Exploring a Potential Link Between Children With Obesity and Thyroid Cancer

Researchers at Boston Children’s Hospital investigated a potential link between childhood obesity and thyroid cancer due to an association between body mass index (BMI) and thyroid cancer in adults.  However, no correlation in children with a high BMI and thyroid cancer was found. The findings were published in JAMA Otolaryngology – Head and Neck Surgery.

Researchers conducted a cross-sectional study from 1998 to 2020 which analyzed 362 pediatric patients (80% girls) under the age of 19 with thyroid nodules of at least 1 centimeter in diameter. They analyzed BMI both as a continuous variable (BMI z score) and as a categorical variable, comparing BMIs greater than the 95th percentile and less than the 95th percentile. Laboratory pathologists confirmed a thyroid cancer diagnosis via resected nodule assessment while clinicians determined whether unresected nodules were malignant or benign based upon cytologic test results and nodule growth patterns.

Of the 362 pediatric patients median aged 15.5 years, 99 (27%) were diagnosed with thyroid cancer, which did not correlate with BMI z scores (odds ratio [OR], 1.14; 95% CI, 0.91-1.43). Higher BMI z scores did correspond with larger nodule size and an increased probability of surgical resection. In the subset of pediatric patients who underwent thyroid surgery, BMI z score remained unaffiliated with thyroid cancer (OR, 0.93; 95% CI, 0.68-1.27). The investigators observed similar findings when analyzing obesity according to percentile categorizations.

Study limitations included the retrospective design and the absence of demographic data that potentially could have influenced BMI.

While their study indicated that elevated BMI does not increase thyroid cancer risk in pediatric patients with thyroid nodules, the authors emphasized, “routine thyroid examination is important in children, and any nodules detected should be evaluated based on the established risk factors described in current consensus guidelines.”

Reference

Ivanova MD, Cherella CE, Modi BP, Smith JR, Wassner AJ. Association between body mass index and thyroid cancer in children with thyroid nodules.  JAMA Otolaryngol Head Neck Surg. Published online February 17, 2022. doi:10.1001/jamaoto.2021.4455