Molecular study of thyroid cancer in world trade center responders

Maaike A.G. van Gerwen; Stephanie Tuminello; Gregory J. Riggins; Thais B. Mendes; Michael Donovan; Emma K.T. Benn; Eric Genden; Janete M. Cerutti; Emanuela Taioli

doi:10.3390/ijerph16091600

Molecular study of thyroid cancer in world trade center responders

Maaike A.G. van Gerwen, Stephanie Tuminello, Gregory J. Riggins, Thais B. Mendes, Michael Donovan, Emma K.T. Benn, Eric Genden, Janete M. Cerutti, Emanuela Taioli

School of Medicine

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Thyroid cancer incidence is higher in World Trade Center (WTC) responders compared with the general population. It is unclear whether this excess in thyroid cancer is associated with WTC-related exposures or if instead there is an over-diagnosis of malignant thyroid cancer among WTC first responders due to enhanced surveillance and physician bias. To maximize diagnostic yield and determine the false positive rate for malignancy, the histological diagnoses of thyroid cancer tumors from WTC responders and age, gender, and histology matched non-WTC thyroid cancer cases were evaluated using biomarkers of malignancy. Using a highly accurate panel of four biomarkers that are able to distinguish benign from malignant thyroid cancer, our results suggest that over-diagnosis by virtue of misdiagnosis of a benign tumor as malignant does not explain the increased incidence of thyroid cancer observed in WTC responders. Therefore, rather than over-diagnosis due to physician bias, the yearly screening visits by the World Trade Center Health Program are identifying true cases of thyroid cancer. Continuing regular screening of this cohort is thus warranted.

Original language	English (US)
Article number	1600
Journal	International journal of environmental research and public health
Volume	16
Issue number	9
DOIs	https://doi.org/10.3390/ijerph16091600
State	Published - May 1 2019

Keywords

9/11
Biomarkers
Screening
Thyroid cancer

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Pollution
Health, Toxicology and Mutagenesis

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10.3390/ijerph16091600

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title = "Molecular study of thyroid cancer in world trade center responders",

abstract = "Thyroid cancer incidence is higher in World Trade Center (WTC) responders compared with the general population. It is unclear whether this excess in thyroid cancer is associated with WTC-related exposures or if instead there is an over-diagnosis of malignant thyroid cancer among WTC first responders due to enhanced surveillance and physician bias. To maximize diagnostic yield and determine the false positive rate for malignancy, the histological diagnoses of thyroid cancer tumors from WTC responders and age, gender, and histology matched non-WTC thyroid cancer cases were evaluated using biomarkers of malignancy. Using a highly accurate panel of four biomarkers that are able to distinguish benign from malignant thyroid cancer, our results suggest that over-diagnosis by virtue of misdiagnosis of a benign tumor as malignant does not explain the increased incidence of thyroid cancer observed in WTC responders. Therefore, rather than over-diagnosis due to physician bias, the yearly screening visits by the World Trade Center Health Program are identifying true cases of thyroid cancer. Continuing regular screening of this cohort is thus warranted.",

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author = "{van Gerwen}, {Maaike A.G.} and Stephanie Tuminello and Riggins, {Gregory J.} and Mendes, {Thais B.} and Michael Donovan and Benn, {Emma K.T.} and Eric Genden and Cerutti, {Janete M.} and Emanuela Taioli",

note = "Funding Information: Acknowledgments: We thank the S{\~a}o Paulo State Research Foundation (FAPESP; grant number 2014/06570-6). JMC is a recipient of a scholarship of Research Productivity from Conselho Nacional de Desenvolvimento Cient{\'i}fico e Tecnol{\'o}gico CNPq. Funding Information: Funding: This work was supported by the National Institute for Occupational Safety and Health-(1U01OH010984-01A1). Publisher Copyright: {\textcopyright} 2019 by the authors. Licensee MDPI, Basel, Switzerland.",

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doi = "10.3390/ijerph16091600",

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volume = "16",

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AU - van Gerwen, Maaike A.G.

AU - Tuminello, Stephanie

AU - Riggins, Gregory J.

AU - Mendes, Thais B.

AU - Donovan, Michael

AU - Benn, Emma K.T.

AU - Genden, Eric

AU - Cerutti, Janete M.

AU - Taioli, Emanuela

N1 - Funding Information: Acknowledgments: We thank the São Paulo State Research Foundation (FAPESP; grant number 2014/06570-6). JMC is a recipient of a scholarship of Research Productivity from Conselho Nacional de Desenvolvimento Científico e Tecnológico CNPq. Funding Information: Funding: This work was supported by the National Institute for Occupational Safety and Health-(1U01OH010984-01A1). Publisher Copyright: © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Thyroid cancer incidence is higher in World Trade Center (WTC) responders compared with the general population. It is unclear whether this excess in thyroid cancer is associated with WTC-related exposures or if instead there is an over-diagnosis of malignant thyroid cancer among WTC first responders due to enhanced surveillance and physician bias. To maximize diagnostic yield and determine the false positive rate for malignancy, the histological diagnoses of thyroid cancer tumors from WTC responders and age, gender, and histology matched non-WTC thyroid cancer cases were evaluated using biomarkers of malignancy. Using a highly accurate panel of four biomarkers that are able to distinguish benign from malignant thyroid cancer, our results suggest that over-diagnosis by virtue of misdiagnosis of a benign tumor as malignant does not explain the increased incidence of thyroid cancer observed in WTC responders. Therefore, rather than over-diagnosis due to physician bias, the yearly screening visits by the World Trade Center Health Program are identifying true cases of thyroid cancer. Continuing regular screening of this cohort is thus warranted.

AB - Thyroid cancer incidence is higher in World Trade Center (WTC) responders compared with the general population. It is unclear whether this excess in thyroid cancer is associated with WTC-related exposures or if instead there is an over-diagnosis of malignant thyroid cancer among WTC first responders due to enhanced surveillance and physician bias. To maximize diagnostic yield and determine the false positive rate for malignancy, the histological diagnoses of thyroid cancer tumors from WTC responders and age, gender, and histology matched non-WTC thyroid cancer cases were evaluated using biomarkers of malignancy. Using a highly accurate panel of four biomarkers that are able to distinguish benign from malignant thyroid cancer, our results suggest that over-diagnosis by virtue of misdiagnosis of a benign tumor as malignant does not explain the increased incidence of thyroid cancer observed in WTC responders. Therefore, rather than over-diagnosis due to physician bias, the yearly screening visits by the World Trade Center Health Program are identifying true cases of thyroid cancer. Continuing regular screening of this cohort is thus warranted.

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Molecular study of thyroid cancer in world trade center responders

Abstract

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