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Using 47,913 cancer-free participants from the Sister Study cohort (baseline 2003–2009), Cox regression models adjusted for attained age and race/ethnicity assessed DTC during follow-up.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/in-utero-and-newborn-factors-and-thyroid-cancer-incidence-in-adult-women-in-the-sister-study-cohort/376081/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/in-utero-and-newborn-factors-and-thyroid-cancer-incidence-in-adult-women-in-the-sister-study-cohort/376081.png","ImageObject",300,407,{"name":42,"@type":43},"Đào","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the study’s main goal regarding thyroid cancer risk?","Question",{"text":63,"@type":64},"To investigate whether in-utero and newborn characteristics are associated with the incidence of differentiated thyroid cancer (DTC) in adult women.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the Sister Study cohort used in this analysis?",{"text":68,"@type":64},"A total of 47,913 cancer-free women at baseline (2003–2009) were included, and DTC incidence during follow-up was analyzed using Cox regression models adjusted for attained age and race/ethnicity.",{"name":70,"@type":61,"acceptedAnswer":71},"Which in-utero or newborn factors were linked to higher DTC incidence?",{"text":72,"@type":64},"Higher DTC incidence was associated with maternal pre-pregnancy or gestational diabetes, gestational hypertension or hypertension-related disorders, and higher birth weight. 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O’Brien2, Rebecca Troisi 3, Dale P. Sandler 2 and Cari M. Kitahara 1 ✉  \nThis is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025  \nBACKGROUND: Thyroid cancer is diagnosed at relatively young ages compared to other adult cancers, for reasons that remain unclear. Our study aimed to investigate associations of in-utero and newborn characteristics with differentiated thyroid cancer (DTC) incidence in adult women.  \nMETHODS: From the [U.S. nationwide](U.S. nationwide) Sister Study cohort, we included 47,913 cancer-free women at baseline (2003–2009). We assessed associations of participants’ in-utero and newborn characteristics and DTC during follow-up using Cox regression models adjusted for attained age (timescale) and race/ethnicity.  \nRESULTS: During follow-up (median = 13.1 years), 239 incident DTC cases were identified. Higher DTC incidence was associated with maternal pre-pregnancy or gestational diabetes (hazard ratio [HR] = 2.36, 95%CI = 0.97–5.74, 5 affected cases), gestational hypertension or hypertension-related disorders (HR = 1.99, 95%CI = 1.20–3.32, 16 affected cases), and higher birth weight (HR per kg= 1.24, 95%CI = 0.95–1.60) . Births occurring at least two weeks before the due date were associated with lower DTC incidence (HR = 0.47, 95%CI = 0.23–0.97, 8 affected cases) . In a model simultaneously adjusted for all these factors, all exposures remained associated with DTC incidence. We observed no associations for other in-utero and newborn characteristics.  \nCONCLUSIONS: These findings contribute to a growing body of evidence that in-utero exposures related to maternal metabolic abnormalities may influence thyroid cancer risk later in life.  \n|  | British Journal of Cancer (2025) 132:1056–1063; [https://doi.org/10.1038/s41416-025-03004-6](https://doi.org/10.1038/s41416-025-03004-6) |  |\n| --- | --- | --- |\n|  |  |  |\n\nINTRODUCTION  \nThyroid cancer has emerged as the fifth most common cancer diagnosed among women globally, with most cases classified as differentiated thyroid cancer (DTC) [1] . Yet, the etiology of thyroid cancer remains largely unknown, with obesity and childhood exposure to ionizing radiation among the few established modifiable risk factors [2] . The disease is diagnosed at relatively young ages compared to most other adulthood cancers [2], suggesting a potential etiologic role of early-life exposures [3, 4] . Throughout gestation, the developing thyroid is highly susceptible to endogenous (e.g., maternal iodine deficiency, thyroid dysfunction, diabetes, fluctuations in maternal and placental estrogen levels) [5–9] and exogenous (e.g., cigarette smoking, endocrine-disrupting chemicals [EDCs]) stressors. These factors may disrupt fetal thyroid function [10, 11], expose the fetus to elevated levels of growth factors [12] and sex steroid hormones [13], which have been suggested to contribute to thyroid cancer development in adulthood [3, 4, 14–16] . Some epidemiologic studies have suggested positive associations for factors reflecting fetal hormone exposures, including maternal and congenital  \nthyroid disorders [17], higher birth weight [17–19], postpartum hemorrhage [17], and hyperemesis gravidarum [20], lending some support to the hypothesis that the gestational period is a susceptible exposure window in thyroid carcinogenesis. However, evidence on the impact of in-utero and birth characteristics on subsequent risk of thyroid cancer remains scarce.  \nTo contribute to the limited research on this topic, we prospectively evaluated associations of a wide range of selfreported in-utero and newborn factors with DTC incidence in the Sister Study, a large [U.S. nationwide](U.S. nati","cbCailOPcGEmlg7E","https://ap.wps.com/l/cbCailOPcGEmlg7E","pdf",465454,"English","# Background\n# Methods\n## Study sample\n# Results\n# Conclusions\n# Introduction","[{\"question\":\"What was the study’s main goal regarding thyroid cancer risk?\",\"answer\":\"To investigate whether in-utero and newborn characteristics are associated with the incidence of differentiated thyroid cancer (DTC) in adult women.\"},{\"question\":\"How was the Sister Study cohort used in this analysis?\",\"answer\":\"A total of 47,913 cancer-free women at baseline (2003–2009) were included, and DTC incidence during follow-up was analyzed using Cox regression models adjusted for attained age and race/ethnicity.\"},{\"question\":\"Which in-utero or newborn factors were linked to higher DTC incidence?\",\"answer\":\"Higher DTC incidence was associated with maternal pre-pregnancy or gestational diabetes, gestational hypertension or hypertension-related disorders, and higher birth weight. Births at least two weeks before the due date were associated with lower DTC incidence.\"}]","In-utero and newborn factors and thyroid cancer incidence in adult women in the Sister Study cohort | PDF",1790217207]