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Exposure to Bisphenol A increases malignancy risk of thyroid nodules in overweight/obese patients

Marotta, Vincenzo; Grumetto, Lucia; Neri, Ilaria; Russo, Giacomo; Tortora, Anna; Izzo, Giulia; Panariello, Ilaria; Rocco, Domenico; Pezzullo, Luciano; Vitale, Mario


Vincenzo Marotta

Lucia Grumetto

Ilaria Neri

Anna Tortora

Giulia Izzo

Ilaria Panariello

Domenico Rocco

Luciano Pezzullo

Mario Vitale


Bisphenol A (BPA) is a widespread thyroid disruptor, but evidence about an association with thyroid cancer is weak. Excess body weight is a risk factor for thyroid cancer and affects activity of endocrine disruptors. Aim of the study was to investigate the association between BPA exposure and thyroid cancer, verifying the effect modification related to body weight.

We performed a multicentre, cross-sectional study including consecutive patients referring for nodular goiter. The quantitative determination of BPA in serum samples was performed through high performance liquid chromatography system, coupled in tandem with ultraviolet and fluorescence detection.

Ninety-six patients were included: 55 benign nodules, 41 thyroid cancers, 28 normal weight, and 68 overweight/obese. BPA was detected in 79 subjects. In the overall study population and in the group with BMI<25 kg/m2 BPA exposure was not significantly correlated to thyroid cancer (p = 0.08 and 0.759, respectively). In the group with BMI≥25 kg/m2, BPA-exposed subjects showed significantly higher risk of malignancy (OR: 5.3, p = 0.028). At multivariate analysis, such association was independent of smoking, alcohol consumption, occupational exposure, and phthalates exposure (p = 0.021 and 0.016, respectively), but was lost after adjustment for the presence of metabolic syndrome (p = 0.089). In overweight/obese subjects, BPA exposure was significantly associated with higher thyroid stimulating hormone levels.

Our study suggests that BPA exposure is a risk factor for thyroid cancer in overweight/obese subjects.

Journal Article Type Article
Acceptance Date Oct 16, 2022
Online Publication Date Oct 25, 2022
Publication Date 2023-01
Deposit Date Oct 26, 2022
Publicly Available Date Oct 26, 2023
Journal Environmental Pollution
Print ISSN 0269-7491
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 316
Article Number 120478
Keywords Thyroid cancer, Thyroid nodules, Thyroid diseases, Environment, Endocrine disrupting chemicals, Bisphenol A, Pollutants, Body mass index
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Exposure to Bisphenol A increases malignancy risk of thyroid nodules in overweight/obese patients (accepted version) (330 Kb)

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