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1、MSøgaardandothersThyroiddiseaseandbreast174:4409414ClinicalStudycancerHypothyroidismandhyperthyroidismandbreastcancerrisk:anationwidecohortstudy111MetteSøgaard,Do´raKo¨rmendine´Farkas,VeraEhrenstein,JensOttoLundeJørgensen2,OlafMDekkers1,3andHenrikToftSørensen1Correspondenceshould
2、beaddressed12DepartmentsofClinicalEpidemiology,EndocrinologyandInternalMedicine(MEA),AarhusUniversityHospital,toMSøgaard3OlofPalmesAlle´43-45,DK-8200AarhusN,DenmarkandDepartmentsofEndocrinologyandClinicalEpidemiology,EmailLeidenUniversityMedicalCenter,Leiden,TheNetherlandsmso@cli
3、n.au.dkAbstractObjective:Theassociationbetweenthyroiddiseaseandbreastcancerriskremainsunclear.We,thereforeexaminedtheassociationbetweenhypothyroidism,hyperthyroidismandbreastcancerrisk.Design:Thiswasapopulation-basedcohortstudy.Methods:Usingnationwideregistries,weidentifiedallwome
4、ninDenmarkwithafirst-timehospitaldiagnosisofhypothyroidismorhyperthyroidism,19782013.Weestimatedtheexcessriskofbreastcanceramongpatientswithhypothyroidismorhyperthyroidismcomparedwiththeexpectedriskinthegeneralpopulation,usingstandardizedincidenceratios(SIRs)asameasureofriskratio.
5、Breastcancerdiagnosesinthefirst12monthsfollowingdiagnosisofthyroiddiseasewereexcludedfromthecalculationstoavoiddiagnosticwork-upbias.Results:Weincluded61873womendiagnosedwithhypothyroidismand80343womendiagnosedwithhyperthyroidism.Medianfollow-uptimewas4.9years(interquartilerange(I
6、QR):1.89.5years)forhypothyroidismand7.4years(IQR:3.113.5years)forhyperthyroidism.Hyperthyroidismwasassociatedwithaslightlyincreasedbreastcancerriskcomparedwiththegeneralpopulation(SIR:1.11,95%CI:1.071.16),whichpersistedbeyond5yearsoffollow-up(SIR:1.13,95%CI:1.081.19).Incomparison
7、,hypothyroidismwasassociatedwithaslightlylowerriskofbreastcancer(SIR:0.94,95%CI:0.881.00).Stratificationbycancerstageatdiagnosis,estrogenreceptorstatus,age,comorbidity,historyofalcohol-relateddiseaseandEuropeanJournalofEndocrinologyclinicaldiagnosesofobesityproducedlittlechangeinc
8、ancerrisk.Conclusions:Wefoundanincreased
