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A risk factor is anything that affects a person's chance of getting a
disease such as cancer. Different cancers have different risk factors.
For example, exposing skin to strong sunlight is a risk factor for skin
cancer. Smoking is a risk factor for a number of cancers.
But risk factors don't tell us everything. Having a risk
factor, or even several risk factors, does not mean that you will get
the disease. And many people who get the disease may not have had any
known risk factors. Even if a person with thyroid cancer has a risk
factor, it is very hard to know how much that risk factor may have
contributed to the cancer.
Scientists have found a few risk factors that make a person
more likely to develop thyroid cancer.
Gender and Age
For unclear reasons thyroid cancers occur about 3 times more
often in women than in men.
Thyroid cancers can occur in people of all ages, but most
cases of papillary and follicular thyroid cancer are found in people
between the ages of 20 and 60 years.
Diet Low in Iodine
Follicular thyroid cancers are more common in areas of the
world where people's diets are low in iodine. In the United States,
dietary iodine is plentiful because iodine is added to table salt and
other foods. A diet low in iodine may also increase the risk of
papillary cancer if the person also is exposed to radioactivity.
Radiation
Exposure to radiation is a proven risk factor for thyroid
cancer. Sources of such radiation include certain medical treatments
and radiation fallout from power plant accidents or nuclear weapons.
Having a history of head or neck radiation treatments in
childhood is a risk factor for thyroid cancer. In the past, children
were sometimes treated with radiation for things we wouldn't use
radiation for now, like acne, fungus infections of the scalp
(ringworm), an enlarged thymus gland, or to shrink tonsils or adenoids.
Years later, studies linked these treatments to an increased risk of
thyroid cancer.
Radiation therapy in childhood for some cancers such as
Hodgkin disease also increases risk. In general, the risk is higher
with younger children. Radiation exposure as an adult carries little
risk of thyroid cancer.
Several studies have pointed to an increased risk of thyroid
cancer in children because of radioactive fallout from nuclear weapons
or power plant accidents. For instance, thyroid cancer is several times
more common than normal in children living near Chernobyl the site of a
1986 nuclear plant accident that exposed millions of people to
radioactivity. Adults involved with the cleanup after the accident and
those who lived near the plant have also had a higher rate of thyroid
cancer. Children with more iodine in their diet appeared to have a
lower risk.
Some radioactive fallout occurred over certain regions of the
United States after nuclear weapons testing in western states during
the 1950s. This exposure was much, much lower than around Chernobyl. At
such low exposures, a higher risk of thyroid cancer has not been
proven. If you are concerned about possible exposure to radioactive
fallout, discuss this with your doctor.
Hereditary Conditions
Several inherited conditions have been linked to different
types of thyroid cancer.
Medullary
thyroid cancer (MTC): About 1 out of 5 medullary thyroid
carcinomas (MTCs) result from inheriting an abnormal gene. These cases
are known as familial
medullary thyroid carcinoma (FMTC). FMTC can occur alone,
or it can be seen along with other tumors.
The combination of FMTC and tumors of other endocrine glands
is called multiple
endocrine neoplasia type 2 (MEN 2). There are 2 subtypes,
MEN 2a and MEN 2b:
- In MEN 2a, MTC occurs along with pheochromocytomas (tumors
in the adrenal glands, which are located on top of the kidneys) and
with parathyroid gland tumors.
- In MEN 2b, MTC is associated with pheochromocytomas and
with benign growths of nerve tissue on the tongue and elsewhere called
neuromas. This subtype is much less common than MEN 2a.
In these inherited forms of MTC, the cancers often develop
during childhood or early adulthood and can spread early. MTC is most
aggressive in the MEN 2b syndrome. If MEN 2a, MEN 2b, or isolated FMTC
runs in your family, then you may be at very high risk of developing
MTC. Ask your doctor for information about having regular blood tests
to look for problems and the possibility of genetic testing.
Other thyroid
cancers: People with certain inherited medical conditions
are at higher risk for more common forms of thyroid cancer. Higher
rates of the disease occur among people with uncommon genetic
conditions such as Gardner
syndrome, Cowden disease, and familial adenomatous polyposis
(FAP).
Papillary and follicular thyroid cancers do seem to run in
some families without a known inherited syndrome; this may account for
about 5% of thyroid cancers. The genetic basis for these cancers is not
totally clear.
Revised: 10/03/2007
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