Association between chronic exposure to different water iodine and thyroid cancer: A retrospective study from 1995 to 2014

The controversy that iodine intake may increase the risk of thyroid cancer has heightened over the past twenty years. In this retrospective study, we mainly analyzed the association between water iodine and thyroid cancer and discussed the possible cause of the increase in thyroid cancer. This study was supported by three hospitals in areas with different water iodine concentration. 5574 patients with thyroid disease were recruited, of which 1429 patients had been diagnosed with thyroid cancer. These samples collectively were used to analyze the relationship of incidence and prevalence associated with water iodine. In addition, the ratio of maximum tumor diameter was analyzed. By analyzing the proportion of patients with thyroid cancer in thyroid diseases, we found a decrease in the proportion of thyroid cancer with increasing water iodine (P < 0.0001). In addition, there was no significant correlation between the median water iodine and the prevalence of thyroid cancer, including papillary thyroid cancer (P > 0.05). Meanwhile, the 5 years' cumulative incidence of thyroid cancer increased with years (P < 0.01). Comparing Cao county and Shan county, which are areas with high water iodine, to adequate iodine area such as in Mudan district, an increasing incidence is observed in 2010-2014 in Mudan district. Again, we observed a significant increase in the proportion of thyroid cancer with tumor size <1 cm (P < 0.01). Therefore, we concluded that cause(s) of increase in thyroid cancer may be ascribed to the sensitive diagnostic techniques and the improvement of living condition, but not water iodine. (C) 2017 Published by Elsevier B.V.