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Persistent organic pollutants, pesticides, and the risk of thyroid cancer

systematic review and meta-analysis

Han, Mi Aha; Kim, Jin Hwab; Song, Han Soob,c

European Journal of Cancer Prevention: July 2019 - Volume 28 - Issue 4 - p 344–349
doi: 10.1097/CEJ.0000000000000481
Research Papers: Head & Neck Cancer

Previous epidemiological studies have reported persistent organic pollutants (POPs) and some nonpersistent pesticides and the risk of thyroid cancer. The aim of this study was to assess the association between exposure to POPs, pesticides, and thyroid cancer by carrying out a meta-analysis. Literature searches were performed using PubMed, Embase, and reference lists of relevant articles. Summary risk estimates for thyroid cancer were calculated using fixed-effects and random-effects models. In addition, several subgroup and sensitivity analyses were carried out. Fifteen studies were reviewed, and eight studies were included in the meta-analysis. Pesticide exposure showed positive, statistically significant associations with thyroid cancer [odds ratio (OR)=1.48, 95% confidence interval (CI)=1.15–1.91, I2=48%, Pheterogenetiy=0.05]. After subgroup analysis, herbicide exposure (OR=3.00, 95% CI=1.38–6.54) and agricultural exposure to pesticides (OR=1.86, 95% CI=1.04–3.32) was associated with an increased risk of thyroid cancer. A sensitivity analysis showed that the results were robust. Exposure to pesticides was associated with an increased risk of thyroid cancer in this meta-analysis. Future studies should investigate exposure to POPs or pesticides with controls for potential confounders using biological samples.

Departments of aPreventive Medicine

bInternal Medicine

cOccupational and Environmental Medicine, College of Medicine, Chosun University, Republic of Korea

Correspondence to Mi Ah Han, MD, PhD, Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea Tel: +82 622 306 481; fax: +82 622 258 293; e-mail:

Received November 6, 2017

Accepted January 17, 2018

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