CHANGING EPIDEMIOLOGY OF THYROID CANCER

虽然男性甲状腺癌的发病率在20世纪70年代有所下降， 20世纪80年代，在华盛顿西部，女性的比率有所上升。 的 35-54岁妇女的发病率增加尤其明显， 从1974年至1987年，失业率几乎翻了一番。 童年时期的接触 头部和颈部的辐射（主要的既定风险因素， 甲状腺癌）似乎不太可能完全解释这些观察结果， 考虑到这个年龄段的女性中这种暴露的普遍性下降， 组 以前的研究表明，激素因素，如使用外源性 与流产相关的雌激素、产次和激素异常 而不孕症可能会增加患甲状腺癌的风险。 但这些 早期的研究可能大大低估了与 由于接触机会不足而使用口服避孕药， 潜伏期不足，或 辐射诱发的癌症 我们提出了一项基于人群的甲状腺癌病例对照研究， 华盛顿西部三个县的妇女，以检验这一假设， 口服避孕药的使用，特别是在生命早期或 长期服用，可能会增加患甲状腺癌的风险。 全是白色女性 国王，皮尔斯和斯诺霍米什县18-64岁的居民， 被诊断为甲状腺滤泡上皮癌， 1988年1月1日至1995年6月30日将确定并邀请 参与这项研究。 癌症病例将通过 监测系统（CSS），一个基于人群的肿瘤登记， 自1974年以来一直服务于该地区。 将通过随机数字选择控件 拨号，并将频率匹配的情况下，年龄（由五年 ）和居住地。 将对病例和对照进行访谈 关于口服避孕药和其他外源性 雌激素，以及生殖和月经史， 不孕症和其他已知或疑似甲状腺癌的危险因素。

While rates of thyroid cancer among men have declined during the 1970s and 1980s in western Washington, rates among women have increased. The increase in incidence is particularly marked for women aged 35-54, in whom rates have nearly doubled from 1974-1987. Exposure to childhood irradiation of the head and neck (the principal established risk factor for thyroid cancer) seems unlikely to fully account for these observations, given the declining prevalence of this exposure among women in this age group. Previous studies suggest that hormonal factors, such as use of exogenous estrogens, parity and hormonal abnormalities associated with miscarriage and infertility may increase risk of thyroid cancer. However, these earlier studies may have considerably underestimated risk associated with oral contraceptive use due to inadequate opportunity for exposure, inadequate years of elapsed latent period, or greater prevalence of radiation-induced cancers. We propose a population-based case-control study of thyroid cancer among women in three counties of western Washington to test the hypothesis that oral contraceptive use, particularly that occurring early in life or for long time periods, may increase risk of thyroid cancer. All white female residents of King, Pierce, and Snohomish Counties aged 18-64 years and diagnosed with incident thyroid cancer of the follicular epithelium from January 1, 1988 through June 30, 1995 will be identified and invited to participate in the study. Cases will be identified through the Cancer Surveillance System (CSS), a population-based tumor registry that has served the area since 1974. Controls will be selected-by random digit dialing and will be frequency matched to cases on age (by five-year intervals) and county of residence. Cases and controls will be interviewed in person regarding their use of oral contraceptives and other exogenous estrogens, as well as reproductive and menstrual history, history of infertility and other known or suspected risk factors for thyroid cancer.