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Flame retardants may affect PTC occurrence, severity
ORLANDO, Fla. — Flame retardants, particularly those used in electronic casings, furniture and upholstery may be contributing the occurrence and severity of papillary thyroid cancer, according to a presenter here.
“The rate of thyroid cancer, papillary thyroid cancer (PTC) in particular, is rapidly increasing and this is coincidental with the use of flame retardant chemical in consumer products,” Julie Ann Sosa, MD, professor of surgery and medicine at Duke Cancer Institute and Duke Clinical Research Institute at Duke University Medical Center in Durham, North Carolina, said during a news conference. “The goal of this project was to evaluate a potential link between exposure to these flame retardant chemicals and PTC. Our results demonstrate that exposure to some flame retardant chemical in the home may indeed be associated with the occurrence and severity of PTC.”
Sosa and colleagues evaluated 70 adults with PTC and 70 age- and sex-matched controls to determine the impact of exposure to flame retardants in the home on PTC occurrence and severity.
“We decided to focus on PTC because this is now overwhelmingly the most common kind of thyroid cancer, representing more than 90% of cases,” Sosa said.
Information on demographics, lifestyle and environment was collected via questionnaire. Clinical data were extracted from medical records, and researchers visited participants’ homes and collected dust samples as a measure of long-term exposure.
“One of the most important questions we asked our subjects was how long they had lived in their homes,” Sosa said. “We wanted to ensure that the potential exposure to flame retardants was long enough. Notably, on average, our subjects, both cases and controls had lived in their homes more than 11 years.”
The researchers found that higher levels of certain flame retardants, including decabromodiphenyl ether (BDE-209) and tris(2-chloroethyl) phosphate (TCEP) in dust were associated with increased odds of developing PTC.
The likelihood of having PTC was 2.29 times higher in participants with dust BDE-209 concentrations above the median level compared with participants with lower concentrations. Higher levels of BDE-209 were associated with small tumors without extrathyroidal extension whereas TCEP was associated with larger more aggressive tumors. Participants with dust TCEP concentrations above the median were 4.14 times more likely to have PTC with extrathyroidal extension compared with lower concentrations.
The presence or absence of BRAF V600E also affected the associations with PTC. Participants with higher BDE-209 levels were 14.2 times more likely to be BRAF negative compared with participants with lower levels.
“With the incidence of thyroid cancer quickly increasing and little knowledge of what may be leading to the drastic increase, it is essential that we understand the potential environmental factors that are contributing to thyroid cancer,” Sosa said. “Our results suggest that exposure to BDE-209 and TCEP in the home environment may be associated with papillary thyroid cancer. This is obviously a critical concern, particularly as use of flame retardants is expected to only increase in the future. I think the greatest challenges going forward are to understand the potential mechanism of the association we have demonstrated and also, the potential role of mixtures of different flame retardants that together could be modifying risk.” – by Amber Cox
Reference:
Sosa JA, et al. SAT-248. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.
Disclosures: Sosa reports financial ties with AstraZeneca, Eli Lilly, GlaxoSmithKline and Novo Nordisk and is a member of the Data Monitoring Committee and the Medullary Thyroid Cancer Consortium Registry.