Nitrate Intake and the Risk of Thyroid Cancer and Thyroid Disease

Overview

Journal Epidemiology

Specialty Public Health

Date 2010 Mar 26

PMID 20335813

Citations 84

Authors

Mary H Ward

Briseis A Kilfoy

Peter J Weyer

Kristin E Anderson

Aaron R Folsom

James R Cerhan

Affiliations

Soon will be listed here.

Abstract

Background: Nitrate is a contaminant of drinking water in agricultural areas and is found at high levels in some vegetables. Nitrate competes with uptake of iodide by the thyroid, thus potentially affecting thyroid function.

Methods: We investigated the association of nitrate intake from public water supplies and diet with the risk of thyroid cancer and self-reported hypothyroidism and hyperthyroidism in a cohort of 21,977 older women in Iowa who were enrolled in 1986 and who had used the same water supply for >10 years. We estimated nitrate ingestion from drinking water using a public database of nitrate measurements (1955-1988). Dietary nitrate intake was estimated using a food frequency questionnaire and levels from the published literature. Cancer incidence was determined through 2004.

Results: We found an increased risk of thyroid cancer with higher average nitrate levels in public water supplies and with longer consumption of water exceeding 5 mg/L nitrate-N (for >or=5 years at >5 mg/L, relative risk [RR] = 2.6 [95% confidence interval (CI) = 1.1-6.2]). We observed no association with prevalence of hypothyroidism or hyperthyroidism. Increasing intake of dietary nitrate was associated with an increased risk of thyroid cancer (highest vs. lowest quartile, RR = 2.9 [1.0-8.1]; P for trend = 0.046) and with the prevalence of hypothyroidism (odds ratio = 1.2 [95% CI = 1.1-1.4]), but not hyperthyroidism.

Conclusions: Nitrate may play a role in the etiology of thyroid cancer and warrants further study.

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References

Hankey B, Ries L, Edwards B . The surveillance, epidemiology, and end results program: a national resource. Cancer Epidemiol Biomarkers Prev. 1999; 8(12):1117-21. View

Bloomfield R, WELSCH C, Garner G, MUHRER M . Effect of dietary nitrate on thyroid function. Science. 1961; 134(3491):1690. DOI: 10.1126/science.134.3491.1690. View

Dal Maso L, Bosetti C, La Vecchia C, Franceschi S . Risk factors for thyroid cancer: an epidemiological review focused on nutritional factors. Cancer Causes Control. 2008; 20(1):75-86. DOI: 10.1007/s10552-008-9219-5. View

Van Maanen J, van Dijk A, Mulder K, De Baets M, Menheere P, van der Heide D . Consumption of drinking water with high nitrate levels causes hypertrophy of the thyroid. Toxicol Lett. 1994; 72(1-3):365-74. DOI: 10.1016/0378-4274(94)90050-7. View

Negri E, Dal Maso L, Ron E, La Vecchia C, Mark S, Preston-Martin S . A pooled analysis of case-control studies of thyroid cancer. II. Menstrual and reproductive factors. Cancer Causes Control. 1999; 10(2):143-55. DOI: 10.1023/a:1008880429862. View

Bogovski P, Bogovski S . Animal Species in which N-nitroso compounds induce cancer. Int J Cancer. 1981; 27(4):471-4. DOI: 10.1002/ijc.2910270408. View

Folsom A, Kaye S, Prineas R, Potter J, Gapstur S, Wallace R . Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women. Am J Epidemiol. 1990; 131(5):794-803. DOI: 10.1093/oxfordjournals.aje.a115570. View

Merino L, Darnerud P, Edberg U, Aman P, Castillo M . Levels of nitrate in Swedish lettuce and spinach over the past 10 years. Food Addit Contam. 2006; 23(12):1283-9. DOI: 10.1080/02652030600930543. View

Hollowell J, Staehling N, Hannon W, Flanders D, Gunter E, Maberly G . Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys I and III (1971-1974 and 1988-1994). J Clin Endocrinol Metab. 1998; 83(10):3401-8. DOI: 10.1210/jcem.83.10.5168. View

10.

Tajtakova M, Semanova Z, Tomkova Z, Szokeova E, Majoros J, Radikova Z . Increased thyroid volume and frequency of thyroid disorders signs in schoolchildren from nitrate polluted area. Chemosphere. 2005; 62(4):559-64. DOI: 10.1016/j.chemosphere.2005.06.030. View

11.

Willett W, Sampson L, Browne M, Stampfer M, Rosner B, Hennekens C . The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol. 1988; 127(1):188-99. DOI: 10.1093/oxfordjournals.aje.a114780. View

12.

Tonacchera M, Pinchera A, Dimida A, Ferrarini E, Agretti P, Vitti P . Relative potencies and additivity of perchlorate, thiocyanate, nitrate, and iodide on the inhibition of radioactive iodide uptake by the human sodium iodide symporter. Thyroid. 2005; 14(12):1012-9. DOI: 10.1089/thy.2004.14.1012. View

13.

Kent W, Hall S, Isotalo P, Houlden R, George R, Groome P . Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease. CMAJ. 2007; 177(11):1357-61. PMC: 2072986. DOI: 10.1503/cmaj.061730. View

14.

Ward M, deKok T, Levallois P, Brender J, Gulis G, Nolan B . Workgroup report: Drinking-water nitrate and health--recent findings and research needs. Environ Health Perspect. 2005; 113(11):1607-14. PMC: 1310926. DOI: 10.1289/ehp.8043. View

15.

Nolan B, Hitt K . Vulnerability of shallow groundwater and drinking-water wells to nitrate in the United States. Environ Sci Technol. 2007; 40(24):7834-40. DOI: 10.1021/es060911u. View

16.

Bloomfield R, WELSCH C, Garner G, MUHRER M . Thyroid compensation under the influence of dietary nitrate. Proc Soc Exp Biol Med. 1962; 111:288-90. DOI: 10.3181/00379727-111-27769. View

17.

Enewold L, Zhu K, Ron E, Marrogi A, Stojadinovic A, Peoples G . Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005. Cancer Epidemiol Biomarkers Prev. 2009; 18(3):784-91. PMC: 2676561. DOI: 10.1158/1055-9965.EPI-08-0960. View

18.

Davies L, Welch H . Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006; 295(18):2164-7. DOI: 10.1001/jama.295.18.2164. View

19.

Nolan B, Hitt K, Ruddy B . Probability of nitrate contamination of recently recharged groundwaters in the conterminous United States. Environ Sci Technol. 2002; 36(10):2138-45. DOI: 10.1021/es0113854. View

20.

De Groef B, Decallonne B, Van der Geyten S, Darras V, Bouillon R . Perchlorate versus other environmental sodium/iodide symporter inhibitors: potential thyroid-related health effects. Eur J Endocrinol. 2006; 155(1):17-25. DOI: 10.1530/eje.1.02190. View