Cancer Causes & Control

, Volume 4, Issue 3, pp 217–224 | Cite as

Parents' use of cocaine and marijuana and increased risk of rhabdomyosarcoma in their children

  • Seymour Grufferman
  • Ann Grossbart Schwartz
  • Frederick B. Ruymann
  • Harold M. Maurer
Research Paper

Parents' use of marijuana and cocaine was evaluated in a national (United States) case-control study of childhood rhabdomyosarcoma (RMS). Subjects were 322 RMS cases, aged 0–20 years, from the Intergroup Rhabdomyosarcoma Study, and 322 matched controls identified by random-digit telephone dialing. Parents of subjects were interviewed by telephone using a structured questionnaire. Mothers' marijuana use during the year before their child's birth was associated with a 3.0-fold increased risk of RMS in the child (95% confidence interval [CI]=1.4–6.5) and maternal cocaine use was associated with a 5.1-fold increased risk (CI=1.0–25.0). Risk was increased 3.1-fold (CI=1.4–6.7) with use of any recreational drug. Fathers' marijuana use was associated with a 2.0-fold increased risk (CI=1.3–3.3), cocaine use with a 2.1-fold increased risk (CI=0.9–4.9), and use of any recreational drug with a 2.0-fold (CI=1.3–3.3) increased risk. Case mothers' cocaine use and both parents' marijuana use were associated with their children being diagnosed at a significantly younger age. It was not possible to determine whether cocaine and marijuana have independent effects, since use of the two drugs was materially correlated. Similarly, mothers' and fathers' use of these drugs was highly correlated. In summary, parents' marijuana and cocaine use during the year preceding their child's birth may increase, by twofold to fivefold, the risk of RMS in their children.

Key words

Alcohol drinking cocaine marijuana smoking neoplasms pregnancy sarcoma substance abuse tobacco United States 


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  1. 1.
    Ruymann FB, Grufferman S.. Introduction and epidemiology of soft tissue sarcomas. In: Maurer HM, Ruymann FB, Pochedly CE, eds. Rhabdomyosarcoma and Related Tumors in Children and Adolescents. Boca Raton, FL: CRC Press, 1991: 3–18.Google Scholar
  2. 2.
    Grufferman S, Wang HH, DeLong ER, Kimm SYS, Delzell ES, Falletta JM. Environmental factors in the etiology of rhabdomyosarcoma in childhood. JNCI 1982; 68: 107–13.Google Scholar
  3. 3.
    Grufferman S, Delzell ES, Maile MC, Michalopoulos G. Parents' cigarette smoking and childhood cancer. Med Hypotheses 1983; 12: 17–20.Google Scholar
  4. 4.
    Grufferman S, Delzell ES, DeLong ER. An approach to conducting epidemiologic research within cooperative clinical trials groups. J Clin Oncol 1984; 2: 670–5.Google Scholar
  5. 5.
    Robison LL, Buckley JD, Daigle AE, et al. Maternal drug use and risk of childhood nonlymphoblastic leukemia among offspring. Cancer 1989; 50: 1904–11.Google Scholar
  6. 6.
    Kuijten RR, Bunin GR, Nass CC, Meadows AT. Gestational and familial risk factors for childhood astrocytoma: results of a case-control study. Cancer Res 1990; 50: 2608–12.Google Scholar
  7. 7.
    Maurer HM, Ruymann FB, Pochedly CE, eds. Rhabdomyosarcoma and Related Tumors in Children and Adolescents. Boca Raton, FL: CRC Press, 1991.Google Scholar
  8. 8.
    US Bureau of the Census. Statistical Abstract of the United States: 1990 (110th Edition). Washington, DC: US Government Printing Office, Department of Commerce, 1990: 550.Google Scholar
  9. 9.
    Grufferman S, Gula MJ, Olshan AF, et al. Experience with random digit telephone dialing for control selection in a case-control study of children [Abstract]. Paediatr Perinat Epidemiol 1991; 5: A17–8.Google Scholar
  10. 10.
    SAS Institute Inc. SAS Technical Report P-217, SAS/STAT Software: The PHREG Procedure, Version 6. Cary, NC: SAS Institute Inc., 1991.Google Scholar
  11. 11.
    World Health Organization. International Classification of Diseases, Ninth Revision. Geneva: WHO, 1977.Google Scholar
  12. 12.
    Grufferman S, Gula MJ, Olshan AF et al. In utero X-ray exposure and risk of childhood rhabdomyosarcoma [Abstract]. Paediatr Perinat Epidemiol 1991; 5: A6–7.Google Scholar
  13. 13.
    Grufferman S, Gula MJ, Olshan AF, et al. Absence of an association between parents' cigarette smoking and risk of rhabdomyosarcoma in their children [Abstract]. Paediatr Perinat Epidemiol 1991; 5: A17.Google Scholar
  14. 14.
    Griffiths RR, Sannerud CA. Chapter 165. Abuse of and dependence on benzodiazepines and other anxiolytic/sedative drugs. In: Meltzer HY, ed. Psychopharmacology: The Third Generation of Progress. New York: Raven Press, 1987: 1535–41.Google Scholar
  15. 15.
    Bingol N, Fuchs M, Diaz V, Stone RK, Gromisch DS. Teratogenicity of cocaine in humans. J Pediatr 1987; 110: 93–6.Google Scholar
  16. 16.
    Roland EH, Volpe JJ. Effect of maternal cocaine use on the fetus and newborn: review of the literature. Pediatr Neurosci 1989; 15: 88–94.Google Scholar
  17. 17.
    Zuckerman B, Frank DA, Hingson R, et al. Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med 1989; 320: 762–8.Google Scholar
  18. 18.
    Handler A, Kistin N, Davis F, Ferré C. Cocaine use during pregnancy: perinatal outcomes. Am J Epidemiol 1991; 133: 818–25.Google Scholar
  19. 19.
    Volpe JJ. Effect of cocaine use on the fetus. N Engl J Med 1992; 327: 399–407.Google Scholar
  20. 20.
    Bunin GR, Kramer S, Marrero O, Meadows AT. Gestational risk factors for Wilms' tumor: results of a case-control study. Cancer Res 1987; 47: 2972–7.Google Scholar
  21. 21.
    Kramer S, Ward E, Meadows AT, Malone KE. Medical and drug risk factors associated with neuroblastoma: a case control study. JNCI 1987; 78: 797–804.Google Scholar
  22. 22.
    Buckley JD, Sather H, Ruccione K, et al. A case-control study of risk factors for hepatoblastoma. A report from the Childrens Cancer Study Group. Cancer 1989; 64: 1169–76.Google Scholar
  23. 23.
    Chavez GF, Mulinare J, Cordero JF. Maternal cocaine use during early pregnancy as a risk factor for congenital urogenital anomalies. JAMA 1989; 2621: 795–8.Google Scholar
  24. 24.
    Gfroerer JC, Hughes AL. The feasibility of collecting drug abuse data by telephone. Public Health Rep 1991; 106: 384–93.Google Scholar
  25. 25.
    National Institute on Drug Abuse. National Household Survey on Drug Abuse: Main Findings 1988. Washington D.C.: US Dept. of Health and Human Services; 1990; DHHS Pub. No. (ADM) 90–1682: 13–34.Google Scholar
  26. 26.
    Chasnoff IJ, Landress HJ, Barrett ME. The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. N Engl J Med 1990; 322: 1202–6.Google Scholar
  27. 27.
    Centers for Disease Control. Statewide prevalence of illicit drug use by pregnant women—Rhode Island. MMWR 1990; 39: 225–7.Google Scholar
  28. 28.
    Gomby DS, Shiono PH: Estimating the number of substance-exposed infants. The Future of Children 1991; 1: 17–25.Google Scholar
  29. 29.
    Prager K, Malin H, Spiegler D, Van Natta P, Placek PJ. Smoking and drinking behavior before and during pregnancy of married mothers of live-born infants and stillborn infants. Public Health Rep 1984; 99: 117–27.Google Scholar
  30. 30.
    Rosenkranz HS, Klopman G. The carcinogenic potential of cocaine. Cancer Lett 1990; 52: 243–6.Google Scholar
  31. 31.
    Lipshultz SE, Frassica JJ, Orav EJ. Cardiovascular abnormalities in infants prenatally exposed to cocaine. J Pediatr 1991; 118: 44–51.Google Scholar
  32. 32.
    Mahalik MP, Gautieri RF, Mann DE. Teratogenic potential of cocaine hydrochloride in CF-1 mice. J Phar Sci 1980; 69: 703–6.Google Scholar
  33. 33.
    Fantel AG, Macphail BJ. The teratogenicity of cocaine. Teratology 1982; 26: 17–19.Google Scholar
  34. 34.
    Ruymann FB, Maddux HR, Ragab A, et al. Congenital anomalies associated with rhabdomyosarcoma: an autopsy study of 115 cases. A report from the Intergroup Rhabdomyosarcoma Study Committee. Med Pediatr Oncol 1988; 16: 33–9.Google Scholar
  35. 35.
    Myrianthopoulos NC, Chung CS. Congenital malformations in singletons: epidemiologic survey. In: Bergsma D, Paul NW, eds. Birth Defects: Original Article Series, Vol. 10, No. 11. New York: Stratton, 1974; 1–58.Google Scholar
  36. 36.
    Breslow NE, Bieckwith JB. Epidemiological features of Wilms' tumor: results of the National Wilms' Tumor Study. JNCI 1982; 68: 429–36.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1993

Authors and Affiliations

  • Seymour Grufferman
  • Ann Grossbart Schwartz
  • Frederick B. Ruymann
  • Harold M. Maurer

There are no affiliations available

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