Constitutional Factors and Irradiation as Risk Factors for Thymoma: A European Case-Control Study.

Lorenzo Simonato, Wolfgang Ahrens, Pascal Guénel, Karl-Heinz Jöckel, Mikael Eriksson, Linda Kaerlev, Franco Merletti, Maria Morales-Suárez-Varela, Agustin Llopis-Gonzalez, Gun Wingren

Journal: International journal of environmental research and public health 2024;21(9):

PMID: 39338125

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Abstract

Little is known about the aetiology of thymoma. This study aims to identify medical risk factors for thymoma as a systematic approach to new hypotheses on the aetiology of this disease. A European multi-centre case-control study was conducted from 1995 to 1997, including incident cases aged 35-69 years with thymoma. Altogether, we accepted 85 cases and 3350 controls, of which we interviewed 77 cases and 2071 population controls about constitutional factors, medical examinations, and former diseases. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Medical examinations with X-ray or radiotherapy performed >20 times at least one year before the thymoma diagnosis indicated a possible risk factor for thymoma (OR 1.58, 95% CI 0.93-2.69). Having the first radiotherapy treatment at least one year before the thymoma diagnosis yielded an OR for thymoma of 2.39; 95% CI (0.96-5.99), and if it was at least five years before, the OR for thymoma was 2.81; 95% CI (1.03-7.72). Having a red/auburn hair colour was associated with thymoma, (OR 3.6, 95% CI 1.4-9.5) whereas having pigmented skin was slightly associated with thymoma (OR 1.8, 95% CI 0.8-3.8). Over twenty instances of X-ray examinations or radiotherapy were identified as potential risk factors for thymoma, along with certain constitutional factors. The observed correlations between benign tumours and thymoma could stem from an inherent predisposition to tumour development or result from detection bias. Given that this is the initial analytical study examining medical risk factors for thymoma, all of the results should be approached with caution, acknowledging the possibility that some findings might be incidental.

Address: Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark.; Center for Clinical Epidemiology, Odense University Hospital, 5230 Odense, Denmark.; Health Promotion, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, 6705 Esbjerg, Denmark.; Department of Oncology, Skåne University Hospital, Lund University, 222 42 Lund, Sweden.; Inserm, CESP (Center for Research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, 94805 Villejuif, France.; Department of Medical Sciences, University of Turin, 10124 Turin, Italy.; Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy and Food Sciences, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, Spain.; CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Spain.; Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.; Institute for Medical Informatics, Biometry and Epidemiology, University Clinic Essen, 45147 Essen, Germany.; Division of Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Linköping University, 581 83 Linköping, Sweden.; Department of Cardiovascular, Thoracic Sciences and Public Health, University of Padova, 35122 Padova, Italy.

DOI: 10.3390/ijerph21091241

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MeSH Terms: Humans, Middle Aged, Case-Control Studies, Thymoma, Male, Risk Factors, Aged, Adult, Female, Europe, Thymus Neoplasms, Odds Ratio, Radiotherapy