(1020) Obesity as a Risk Factor for Pediatric Thyroid Cancer

Introduction: Pediatric thyroid cancer incidence has increased in recent years, paralleling the rise in pediatric obesity, which has been proposed as a potential risk factor through metabolic and hormonal mechanisms. This study aims to evaluate the association between obesity and pediatric thyroid cancer.

Methods: This retrospective cohort study utilized the TriNetX Research Network to identify pediatric patients (≤18 years) diagnosed with thyroid cancer (ICD-10-CM C73) from 2006 to 2024. Pediatric patients without thyroid cancer were selected as controls. Propensity score matching (1:1) was performed to balance age, sex, race, and ethnicity between the thyroid cancer and non-cancer cohorts. Obesity prevalence (ICD-10-CM E66) was then compared among matched groups. Annual thyroid cancer incidence and pediatric obesity prevalence were compared over time.

Results: After 1:1 propensity score matching, 2,053 children with thyroid cancer were matched to 2,053 children without cancer. The cohorts were well balanced in terms of age and sex, with mean age at index similar between groups (12.7 ± 5.06 years in the thyroid cancer cohort vs 12.6 ± 4.94 years in the non-cancer cohort; p=.48). The proportion of female patients was similar between cohorts (71.4% vs 70.0%; p=.35), and race and ethnicity was also balanced. Despite this demographic similarity, obesity was significantly more prevalent among children with thyroid cancer compared with matched controls (6.28% [129/2,053] vs 1.36% [28/2,053]; p<.001). Annual pediatric thyroid cancer incidence and obesity prevalence demonstrated a strong positive temporal correlation (Pearson r=0.96, p<.001).

Conclusions: Given the association between obesity and pediatric thyroid cancer, clinicians should consider obesity as a modifiable risk factor, supporting the importance of early weight management in pediatric populations. Further research is needed to understand the mechanisms underlying this association.