Publications by authors named "Joseph Sebbag"

9 Publications

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Non-Essential Trace Elements Dietary Exposure in French Polynesia: Intake Assessment, Nail Bio Monitoring and Thyroid Cancer Risk

Asian Pac J Cancer Prev 2019 Feb 26;20(2):355-367. Epub 2019 Feb 26.

Radiation Epidemiology Group, Centre for Research in Epidemiology and Population Health (CESP), UMR 1018 Inserm, Villejuif, France.

Background: In French Polynesia, thyroid cancer mortality and incidence is reported to be the highest in the world. Excessive levels of non-essential trace elements (nETE) in the body are associated with several types of cancer. Objective: The present study aims to provide quantitative information on food contamination by mercury (Hg), lead (Pb), arsenic (As) and cadmium (Cd) in French Polynesia and its potential correlation with measurements performed in fingernails of Polynesians, and then to investigate the potential association between these nETE and different thyroid cancer risks. Methods: The study population included 229 interviewed cases and 373 interviewed controls We performed a descriptive analysis of Polynesian food and examined the association between thyroid cancer risk and daily intake levels of nETE and with fingernail nETE levels. Results: Hg contamination was mainly present in sea products, Pb contamination was present in almost all samples, Cd was detectable in starchy food and As was detectable in all sea products. No patient exceeded dietary contamination WHO limits for Pb, 2 participants exceeded it for Hg and 3 individuals (0.5%) for cadmium. In fingernail clippings, the most detectable pollutant was Pb (553 participants), then Hg (543 participants) then Cd (only in 130 participants). Thyroid cancer risk was increased more than 4 times by Pb daily intake in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.01), and 2 times more in women with more than 3 pregnancies than in those with none or less (p for interaction =0.005); it was also increased following As intake by more than 30% in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.05). Conclusion: Locally produced foods are not a source of nETE exposure in French Polynesia. Dieatry nETE exposure and fingernail nETE concentration are not associated to differentiated thyroid cancer risk. No correlation found between nETE dietary exposure and fingernail nETE concentration.
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http://dx.doi.org/10.31557/APJCP.2019.20.2.355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6897028PMC
February 2019

Common variants at 9q22.33, 14q13.3, and ATM loci, and risk of differentiated thyroid cancer in the French Polynesian population.

PLoS One 2015 7;10(4):e0123700. Epub 2015 Apr 7.

Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, F-94800, Villejuif, France; University Paris-Sud, UMRS 1018, F-94807, Villejuif, France; IGR, F-94800, Villejuif, France.

Background: French Polynesia has one of the highest incidence rates of thyroid cancer worldwide. Relationships with the atmospheric nuclear weapons tests and other environmental, biological, or behavioral factors have already been reported, but genetic susceptibility has yet to be investigated. We assessed the contribution of polymorphisms at the 9q22.33 and 14q13.3 loci identified by GWAS, and within the DNA repair gene ATM, to the risk of differentiated thyroid cancer (DTC) in 177 cases and 275 matched controls from the native population.

Principal Findings: For the GWAS SNP rs965513 near FOXE1, an association was found between genotypes G/A and A/A, and risk of DTC. A multiplicative effect of allele A was even noted. An excess risk was also observed in individuals carrying two long alleles of the poly-alanine tract expansion in FOXE1, while no association was observed with rs1867277 falling in the promoter region of the gene. In contrast, the GWAS SNP rs944289 (NKX2-1) did not show any significant association. Although the missense substitution D1853N (rs1801516) in ATM was rare in the population, carriers of the minor allele (A) also showed an excess risk. The relationships between these five polymorphisms and the risk of DTC were not contingent on the body surface area, body mass index, ethnicity or dietary iodine intake. However, an interaction was evidenced between the thyroid radiation dose and rs944289.

Significance: A clear link could not be established between the high incidence in French Polynesia and the studied polymorphisms, involved in susceptibility to DTC in other populations. Important variation in allele frequencies was observed in the Polynesian population as compared to the European populations. For FOXE1 rs965513, the direction of association and the effect size was similar to that observed in other populations, whereas for ATM rs1801516, the minor allele was associated to an increased risk in the Polynesian population and with a decreased risk in the European population.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0123700PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388539PMC
April 2016

Lack of association between fingernail selenium and thyroid cancer risk: a case-control study in French Polynesia.

Asian Pac J Cancer Prev 2014 ;15(13):5187-94

Radiation Epidemiology Group, Centre for Research in Epidemiology and Population Health (CESP), UMR 1018 Inserm, France E-mail

Background: Numerous studies have suggested that selenium deficiency may be associated with an increased risk for several types of cancer, but few have focused on thyroid cancer.

Materials And Methods: We examined the association between post-diagnostic fingernail selenium levels and differentiated thyroid cancer risk in a French Polynesian matched case-control study. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals.

Results: The median selenium concentration among controls was 0.76 μg/g. Significantly, we found no association between fingernail selenium levels and thyroid cancer risk after conditioning on year of birth and sex and additionally adjusting for date of birth (highest versus lowest quartile: odds-ratio=1.12, 95% confidence interval: 0.66-1.90; p-trend=0.30). After additional adjustment for other covariates, this association remained non-significant (p-trend=0.60). When restricting the analysis to thyroid cancer of 10 mm or more, selenium in nails was non-significantly positively linked to thyroid cancer risk (p-trend=0.09). Although no significant interaction was evidenced between iodine in nails and selenium in nails effect (p=0.70), a non-significant (p-trend =0.10) positive association between selenium and thyroid cancer risk was seen in patients with less than 3 ppm of iodine in nails. The highest fingernail selenium concentration in French Polynesia was in the Marquises Islands (M=0.87 μg/g) and in the Tuamotu-Gambier Archipelago (M=0.86 μg/g).

Conclusions: Our results do not support, among individuals with sufficient levels of selenium, that greater long-term exposure to selenium may reduce thyroid cancer risk. Because these findings are based on post-diagnostic measures, studies with prediagnostic selenium are needed for corroboration.
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http://dx.doi.org/10.7314/apjcp.2014.15.13.5187DOI Listing
April 2015

Differentiated thyroid carcinoma risk factors in French Polynesia.

Asian Pac J Cancer Prev 2014 ;15(6):2675-80

Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, France E-mail :

Background: To investigate differentiated thyroid cancer risk factors in natives of French Polynesia is of interest because of the very high incidence of this cancer in the archipelago.

Materials And Methods: To assess the role of various potential risk factors of thyroid cancer in the natives of French Polynesia we performed a case-control study. The study included almost all the French Polynesians diagnosed with differentiated thyroid carcinoma between 1981 and 2003 (n=229) and 373 French Polynesian control individuals from the general population without cancer.

Results: Thyroid radiation dose received from nuclear fallout before the age of 15, a personal history of neck or/and head medical irradiation, obesity, tallness, large number of children, an artificial menopause, a familial history of thyroid cancer, a low dietary iodine intake, and having a spring as the main source of drinking water were found to be significant risk factors. No roles of smoking habits, alcohol consumption, iodine containing drugs, and exposure to pesticides were evidenced.

Conclusions: Except for smoking, differentiated thyroid carcinoma risk factors in natives of French Polynesia are similar to those in other populations. Our finding on the role of having a spring as a drinking water origin is coherent with some other studies and could be due to geological factors.
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http://dx.doi.org/10.7314/apjcp.2014.15.6.2675DOI Listing
January 2015

Dietary patterns, goitrogenic food, and thyroid cancer: a case-control study in French Polynesia.

Nutr Cancer 2012 ;64(7):929-36

Radiation Epidemiology Group, CESP Centre for research in Epidemiology and Population Health, U1018 INSERM, Villejuif, France.

French Polynesia has one of the world's highest thyroid cancer incidence rates. A case-control study among native residents of French Polynesia included 229 cases of differentiated thyroid cancer diagnosed between 1979 and 2004, and 371 population controls. Dietary patterns and goitrogenic food consumption (cabbage, cassava) were analyzed. We used a factor analysis to identify dietary patterns and a conditional logistic regression analysis to investigate the association between dietary patterns or food items and thyroid cancer risk. Two distinct dietary patterns were identified: traditional Polynesian and Western. A nonsignificant inverse association was observed between the traditional Polynesian dietary pattern and thyroid cancer risk. The Western pattern was not associated with thyroid cancer risk. Cassava consumption was significantly associated with a decreased risk of thyroid cancer. In conclusion, a traditional Polynesian dietary pattern led to a weak reduced risk of thyroid cancer in French Polynesia. The protective effect of cassava on this cancer does not seem to be substantially different from that of cabbage, which was the main goitrogenic food studied to date.
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http://dx.doi.org/10.1080/01635581.2012.713538DOI Listing
March 2013

Dietary iodine and thyroid cancer risk in French Polynesia: a case-control study.

Thyroid 2012 Apr 26;22(4):422-9. Epub 2012 Jan 26.

Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, U1018 INSERM, Villejuif, France.

Background: French Polynesia has one of the world's highest thyroid cancer incidence rates. Iodine is suspected to play a role in this high incidence. The objective of this study was to assess whether low dietary iodine is related to a higher risk of thyroid cancer in the French Polynesian population.

Methods: A case-control study was performed among native residents of French Polynesia. It included 229 cases of differentiated thyroid cancer diagnosed between 1979 and 2004 (203 women, 26 men) matched with 371 population controls (324 women, 47 men) on the date of birth. The current study is focused on dietary iodine intake and fish consumption (food rich in iodine) and analyzed by conditional logistic regression.

Results: Daily dietary iodine intake was insufficient (<150 μg/day) in 60% of both cases and controls. A decreased risk of thyroid cancer was observed with a higher consumption of fish (p(trend)=0.008) and shellfish (p(trend)=0.002), and also with a higher dietary iodine intake (p(trend)=0.03). There was no significant interaction between the effects of the thyroid radiation dose and the dietary iodine intake (p=0.2).

Conclusion: French Polynesia is a mild iodine deficiency area in which a higher consumption of food from the sea and a higher dietary iodine intake are significantly associated with a decreased risk of thyroid cancer. The quantification of this reduction requires specific investigation of iodine intake in traditional Polynesian food.
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http://dx.doi.org/10.1089/thy.2011.0173DOI Listing
April 2012

Family history of thyroid cancer and the risk of differentiated thyroid cancer in French polynesia.

Thyroid 2010 Apr;20(4):393-400

Radiation Epidemiology Group U1018, INSERM, Villejuif Cedex, France .

Background: Differentiated thyroid carcinoma is considered to be the nonhereditary cancer for which familial inheritance is the highest. To date, no familial aggregation analysis of this cancer has been performed in Maohi populations, which exhibit a very high incidence rate. Therefore, we evaluate the risk of differentiated thyroid cancer associated with a family history of thyroid cancer in natives of French Polynesia.

Methods: We investigated thyroid cancer incidence in the first-degree relatives of 225 cases of differentiated thyroid carcinomas diagnosed between 1979 and 2004 in patients born in French Polynesia, and 368 randomly selected population controls matched for sex and age, born and residing in French Polynesia. All but five thyroid cancers declared among relatives were validated.

Results: Twenty-four cases declared a family history of thyroid cancer, when compared with 11 controls. Individuals with an affected first-degree relative had a 4.5-fold (95% confidence interval [CI], 1.9-10.6) increased risk of differentiated thyroid cancer. This odds ratio (OR) was not significantly higher when a male first-degree relative was affected (OR, 10.0; 95% CI, 1.3-74.8) compared with a female (OR, 4.0; 95% CI, 1.5-10.3) and was not different for patients who had a nonaggressive thyroid microcarcinoma (OR, 3.5; 95% CI, 0.6-16.4) than those who had a larger cancer (OR, 6.0; 95% CI, 1.8-20.5). This OR was borderline significantly (p, 0.07) higher in Maohis (OR, 11.0; 95% CI, 2.4-48.8) than in individuals of mixed origin (OR, 2.1; 95% CI, 0.8-5.9).

Conclusion: Our study shows that the familial inheritance of differentiated thyroid cancer is particularly high in Maohi populations.
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http://dx.doi.org/10.1089/thy.2009.0350DOI Listing
April 2010

Anthropometric factors in differentiated thyroid cancer in French Polynesia: a case-control study.

Cancer Causes Control 2009 Jul 30;20(5):581-90. Epub 2008 Nov 30.

INSERM Unit 605, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France.

Objectives: French Polynesia has one of the world's highest thyroid cancer incidence rates. A case-control study among native residents of French Polynesia included 219 cases of differentiated thyroid cancers diagnosed between 1979 and 2004 (195 women/24 men) matched with 359 population controls (315 women/44 men) on the date of birth.

Methods: Anthropometric factors were analyzed by conditional logistic regression.

Results: The risk of thyroid cancer for women in the highest quartile of body mass index (BMI) before diagnosis and at age 18 was 2.3-fold higher (95% CI, 1.1-4.7 p = 0.04) and 2.3-fold higher (95% CI, 1.2-4.4 p < 0.01), respectively, compared with the lowest. Women who were overweight (BMI = 25-29.9 kg/m2) or obese (BMI > or = 30 kg/m2) at age 18 and before diagnosis had an increased risk compared with those with a normal lifelong weight (OR = 6.2; 95% CI, 2.5-15.5 p < 0.01). Results for excess weight appeared in similar directions for men, although the number of cases was too small to provide reliable estimates. Height was positively associated with thyroid cancer among men and women.

Conclusion: This study shows the role of excess body weight, especially if the onset is during early adulthood, and elevated height in the risk of differentiated thyroid cancer in populations born in French Polynesia.
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http://dx.doi.org/10.1007/s10552-008-9266-yDOI Listing
July 2009

Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in native women in French Polynesia: a population-based case-control study.

Am J Epidemiol 2008 Jan 26;167(2):219-29. Epub 2007 Oct 26.

Unit 605, INSERM, Villejuif, France.

French Polynesia has one of the world's highest incidence rates of thyroid cancer. A case-control study among native residents of French Polynesia included 201 women diagnosed with differentiated thyroid cancer before the age of 56 years, between 1981 and 2004, matched to 324 population controls on date of birth. Face-to-face interviews were conducted from 2002 to 2004. Odds ratios were calculated by using conditional logistic regression and were reported in the total group and by ethnic group ("Polynesian" vs. "mixed"). The risk of thyroid cancer increased with natural (odds ratio = 1.9) or artificial (odds ratio = 4.5) menopause compared with that associated with a premenopausal status and with number of births (p for trend = 0.03): odds ratios for one, two, three, four or five, six or seven, and eight or more births were, respectively, 0.90, 1.6, 2.3, 2.2, 2.7, and 1.7 compared with a nulliparous status. Similar results were observed for Polynesian women. No association was observed with irregular menstrual cycles, age at menopause, history of miscarriage or induced abortion, time since last birth, age at and outcome of first pregnancy, or breastfeeding. This study confirms the role of menstrual and reproductive factors in the risk of differentiated thyroid cancer in Pacific island populations.
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http://dx.doi.org/10.1093/aje/kwm288DOI Listing
January 2008