Cigarette smoking, alcohol intake, and thyroid cancer risk: A pooled analysis of five prospective studies in the United States

Cari M. Kitahara, Martha S. Linet, Laura E. Beane Freeman, David P. Check, Timothy R. Church, Yikyung Park, Mark P. Purdue, Catherine Schairer, Amy Berrington De González

Research output: Contribution to journalArticlepeer-review

105 Scopus citations


Objective We examined the associations between cigarette smoking, alcohol intake, and thyroid cancer risk in a pooled analysis of five prospective studies. Methods Data from five prospective U.S. studies were standardized and then combined into one aggregate dataset (384,433 men and 361,664 women). Pooled hazard ratios (HR) and 95 % confidence intervals (CI) for thyroid cancer were estimated from mutually adjusted models of cigarette smoking and alcohol intake, which were additionally adjusted for age, sex, education, race, marital status, body mass index, and cohort. Results Over follow-up, 1,003 incident thyroid cancer cases (335 men and 668 women) were identified. Compared to never smokers, current smoking was associated with reduced risk of thyroid cancer (HR = 0.68, 95 % CI 0.55-0.85); this association was slightly stronger among nondrinkers (HR = 0.46, 95 % CI 0.29-0.74). No reduction in risk was observed for former, compared to never, smokers. Greater smoking intensity, duration, and pack-years were associated with further reductions in risk among former and current smokers. Alcohol intake was also inversely associated with thyroid cancer risk (C7 drinks/week versus 0, HR = 0.72, 95 % CI 0.58-0.90, p trend = 0.002). Inverse associations with smoking and alcohol were more pronounced for papillary versus follicular tumors. Conclusion The results of this pooled analysis suggest that both cigarette smoking and alcohol consumption are associated with reduced risks of papillary thyroid cancer and, possibly, follicular thyroid cancer.

Original languageEnglish (US)
Pages (from-to)1615-1624
Number of pages10
JournalCancer Causes and Control
Issue number10
StatePublished - Oct 2012

Bibliographical note

Funding Information:
Acknowledgments This work was supported in part by the Intramural Research Program of the National Institutes of Health, the National Institute of Environmental Health Sciences (Z01-ES049030) and National Cancer Institute (Z01-CP010119).


  • Alcohol intake
  • Cigarette smoking
  • Epidemiology
  • Prospective study
  • Thyroid neoplasms


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