Infectious exposure in the first year of life and risk of central nervous system tumors in children: analysis of day care, social contact, and overcrowding
- 142 Downloads
Little is known regarding the aetiology of central nervous system tumors in children. Recent studies have speculated on a potential infectious aetiology, but no clear associations have been found. This article uses parent reported questionnaire data from the UK Childhood Cancer Study (UKCCS), a population-based case–control study, to examine the relationship between the infectious exposure in the first year of life and the likelihood of developing a CNS tumor. The variables representing infectious exposure were social contact (including social contact with other infants and attendance at informal and formal day care), sharing a bedroom with another child, birth order, and exposure to a school-age child within the home. Children reported to have had no social contact with other infants in the first year of life displayed an increased risk of developing a CNS tumor when compared to those who had (OR 1.37, 95% CI 1.08–1.75). This effect was most prominent in the primitive neuroectodermal tumor/medulloblastoma subgroup (OR 1.78, 95% CI 1.12–2.83). Those who had attended informal (OR 0.86, 95% CI 0.68–1.09) or formal day care (OR 0.93, 95% CI 0.68–1.26) showed slightly non-statistically significant reduced risks when compared to those reporting social contact only. No association with any of the other variables was observed. Overall, the inconsistent findings by variable and tumor subtype suggest that an early exposure to infections is not strongly implicated in the aetiology of CNS tumors. However, the effect for social contact outside the home, particularly for PNET/medulloblastomas warrants further investigation.
KeywordsChildhood cancer Childhood neoplasms CNS tumors Brain tumors Infectious exposure Social contact UKCCS
UKCCS Management committee—KK Cheng, Central region; N Day, East Anglia region; R Cartwright, A Craft, North East region; JM Birch, OB Eden, North West region; PA McKinney, Scotland; J Peto, South East region; V Beral, E Roman, South Midlands region; P Elwood, South Wales region; FE Alexander, South West region; CED Chilvers, Trent region; R Doll, Epidemiological Studies Unit, University of Oxford, Oxford; CM Taylor Immunogenetics Laboratory, University of Manchester, Manchester; M Greaves, Leukaemia Research Fund Centre, Institute of Cancer Research; D Goodhead, Radiation and Genome Stability Unit, Medical Research Council, Harwell; FA Fry, National Radiological Protection Board; G Adams, UK Coordinating Committee for Cancer Research. Writing Committee—N Day, J Skinner, East Anglia region; E Roman, South Midlands region; SG Allen, MP Maslanyj, TJ Mee, National Radiological Protection Board. Regional Investigators—KK Cheng, E Gilman, Central region; N Day, J Skinner, D Williams, East Anglia region; R Carwright, A Craft, North East region; JM Birch, O B Eden, North West region; PA McKinney, Scotland; J Deacon, J Peto, South East region; V Beral, E Roman, South Midlands region; P Elwood, South Wales region; FE Alexander, M Mott, South West region; CED Chilvers, K Muir, Trent region. Leukaemia Research Fund Data Management Processing Group—R Cartwright, G Law, J Simpson, E Roman. A complete list of investigators is given in: The United Kingdom Childhood Cancer Study: objectives, material, and methods. Br J Cancer.
The UKCCS was sponsored and administered by the United Kingdom Coordinating Committee on Cancer Research and was supported by the Childhood Cancer and Leukaemia Group (formerly UKCCSG), paediatric oncologists, and by the National Radiological Protection Board. Financial support was provided by: Cancer Research UK, Leukaemia Research Fund, and Medical Research Council through grants to their units; Leukaemia Research Fund for the UKCCS data centre at the University of York; Leukaemia Research Fund, Department of Health, member companies of the Electricity Association, Irish Electricity Supply Board, National Grid Company PLC, and Westlakes Research (Trading) Ltd for general expenses of the study; Kay Kendall Leukaemia Fund for associated laboratories studies; and Foundation of Children with Leukaemia for study of electrical fields. The investigation in Scotland was funded by the Scottish Office, Scottish Power PLC, Scottish Hydro-electric plc, and Scottish Nuclear Ltd. We thank the members of the UKCCSG for their support, the staff of the local hospitals, the family physicians, and their practice staff. We especially thank the families of the children included in the study for their help. The analyses for this paper were supported by Cancer Research UK. JM Birch is a Cancer Research UK Professorial Fellow.
- 5.Little J (1999) Epidemiology of childhood cancer, International Agency for Research on Cancer, IARC Scientific Publications No. 149. IARC Scientific Publications, LyonGoogle Scholar
- 35.Fritz A (2000) International classification of diseases for oncology, vol vii, 3rd edn. World Health Organization, Geneva 240 ppGoogle Scholar
- 36.Townsend PPP, Beattie A (1988) Health and deprivation: inequality and the North. Croom Helm, LondonGoogle Scholar
- 39.Kleihues P, Cavenee WK, International Agency for Research on Cancer (2000) Pathology and genetics of tumours of the nervous system. IARC Press, Lyon 314 ppGoogle Scholar
- 46.Office for National Statistics (2003) Day care places for children. In: Summerfield C, Babb P (eds) Social trends, vol 33. HMSO, LondonGoogle Scholar