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Hyperthyroidism Potentially Linked To Increased Ovarian Cancer Risk
There may be a causal relaPatients with hyperthyroidism are at increased risk of ovarian cancer (OC), although the link between the conditions is not yet fully understood.
Patients with hyperthyroidism may be at an increased risk of ovarian cancer (OC), according to a study published in BMC Cancer that aimed to investigate the potential causal impact of thyroid dysfunction on OC risk.1
According to the National Cancer Institute, the annual incidence of OC is about 11.6 cases per 100,000 US women, with 60% diagnosed at an advanced stage.2 Also, the researchers noted that OC has become a global health issue for women as survival rates have not improved despite clinical surgery advancements.1
Additionally, OC's pathogenesis is poorly understood, but reported risk factors include genetic and endocrine factors. As the body's principal endocrine gland, the thyroid synthesizes and secretes hormones crucial for regulating various functions, such as metabolism and growth. The researchers noted that thyroid hormones possess cancer-promoting effects by stimulating cell differentiation and proliferation. Therefore, thyroid dysfunction is considered a potential risk factor for cancer development and prevention.
However, data regarding the impact of thyroid hormones on ovary function remain unclear. Similarly, the existing evidence on the association between OC and thyroid function is contradictory, making it difficult to establish a causal relationship between them.
Because of this, the researchers aimed to investigate the causal impact of thyroid dysfunction on OC through a Mendelian randomization (MR) study; MR uses genetic information to explore causal exposure-outcome links.3 More specifically, they explored the causal relationships among hypothyroidism, hyperthyroidism, free thyroxine (FT4), thyrotropin (TSH), and OC risk. The researchers explained that the study would help examine OC's origin and offer new clinical prevention and treatment methods.1
The researchers found a causal relationship between hyperthyroidism and ovarian cancer (OC) risk.Image Credit: Vitalii Vodolazskyi - stock.Adobe.Com
They used summary data from genome-wide association studies (GWASs) of European ancestry cohorts, namely the Integrative Epidemiology Unit (IEU) OpenGWAS database and the ThyroidOmics Consortium database. Overall, the researchers analyzed 410,141 hypothyroidism samples, 484,598 hyperthyroidism samples, 199,741 OC samples, and 72,167 combined TSH and FT4 samples.
From GWAS summary statistics, they extracted prominent single nucleotide polymorphisms (SNPs) to serve as genetic instrumental variables (IVs) for thyroid dysfunction and OC. After a series of quality evaluations, the researchers selected 17, 66, 26, and 11 SNPs as effective IVs for hyperthyroidism, hypothyroidism, TSH, and FT4, respectively.
The researchers used the inverse variance-weighted (IVW) method to assess the potential causal effect of thyroid dysfunction on OC. They further assessed the causal effect through complementary approaches, like simple mode, MR-Egger, weighted mode, and weighted median. Additionally, the researchers conducted various sensitivity analyses, including Cochran's Q test and the leave-one-out test, to assess the robustness of their findings.
Through the IVW analysis, the researchers discovered a significant correlation between hyperthyroidism levels and an elevated OC risk (OR, 1.094; 95% CI, 1.029-1.164; P = .004). These results were also reflected through the MR-Egger (OR, 1.174; 95% CI, 1.054-1.308; P = .011), weighted mode (OR, 1.133; 95% CI, 1.044-1.229; P .011), and weighted median (OR, 1.148; 95% CI, 1.057-1.245; P = .001) methods. However, the researchers did not find a statistically significant causal relationship between TSH, FT4, hypothyroidism, and OC risk.
The sensitivity analyses demonstrated reliable, consistent results, with no significant heterogeneity estimates. More specifically, when hyperthyroidism was used as the exposure, no heterogeneity was noted among SNPs (Cochran's Q value, 12.773; P = .689). Heterogeneity was also not found in hypothyroidism (P = .279), FT4 (P = .473), or TSH (P = .561).
The stability of their results was further confirmed by the leave-one-out test, along with the scatter and funnel plots. Therefore, the results obtained through their IVW analysis are considered reliable.
The researchers acknowledged some limitations, one being that all participants were of European descent; this limits the generalizability of their findings to other races and ethnicities. Also, the researchers could not distinguish between different OC types. Despite these limitations, the researchers used their findings to suggest areas for future research.
"This study suggests a causal relationship between hyperthyroidism and OC, underscoring the importance of thyroid hormones in the prevention and treatment of the female reproductive system. However, the mechanism by which the hypothalamic-pituitary-thyroid axis promotes OC development remains incompletely understood and requires further study.," the authors concluded.
References
OSU Medical School Graduate Overcomes Thyroid Cancer To Achieve Dream Of Becoming A Doctor
A graduate of OSU's medical school has a unique story after battling cancer. Brandon Garner is in remission and on a mission to heal others.Tuesday, May 28th 2024, 5:32 pm
By: News On 6
A graduate of OSU's medical school has a unique story after battling cancer.
After dissecting a pig heart for a middle school science experiment, Brandon Garner knew he wanted to be a doctor, but he didn't know just how hard that path would be.
"Since an early age, I hated seeing people in pain, and so I love being able to help people," he said.
When Garner found out he got into OSU School of Medicine, he was one step closer to his goal.
"It was such a surreal moment because it had been my dream since fifth grade, and so getting that call was just amazing," Garner said.
He didn't know it then, but Brandon would face a major setback during those four years.
"We were in a lab, and I asked one of the doctors, 'Hey, I have been having these weird symptoms. Do you have any ideas?' and she said, 'Oh, let me check your thyroid,' so she did, and she said, 'Oh, it's enlarged. You need to get that checked out.'"
After an ultrasound and a biopsy, it became clear something wasn't right.
A word that was a part of his classes and seminars--possible cancer--took on a different meaning.
"Going through medical school, it's already tough enough, and then you have this weird-looking diagnosis kind of hovering over the whole thing also," Garner said.
Brandon was diagnosed with Papillary Thyroid Carcinoma.
"As the radiation went on it, it got pretty hard to retain information in school," he said. "My throat was burning, and it felt like a sunburn on the outside, and it was tough. I tried pushing through; I thought, 'I can't give up.'"
Brandon didn't give up. He went into remission and graduated from med school two weeks ago.
He lost the title of patient and gained a new one--doctor.
"We went through this horrible journey with setbacks, and to me, it was like victory. We did this."
Brandon starts his residency at OSU Tulsa Family Medicine soon and will be there for the next three years.
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