Abstract
Autism spectrum disorder (ASD) and intellectual disability (ID) are neurodevelopmental disorders with strong genetic components. Increasingly, research attention has focused on whether genetic factors conveying susceptibility for these conditions, also influence the risk of other health conditions, such as cancer. We examined the occurrence of hospital admissions and treatment/services for cancer in mothers of children with ASD with or without ID compared with other mothers. After linking Western Australian administrative health databases, we used Cox regression to estimate the hazard ratios (HRs) of any hospitalisations and treatment/services for cancer in these groups of mothers. Mothers of children with ASD without ID had greater risk of admissions for cancer (HR 1.29 [95 % CI 1.1, 1.7]), and for treatment/services in particular (HR 1.41 [95 % CI 1.0, 2.0]), than mothers of children with no ASD/ID, while mothers of children with ASD with ID were no more likely to have a cancer-related hospital admission than other mothers. Mothers of children with autism without ID had increased risk of cancer, which may relate to common genetic pathways.
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Notes
Department of Health. Data linkage, Western Australia: Access and Application Perth: Government of Western Australia; 2010. Available from: http://www.datalinkage-wa.org.au/accessand-application.
Department of Health. Data Linkage Western Australia: Ethics 2010. Available from: http://www.datalinkage-wa.org/access-andapplication/ethics.
References
American Psychiatric Association. (2013). The diagnostic and statistical manual of mental disorders: DSM 5. Arlington, VA: Bookpoint US.
Australian Bureau of Statistics. (2009). Information paper: An introduction to socio-economic indexes for areas (SEIFA). Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/2039.0.
Australian Institute for Health and Welfare. (2015). Coded clinical data 2015. Available from: http://www.aihw.gov.au/hospitals-data/national-hospital-morbidity-data/coded-clinical-data/.
Blatt, J., Deal, A., & Mesibov, G. (2010). Autism in children and adolescents with cancer. Pediatric Blood and Cancer, 54(1), 144–147.
Chiang, H.-L., Liu, C.-J., Hu, Y.-W., Chen, S.-C., Hu, L.-Y., Shen, C.-C., et al. (2015). Risk of cancer in children, adolescents, and young adults with autistic disorder. Journal of Pediatrics, 166(2), 418–423.
Chida, Y., Hamer, M., Wardle, J., & Steptoe, A. (2008). Do stress-related psychosocial factors contribute to cancer incidence and survival? Nature Clinical Practice Oncology, 5(8), 466–475.
Christensen, D., Davis, G., Draper, G., Mitrou, F., McKeown, S., Lawrence, D., et al. (2014). Evidence for the use of an algorithm in resolving inconsistent and missing Indigenous status in administrative data collections. Australian Journal of Social Issues, 49(4), 423.
Condon, J., Zhang, X., Baade, P., Griffiths, K., Cunningham, J., Roder, D., et al. (2014). Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality. Population Health Metrics, 12(1), 1.
Crespi, B. (2011). Autism and cancer risk. Autism Research, 4(4), 302–310.
Department of Health of Western Australia. (2011). What we collect and manage 2011, 12 May 2011. Available from: http://www.health.wa.gov.au/healthdata/statewide/index.cfm.
Fairthorne, J., de Klerk, N., & Leonard, H. (2016a). Brief report: burden of care in mothers of children with autism spectrum disorder or intellectual disability. Journal of Autism and Developmental Disorders, 46(3), 1103–1109.
Fairthorne, J., Jacoby, P., Bourke, J., de Klerk, N., & Leonard, H. (2016b). Onset of maternal psychiatric disorders after the birth of a child with autism spectrum disorder: A retrospective cohort study. Autism, 20(1), 37–44.
Feero, W. G., Guttmacher, A., Mefford, H., Batshaw, M., & Hoffman, E. (2012). Genomics, intellectual disability, and autism. New England Journal of Medicine, 366(8), 733–743.
Greenlee, R. T., Murray, T., Bolden, S., & Wingo, P. A. (2000). Cancer statistics, 2000. CA: A Cancer Journal for Clinicians, 50(1), 7–33.
Holman, C., Bass, A., Rouse, I., & Hobbs, M. (1999). Population-based linkage of health records in Western Australia: development of a health services research linked database. Australian and New Zealand Journal of Public Health, 23, 453–459.
Ingudomnukul, E., Baron-Cohen, S., Wheelwright, S., & Knickmeyer, R. (2007). Elevated rates of testosterone-related disorders in women with autism spectrum conditions. Hormones and Behavior, 51(5), 597–604.
Institute for Digital Research and Education. (2014). Supplemental notes to applied survival analysis. Los Angeles, CA: UCLA Statistical Consulting Group, 16 April 2016. Available from: http://www.ats.ucla.edu/stat/examples/asa/test_proportionality.htm.
Klint, Å., Engholm, G., Storm, H., Tryggvadóttir, L., Gislum, M., Hakulinen, T., et al. (2010). Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964–2003: Followed up to the end of 2006. Acta Oncologica, 49(5), 578–607.
Leonard, H., Glasson, E., Nassar, N., Whitehouse, A., Bebbington, A., Bourke, J., et al. (2011). Autism and intellectual disability are differentially related to sociodemographic background at birth. PLoS One, 6(3), e17875.
Levav, I., Lipshitz, I., Novikov, I., Pugachova, I., Kohn, R., Barchana, M., et al. (2007). Cancer risk among parents and siblings of patients with schizophrenia. British Journal of Psychiatry, 190(2), 156–161.
Lucá, R., Averna, M., Zalfa, F., Vecchi, M., Bianchi, F., La Fata, G., et al. (2013). The Fragile X protein binds mRNAs involved in cancer progression and modulates metastasis formation. EMBO Molecular Medicine, 5(10), 1523–1536.
Schubbert, S., Shannon, K., & Bollag, G. (2007). Hyperactive Ras in developmental disorders and cancer. Nature Reviews Cancer, 7(4), 295–308.
Schwab, J. (2002). Multinomial logistic regression: basic relationships and complete problems. Austin: University of Texas.
Sullivan, S., Hussain, R., Threlfall, T., & Bittles, A. (2004). The incidence of cancer in people with intellectual disabilities. Cancer Causes and Control, 15(10), 1021–1025.
Surveillance Epidemiology and End Results. (2014). ICD-9-CM to ICD-10-CM based on FY2014 ICD-9-CM codes New York: US Government. Available from: http://seer.cancer.gov/tools/conversion/2014/ICD9CM_to_ICD10CM_2014CF.pdf.
Tan, M.-H., Mester, J., Ngeow, J., Rybicki, L., Orloff, M., & Eng, C. (2012). Lifetime cancer risks in individuals with germline PTEN mutations. Clinical Cancer Research, 18(2), 400–407.
Tatton-Brown, K., Seal, S., Ruark, E., Harmer, J., Ramsay, E., del Vecchio, Duarte S., et al. (2014). Mutations in the DNA methyltransferase gene DNMT3A cause an overgrowth syndrome with intellectual disability. Nature Genetics, 46(4), 385–388.
van Loon, A., Burg, J., Goldbohm, R., & van den Brandt, P. (1995). Differences in cancer incidence and mortality among socio-economic groups. Scandinavian Journal of Public Health, 23(2), 110–120.
Varga, E., Pastore, M., Prior, T., Herman, G., & McBride, K. (2009). The prevalence of PTEN mutations in a clinical pediatric cohort with autism spectrum disorders, developmental delay, and macrocephaly. Genetics in Medicine, 11(2), 111–117.
World Health Organisation. (2006). International statistical classification of diseases and related health problems, 10th Revision, Version for 2007. Available from: http://apps.who.int/classifications/apps/icd/icd10online/.
Acknowledgments
This work was partly supported by the Australian National Health and Medical Research Council Program Grant #572742. AJOW is supported by a Senior Research Fellowship from the Australian National Health and Medical Research Council, #1077966. We gratefully acknowledge the data contribution from the Intellectual Disability Exploring Answers (IDEA) Data-base.
Authors’ contributions
All authors participated in study conception, design, analysis, and interpretation of data. JF analysed the data and was advised by NdK. JF wrote the initial manuscript and prepared subsequent drafts after input from all co-authors. All authors read and approved the final manuscript for submission.
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Some access restrictions apply to the data underlying our findings. Our data was provided by a third party, the Western Australian Department of Health.Footnote 1 Principal 3 of the conditions for ethical approval state that the information must not be further disclosed to others without prior approval from the Data Custodians and DOHHREC.Footnote 2 Hence, interested persons would have to go through the same procedure as we did to obtain the dataset. All information regarding contact details and downloading of the necessary forms are available from the referenced web pages.
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Ethical approval for this study (#2011/64) was Granted by the Western Australian Department of Health Human Research Ethics Committee (DOHHREC).
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Fairthorne, J.C., de Klerk, N.H., Leonard, H.M. et al. Mothers of Children with Autism have Different Rates of Cancer According to the Presence of Intellectual Disability in Their Child. J Autism Dev Disord 46, 3106–3114 (2016). https://doi.org/10.1007/s10803-016-2847-9
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DOI: https://doi.org/10.1007/s10803-016-2847-9