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Consumption of Fish Is Not Associated with Risk of Differentiated Thyroid Carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

Zamora-Ros R 1 , Castañeda J 2 , Rinaldi S 3 , Cayssials V 2 , Slimani N 3 , Weiderpass E 4 Show all authors , Tsilidis KK 5 , Boutron-Ruault MC 6 , Overvad K 7 , Eriksen AK 8 , Tjønneland A 8 , Kühn T 9 , Katzke V 9 , Boeing H 10 , Trichopoulou A 11 , La Vecchia C 11 , Kotanidou A 11 , Palli D 12 , Grioni S 13 , Mattiello A 14 , Tumino R 15 , Sciannameo V 16 , Lund E 4 , Merino S 17 , Salamanca-Fernández E 18 , Amiano P 19 , Huerta JM 19 , Barricarte A 19 , Ericson U 20 , Almquist M 21 , Hennings J 22 , Sandström M 23 , Bueno-de-Mesquita HB 24 , Peeters PH 24 , Khaw KT 25 , Wareham NJ 26 , Schmidt JA 27 , Cross AJ 24 , Riboli E 24 , Scalbert A 3 , Romieu I 3 , Agudo A 2 , Franceschi S 3

Affiliations 

  • 1 Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; rzamora@iconcologia.net
  • 2 Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
  • 3 International Agency for Research on Cancer, Lyon, France
  • 4 Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway
  • 5 Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
  • 6 Université Paris-Saclay, Université Paris-Sud, University of Versailles Saint-Quentin-en-Yvelines (UVSQ), Center for Research in Epidemiology and Population Health (CESP), National Institute of Health and Medical Research (INSERM), Villejuif, France
  • 7 Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus, Denmark
  • 8 Danish Cancer Society Research Center, Copenhagen, Denmark
  • 9 Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
  • 10 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  • 11 Hellenic Health Foundation, Athens, Greece
  • 12 Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
  • 13 Nutritional Epidemiology Unit, IRCCS Foundation National Institute of Tumors, Milan, Italy
  • 14 Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
  • 15 Cancer Registry and Histopathology Unit, "Civic MP Arezzo" Hospital, ASP Ragusa, Italy
  • 16 Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Turin, Italy
  • 17 Public Health Directorate, Asturias, Spain
  • 18 Andalusian School of Public Health, Instituto de Investigación Biosanitaria ibs. Granada, University Hospitals of Granada/University of Granada, Granada, Spain
  • 19 Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
  • 20 Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
  • 21 Department of Surgery, University Hospital Lund, Lund, Sweden
  • 22 Surgical and Perioperative Sciences and
  • 23 Radiation Sciences, Umeå University, Umeå, Sweden
  • 24 School of Public Health, Imperial College London, London, United Kingdom
  • 25 Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
  • 26 Medical Research Center Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; and
  • 27 Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
J Nutr, 2017 Jul;147(7):1366-1373.
PMID: 28592517 DOI: 10.3945/jn.117.247874

Abstract

Background: Differentiated thyroid cancer (TC) is the most common endocrine cancer. Fish can be an important source of iodine and other micronutrients and contaminants that may affect the thyroid gland and TC risk.Objective: We prospectively evaluated the relations between the consumption of total fish and different fish types and shellfish and TC risk in the EPIC (European Prospective Investigation into Cancer and Nutrition) study.Methods: EPIC is a cohort of >500,000 men and women, mostly aged 35-70 y, who were recruited in 10 European countries. After a mean follow-up of 14 y, 748 primary differentiated TC cases were diagnosed; 666 were in women and 601 were papillary TC. Data on intakes of lean fish, fatty fish, fish products, and shellfish were collected by using country-specific validated dietary questionnaires at recruitment. Multivariable Cox regression was used to calculate HRs and 95% CIs adjusted for many potential confounders, including dietary and nondietary factors.Results: No significant association was observed between total fish consumption and differentiated TC risk for the highest compared with the lowest quartile (HR: 1.03; 95% CI: 0.81, 1.32; P-trend = 0.67). Likewise, no significant association was observed with the intake of any specific type of fish, fish product, or shellfish. No significant heterogeneity was found by TC subtype (papillary or follicular tumors), by sex, or between countries with low and high TC incidence.Conclusion: This large study shows that the intake of fish and shellfish was not associated with differentiated TC risk in Europe, a region in which iodine deficiency or excess is rare.

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