283–289.
    CrossRefPubMed
  25. Farquhar CM, Sadler L, Harvey SA, et al. The association of hysterectomy and menopause: a prospective cohort study. BJOG. 2005; 112(7): 956–962.
    CrossRefPubMed
  26. Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021; 372: n160.
    CrossRefPubMed
  27. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358: j4008.
    CrossRefPubMed
  28. Parmar M, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Statistics in Medicine. 1998; 17(24): 2815–2834, doi: 10.1002/(sici)1097-0258(19981230)17:24<2815::aid-sim110>3.0.co;2-8.
    PubMed
  29. Hoaglin DC. Misunderstandings about Q and 'Cochran's Q test' in meta-analysis. Stat Med. 2016; 35(4): 485–495.
    CrossRefPubMed
  30. Frentzel-Beyme R, Helmert U. Association between malignant tumors of the thyroid gland and exposure to environmental protective and risk factors. Rev Environ Health. 2000; 15(3): 337–358.
    CrossRefPubMed
  31. Caini S, Gibelli B, Palli D, et al. Menstrual and reproductive history and use of exogenous sex hormones and risk of thyroid cancer among women: a meta-analysis of prospective studies. Cancer Causes Control. 2015; 26(4): 511–518.
    CrossRefPubMed
  32. Mannathazhathu AS, George PS, Sudhakaran S, et al. Reproductive factors and thyroid cancer risk: meta-analysis. Head Neck. 2019; 41(12): 4199–4208.
    CrossRefPubMed
  33. Wang P, Lv L, Qi F, et al. Increased risk of papillary thyroid cancer related to hormonal factors in women. Tumour Biol. 2015; 36(7): 5127–5132.
    CrossRefPubMed
  34. Negri E, Dal Maso L, Ron E, et al. A pooled analysis of case-control studies of thyroid cancer. II. Menstrual and reproductive factors. Cancer Causes Control. 1999; 10(2): 143–155.
    CrossRefPubMed
  35. Wilson LF, Tuesley KM, Webb PM, et al. Hysterectomy and risk of breast, colorectal, thyroid, and kidney cancer - an Australian data linkage study. Cancer Epidemiol Biomarkers Prev. 2021; 30(5): 904–911.
    CrossRefPubMed
  36. Kim M, Kim BoH, Lee H, et al. Thyroid cancer after hysterectomy and oophorectomy: a nationwide cohort study. Eur J Endocrinol. 2021; 184(1): 143–151.
    CrossRefPubMed
  37. Guenego A, Mesrine S, Dartois L, et al. Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort. Clin Endocrinol (Oxf). 2019; 90(2): 360–368.
    CrossRefPubMed
  38. Falconer H, Yin Li, Bellocco R, et al. Thyroid cancer after hysterectomy on benign indications: Findings from an observational cohort study in Sweden. Int J Cancer. 2017; 140(8): 1796–1801.
    CrossRefPubMed
  39. Altman D, Yin Li, Falconer H. Long-term cancer risk after hysterectomy on benign indications: population-based cohort study. Int J Cancer. 2016; 138(11): 2631–2638.
    CrossRefPubMed
  40. Kabat GC, Kim MY, Wactawski-Wende J, et al. Menstrual and reproductive factors, exogenous hormone use, and risk of thyroid carcinoma in postmenopausal women. Cancer Causes Control. 2012; 23(12): 2031–2040.
    CrossRefPubMed
  41. Braganza MZ, Berrington de González A, Schonfeld SJ, et al. Benign breast and gynecologic conditions, reproductive and hormonal factors, and risk of thyroid cancer. Cancer Prev Res (Phila). 2014; 7(4): 418–425.
    CrossRefPubMed
  42. Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D. Cancer: epidemiology and prevention. Oxford University Press, Oxford 2018.
  43. Lewy-Trenda I. Estrogen and progesterone receptors in neoplastic and non-neoplastic thyroid lesions. Pol J Pathol. 2002; 53(2): 67–72.
    PubMed
  44. Bouman A, Heineman MJ, Faas MM. Sex hormones and the immune response in humans. Hum Reprod Update. 2005; 11(4): 411–423.
    CrossRefPubMed
  45. Kim JJ, Kurita T, Bulun SE. Progesterone action in endometrial cancer, endometriosis, uterine fibroids, and breast cancer. Endocr Rev. 2013; 34(1): 130–162.
    CrossRefPubMed
  46. Luoto R, Auvinen A, Pukkala E, et al. Hysterectomy and subsequent risk of cancer. Int J Epidemiol. 1997; 26(3): 476–483.
    CrossRefPubMed
  47. Luoto R, Grenman S, Salonen S, et al. Increased risk of thyroid cancer among women with hysterectomies. Am J Obstet Gynecol. 2003; 188(1): 45–48.
    CrossRefPubMed
  48. Rossing MA, Voigt LF, Wicklund KG, et al. Reproductive factors and risk of papillary thyroid cancer in women. Am J Epidemiol. 2000; 151(8): 765–772.
    CrossRefPubMed
  49. Wong EY, Ray R, Gao DL, et al. Reproductive history, occupational exposures, and thyroid cancer risk among women textile workers in Shanghai, China. Int Arch Occup Environ Health. 2006; 79(3): 251–258.
    CrossRefPubMed
  50. Truong T, Orsi L, Dubourdieu D, et al. Role of goiter and of menstrual and reproductive factors in thyroid cancer: a population-based case-control study in New Caledonia (South Pacific), a very high incidence area. Am J Epidemiol. 2005; 161(11): 1056–1065.
    CrossRefPubMed
  51. Lundholm C, Forsgren C, Johansson ALV, et al. Hysterectomy on benign indications in Sweden 1987-2003: a nationwide trend analysis. Acta Obstet Gynecol Scand. 2009; 88(1): 52–58.
    CrossRefPubMed
  52. Bíró J, Eneroth P, Ritzén EM. Effects of hysterectomy and in-vivo treatment with uterine extracts on plasma concentrations of growth hormone, thyrotrophin and thyroid hormones in rats: a kinetic study. J Endocrinol. 1984; 101(3): 243–248.
    CrossRefPubMed
  53. Patak E, Pinto FM, Story ME, et al. Functional and molecular characterization of tachykinins and tachykinin receptors in the mouse uterus. Biol Reprod. 2005; 72(5): 1125–1133.
    CrossRefPubMed
  54. Kim MH, Park YeR, Lim DJ, et al. The relationship between thyroid nodules and uterine fibroids. Endocr J. 2010; 57(7): 615–621.
    CrossRefPubMed

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