Thyroid cancer risk in the Swedish AMORIS study: the role of inflammatory biomarkers in serum

// Arunangshu Ghoshal 1, 9 , Hans Garmo 1, 2 , Rhonda Arthur 1 , Paul Carroll 8 , Lars Holmberg 1 , Niklas Hammar 3, 4 , Ingmar Jungner 5 , Hakan Malmstrom 6, 10 , Mats Lambe 2, 6 , Goran Walldius 7 and Mieke Van Hemelrijck 1, 3 1 King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research, London, UK 2 Regional Cancer Centre, Uppsala University, Uppsala, Sweden 3 Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden 4 AstraZeneca RD AMORIS cohort; cox analysis; serum inflammatory markers; thyroid cancer Received: July 25, 2017      Accepted: November 07, 2017      Published: December 04, 2017 ABSTRACT Chronic inflammation is one of the underlying risks associated with thyroid cancer. We ascertained the association between commonly measured serum biomarkers of inflammation and the risk of thyroid cancer in Swedish Apolipoprotein-related MORtality RISk (AMORIS) study. 226,212 subjects had baseline measurements of C-reactive protein, albumin and haptoglobin. Leukocytes were measured in a subgroup of 63,845 subjects. Associations between quartiles and dichotomized values of inflammatory markers and risk of thyroid cancer were analysed using multivariate Cox proportional hazard models. 202 individuals were diagnosed with thyroid cancer during a mean follow-up of 19.6 years. There was a positive association between lower albumin levels and risk of developing thyroid cancer [Hazard Ratio for albumin ≤ 40 g/L: 1.50 (95% Confidence Interval = 1.04–2.16)]. When stratified by a metabolic score, we observed similar association for albumin with higher HR among those with metabolic score ≥ 1, as compared to those with metabolic score of 0 [HR 1.98 (95% CI = 1.11-3.54) vs 1.17 (95% CI = 0.72–1.89)] ( P = 0.19). Apart from albumin, none of the serum markers of inflammation studied showed a link with the risk of developing thyroid cancer–suggesting that the role of inflammation may be more complicated and requires assessment of more specialised measurements of inflammation.