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Lower postsurgical thyroid cancer rates found among adults with obesity
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A cohort of adults with obesity or morbid obesity had a lower rate of papillary thyroid malignancy after thyroid surgery than adults without obesity, according to findings published in the Journal of Surgical Research.
“This study highlights the unclear association between obesity and thyroid cancer, suggesting other factors may be involved in the etiology of [papillary thyroid cancer],” Rachel S. Handelsman, BS, of the department of surgery at the University of Miami Leonard M. Miller School of Medicine, and colleagues wrote.
Handelsman and colleagues retrospectively reviewed data after thyroid lobectomy or total thyroidectomy procedures from 991 adults with a BMI of at least 18.5 kg/m2 (mean age, 48 years; 84.9% women). All surgeries were conducted between January 2010 and August 2018. The researchers identified thyroid-stimulating hormone levels and BMI before surgery and confirmed tumor malignancy after the operations.
A BMI of 30 kg/m2 to 39.9 kg/m2 meant a participant had obesity, and participants with a BMI of at least 40 kg/m2 were considered to have morbid obesity. Participants with a BMI less than 30 kg/m2 were categorized as not having obesity.
The researchers reported that 52% of participants had malignant papillary thyroid cancer after surgery, but that the rate was lower for those with morbid obesity (41%) and those with obesity (48%) compared with those without obesity (55%; P = .029). In addition, participants with obesity were less likely to have thyroid cancer (OR = 0.587; 95% CI, 0.327-1.051), although the researchers noted that this connection did not reach significance.
“The observation of lower rates of thyroid malignancy among obese patients indicates different surgical management of obese patients compared with nonobese patients is not warranted based on BMI alone,” the researchers wrote. “Surgeons should therefore continue to utilize their respective institutional experiences when determining patient care in this population.”
Women with morbid obesity had a 42% malignancy rate compared with rates of 44% and 53% in those with obesity and without obesity, respectively (P = .045). The same significance was not noted in men, according to the researchers. In fact, papillary thyroid cancer odds were nearly doubled for men vs. women (OR = 1.916; 95% CI, 1.331-2.759).
“Interestingly, men were found to have a higher risk of [papillary thyroid cancer] than women in this report,” the researchers wrote. “This contrasts with the well-established gender disparity in thyroid cancer in which women are almost three times more likely to have thyroid malignancies than men.”
Disclosures: The authors report no relevant financial disclosures.
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