Evidence map›Paper›PMID 34439207›Full record

ReviewCancers2021

Heavy Metals in the Environment and Thyroid Cancer.

Fiorenza Gianì, Roberta Masto, Maria Antonietta Trovato, Pasqualino Malandrino, Marco Russo, Gabriella Pellegriti, Paolo Vigneri, Riccardo Vigneri

Open access · goldAbstract readReview
In one paragraph

Review in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Dietary Pattern and Risk of Thyroid Cancer: A Systematic Review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Heavy metals as endocrine disruptors.Turkish journal of medical sciences · 2026
    Review
  9. Article
  10. Article
  11. Elemental comparative analysis of 18 elements reveal distinct patterns in benign and malignant thyroid tissues.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2025
    Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Fiorenza GianìEndocrinology, Garibaldi-Nesima Medical Center, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.ORCID 0000-0002-1901-8230
Roberta MastoEndocrinology, Garibaldi-Nesima Medical Center, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
Maria Antonietta TrovatoSurgical Oncology, Garibaldi-Nesima Medical Center, 95122 Catania, Italy.
Pasqualino MalandrinoEndocrinology, Garibaldi-Nesima Medical Center, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.ORCID 0000-0003-2474-0954
Marco RussoEndocrinology, Garibaldi-Nesima Medical Center, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
Gabriella PellegritiEndocrinology, Garibaldi-Nesima Medical Center, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
Paolo VigneriMedical Oncology and Center of Experimental Oncology and Hematology, Department of Clinical and Experimental Medicine, University of Catania, A.O.U. Policlinico Vittorio Emanuele, 95125 Catania, Italy.ORCID 0000-0002-5943-6066
Riccardo VigneriEndocrinology, Garibaldi-Nesima Medical Center, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
University of Catania · ITOspedale Garibaldi · IT

Funding

Associazione Italiana per la Ricerca sul Cancro 19897
6 · The paper itself

Abstract

In recent decades, the incidence of thyroid cancer has increased more than most other cancers, paralleling the generalized worldwide increase in metal pollution. This review provides an overview of the evidence supporting a possible causative link between the increase in heavy metals in the environment and thyroid cancer. The major novelty is that human thyroid stem/progenitor cells (thyrospheres) chronically exposed to different metals at slightly increased environmentally relevant concentrations show a biphasic increase in proliferation typical of hormesis. The molecular mechanisms include, for all metals investigated, the activation of the extracellular signal-regulated kinase (ERK1/2) pathway. A metal mixture, at the same concentration of individual metals, was more effective. Under the same conditions, mature thyrocytes were unaffected. Preliminary data with tungsten indicate that, after chronic exposure, additional abnormalities may occur and persist in thyrocytes derived from exposed thyrospheres, leading to a progeny population of transformation-prone thyroid cells. In a rat model predisposed to develop thyroid cancer, long-term exposure to low levels of metals accelerated and worsened histological signs of malignancy in the thyroid. These studies provide new insight on metal toxicity and carcinogenicity occurring in thyroid cells at a low stage of differentiation when chronically exposed to metal concentrations that are slightly increased, albeit still in the "normal" range.

Indexed as

metal carcinogenesismetal mixturemetal pollutionmetalsthyroid cancerthyroid stem cellsvolcanic pollution

Identifiers

PMID34439207
PMCPMC8393334
OpenAlexW3188940793

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.