Impact of Overweight and Obesity on US Papillary Thyroid Cancer Incidence Trends (1995–2015)
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Background: Since the early 1980s, papillary thyroid cancer (PTC) incidence rates and the prevalence of obesity, a risk factor for PTC, have increased substantially in the United States. We estimated the proportion of PTC incidence in the United States attributable to overweight and obesity during 1995–2015. Methods: National Institutes of Health-AARP Diet and Health Study cohort data (n = 457 331 participants, 50–71 years and cancer-free at baseline) were used to estimate multivariable-adjusted hazard ratios (HRs) for PTC across body mass index categories. Population attributable fractions (PAFs) were calculated using estimated hazard ratios and annual overweight and obesity prevalence estimates from the National Health Interview Survey. PAF estimates were combined with Surveillance, Epidemiology, and End Results-13 data to calculate annual percent changes in PTC incidence rates attributable (and unrelated) to overweight and obesity. Results: Overweight (25.0–29.0 kg/m2) and obesity (≥30.0 kg/m2) were associated with 1.26-fold (95% confidence interval [CI] = 1.05- to 1.52-fold) and 1.30-fold (95% CI = 1.05- to 1.62-fold) increased risks of PTC, respectively, and nearly threefold (HR = 2.93, 95% CI = 1.25 to 6.87) and greater than fivefold (HR = 5.42, 95% CI = 2.24 to 13.1) increased risks of large (>4 cm) PTCs compared with normal weight (18.5–24.9 kg/m2). During 1995–2015, PAF estimates for overweight and obesity increased from 11.4% to 16.2% for all PTCs and from 51.4% to 63.2% for large PTCs. Overweight or obesity accounted for 13.6% and 57.8% of the annual percent changes in total (5.9%/y) and large (4.5%/y) PTC incidence rates, respectively, during 1995–2015. Conclusions: Overweight and obesity may have contributed importantly to the rapid rise in PTC incidence during 1995–2015. By 2015, we estimate that one of every six PTCs diagnosed among adults 60 years or older, including nearly two-thirds of large PTCs, were attributable to overweight and obesity.
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A recent study estimated that 16% of thyroid cancers overall and 63% of large tumors in the United States were attributable to obesity.
“a recent study estimated that 16% of the cancers overall and 63% of large tumors in the United States were attributable to obesity, 157”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [157]
The Results (page unavailable) estimate that 7,500 of 47,000 expected US papillary thyroid cancer diagnoses in 2019, and 2,350 of 3,700 large papillary tumors, were attributable to overweight and obesity—approximately 16% and 63%, respectively. The citing sentence preserves the proportions but says obesity alone and thyroid cancers generally, whereas the paper's estimates include overweight and concern papillary thyroid cancer. (LLM, conf=0.89)
Experimental — accuracy not yet measuredThe relatively high proportion of obese patients among those receiving GLP-1RA treatment could produce a bias, since excess weight is a risk factor for thyroid malignancies.
“the relatively high proportion of obese patients among those receiving treatment could produce a bias, since excess weight is a risk factor for thyroid malignancies.22,63”
From Glucagon‐like peptide‐1 receptor agonists and risk of thyroid cancer: A systematic review and meta‐analysis of randomized controlled trials (2024) · cites this paper as [63]
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- Authors
- Kitahara, C. M., Pfeiffer, R. M., Sosa, J. A., & Shiels, M. S.
- Affiliations
- Division of Cancer Epidemiology and Genetics (US)
- University of California, San Francisco (US)
- Corresponding author
- Kitahara, Cari M
- Venue
- JNCI: Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-12-05
- Volume
- 112
- Issue
- 8
- Pages
- 810-817
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- PMC
- PMC7825478
- OpenAlex
- W2981876570
- Cited by
- 142
- References
- 55
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 22 · 2023: 25 · 2022: 32 · 2021: 20 · 2020: 13
- FWCI
- 13.59
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- JNCI Journal of the National Cancer Institute (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- Funders
- Intramural Research Program of the National Cancer Institute at the National Institutes of Health
- NIH
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- papillary thyroid carcinoma, overweight, obesity, body mass index, cancer incidence trends, population attributable fraction, obesity as cancer risk factor, AARP Diet and Health Study
- MeSH terms
- Thyroid Cancer, Papillary, Aged, Female, Humans, Male, Middle Aged, Obesity, Risk Factors, Thyroid Neoplasms, United States, Cohort Studies, Body Mass Index, Incidence, Prevalence, SEER Program, Overweight
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