Childhood infectious disease and premature death from cancer: a prospective cohort study
First Online: 15 February 2013 Received: 08 August 2012 Accepted: 27 January 2013 DOI:
Cite this article as: Tennant, P.W.G., Parker, L., Thomas, J.E. et al. Eur J Epidemiol (2013) 28: 257. doi:10.1007/s10654-013-9775-1 Abstract
Studies of the association between early life infections and cancer have produced inconsistent findings, possibly due to limited adjustment for confounding and retrospective designs. This study utilised data from the Newcastle Thousand Families Study, a prospective cohort of 1,142 individuals born in Newcastle-upon-Tyne in 1947, to assess the impact of various childhood infectious diseases on cancer mortality during ages 15–60 years. Detailed information was collected prospectively on a number of early life factors. Deaths from cancer during ages 15–60 years were analysed in relation to childhood infections, adjusting for potential early-life confounders, using Cox proportional-hazards regression. In a subsample who returned questionnaires at aged 49–51 years, additional adjustment was made for adult factors to predict death from cancer during ages 50–60 years. Childhood history of measles and influenza, were both independently associated with lower cancer mortality during ages 15–60 years (adjusted hazard ratios = 0.39, 95 % CI 0.17–0.88 and 0.49, 95 % CI 0.24–0.98 respectively). In contrast, childhood pertussis was associated with higher cancer mortality during ages 15–60 years (adjusted hazard ratio = 4.88, 95 % CI 2.29–10.38). In the subsample with additional adjustment for adult variables, measles and pertussis remained significantly associated with cancer mortality during ages 50–60 years. In this pre-vaccination cohort, childhood infection with measles and influenza were associated with a reduced risk of death from cancer in adulthood, while pertussis was associated with an increased risk. While these results suggest some disease-specific associations between early-life infections and cancer, further studies are required to confirm the specific associations identified.
Keywords Epidemiology Communicable diseases Malignancy Pertussis Measles Electronic supplementary material
The online version of this article (doi:
) contains supplementary material, which is available to authorized users. 10.1007/s10654-013-9775-1 References
World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: WHO Press; 2009. Available from:
(accessed 6 July 2012).
Blackwell DL, Hayward MD, Crimmins EM. Does childhood health affect chronic morbidity in later life? Soc Sci Med. 2001;52:1269–84.
Tennant PWG, Gibson GJ, Pearce MS. Lifecourse predictors of adult respiratory function: results from the Newcastle Thousand Families Study. Thorax. 2008;63:823–30.
Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer. 2006;118:3030–44.
Bach J-F. The effect of infections on susceptibility to autoimmune and allergic diseases. NEJM. 2002;347:911–20.
Hoption Cann SA, van Netten JP, van Netten C. Acute infections as a means of cancer prevention: opposing effects to chronic infections? Cancer Detect Prev. 2006;30:83–93.
Pearl R. Cancer and tuberculosis. Am J Epidemiol. 1929;9:97.
Engel P. Über den Infektionsindex der Krebskranken. Wien Klin Wochenschr. 1934;47:1118–9.
Engel P. Über den Einfluss des Alters auf den Infektionsindex der Krebskranken. Wien Klin Wochenschr. 1935;48:112.
Sinek F. Versuch einer statistischen Erfassung endogener Faktoren bei Carcinomkranken. J Cancer Res Clin Oncol. 1936;44:492–527.
Abel U, Becker N, Angerer R, et al. Common infections in the history of cancer patients and controls. J Cancer Res Clin Oncol. 1991;117:339–44.
Albonico HU, Bräker HU, Hüsler J. Febrile infectious childhood diseases in the history of cancer patients and matched control. Med Hypotheses. 1998;51:315–20.
Hoffmann C, Rosenberger A, Tröger W, Bühring M. Kinderkrankheiten, Infektionskrankheiten und Fieber als potentielle Risikofaktoren für Krebserkrankungen? Forsch Komplementärmed. 2002;9:323–30.
Kölmel KF, Gefeller O, Haferkamp B. Febrile infections and malignant melanoma: results of a case-control study. Melanoma Res. 1992;2:207–12.
McDuffie HH, Pahwa P, McLaughlin JR, et al. Non-Hodgkin’s lymphoma and specific pesticide exposures in men: cross-Canada study of pesticides and health. Cancer Epidemiol Biomarkers Prev. 2001;10:1155–63.
Wrotek S, Kamecki K, Kwiatkowski S, Kozak W. Cancer patients report a history of fewer fevers during infections than healthy controls. J Pre-Clin Clin Res. 2009;3:31–5.
Green J, Cairns BJ, Casabonne D, Wright FL, Reeves G, Beral V. Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk. Lancet Oncol. 2011;12:785–94.
Pearce MS, Unwin NC, Parker L, Craft AW. Cohort profile: the Newcastle Thousand Families 1947 Birth Cohort. Int J Epidemiol. 2009;38:932–7.
Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995;73:17–24.
Kuh DJ, Cooper C. Physical activity at 36 years: patterns and childhood predictors in a longitudinal study. J Epidemiol Community Health. 1992;46:114–9.
Tu SM. Heterogeneity of cancer. origin of cancer: clinical perspectives and implications of a stem-cell theory of cancer. New York: Springer; 2010. p. 129–36.
Maynard M, Gunnell D, Emmett P, Frankel S, Davey Smith G. Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort. J Epidemiol Community Health. 2003;57:218–25.
Strachan DP, Cook DG. Health effects of passive smoking. 1. Parental smoking and lower respiratory illness in infancy and early childhood. Thorax. 1997;52:905–14.
Boffetta P, Trédaniel J, Greco A. Risk of childhood cancer and adult lung cancer after childhood exposure to passive smoke: a meta-analysis. Environ Health Perspect. 2000;108:73–82.
Newhouse ML, Pearson RM, Fullerton JM, Boesen EA, Shannon HS. A case control study of carcinoma of the ovary. Br J Prevent Soc Med. 1977;31:148–53.
West RO. Epidemiologic study of malignancies of the ovaries. Cancer. 1966;19:1001–7.
Schiffman MH, Hartge P, Lesher LP, McGowan L. Mumps and postmenopausal ovarian cancer. Am J Obstet Gynecol. 1985;152:116.
Krone B, Kölmel KF, Henz BM, Grange JM. Protection against melanoma by vaccination with Bacille Calmette-Guérin (BCG) and/or vaccinia: an epidemiology-based hypothesis on the nature of a melanoma risk factor and its immunological control. Eur J Cancer. 2005;41:104–17.
Cramer DW, Finn OJ. Epidemiologic perspective on immune-surveillance in cancer. Curr Opin Immunol. 2011;23:265–71.
Sorahan T, Prior P, Lancashire RJ, et al. Childhood cancer and parental use of tobacco: deaths from 1971 to 1976. Br J Cancer. 1997;76:1525–31.
Simon MI, Strathmann MP, Gautam N. Diversity of G proteins in signal transduction. Science. 1991;252:802–8.
Mulholland EK, Griffiths UK, Biellik R. Measles in the 21st century. N Eng J Med. 2012;366:1755–7.
Guiso N, Liese J, Plotkin S. The Global Pertussis Initiative: meeting report from the fourth regional roundtable meeting, France, April 14–15, 2010. Hum Vaccin. 2011;7:481–8.
Kmietowicz Z. Pertussis cases rise 10-fold among older children and adults in England and Wales. Br Med J. 2012;345:e5008.
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