Cancer Causes & Control

, Volume 26, Issue 11, pp 1575–1582 | Cite as

Birth order and risk of childhood cancer in the Danish birth cohort of 1973–2010

  • Joachim SchüzEmail author
  • George Luta
  • Friederike Erdmann
  • Gilles Ferro
  • Andrea Bautz
  • Sofie Bay Simony
  • Susanne Oksbjerg Dalton
  • Tracy Lightfoot
  • Jeanette Falck Winther
Original paper



Many studies have investigated the possible association between birth order and risk of childhood cancer, although the evidence to date has been inconsistent. Birth order has been used as a marker for various in utero or childhood exposures and is relatively straightforward to assess.


Data were obtained on all children born in Denmark between 1973 and 2010, involving almost 2.5 million births and about 5,700 newly diagnosed childhood cancers before the age of 20 years. Data were analyzed using Poisson regression models.


We failed to observe associations between birth order and risk of any childhood cancer subtype, including acute lymphoblastic leukemia; all rate ratios were close to one. Further analyses stratified by birth cohort (those born between 1973 and 1990, and those born between 1991 and 2010) also failed to show any associations. Considering stillbirths and/or controlling for birth weight and parental age in the analyses had no effect on the results. Analyses by years of birth (those born between 1973 and 1990, and those born between 1991 and 2010) did not show any changes in the overall pattern of no association.


In this large cohort of all children born in Denmark over an almost 40-year period, we did not observe an association between birth order and the risk of childhood cancer.


Birth order Childhood cancer Leukemia Risk factors Denmark 



Acute lymphoblastic leukemia


Acute myeloblastic leukemia


Central nervous system


Rate ratio


95 % Confidence interval



No specific funding was obtained for this study. Costs for data retrieval were covered by the collaboration agreement between the IARC and the Danish Cancer  Society Research Center.

Compliance with ethical standards

Conflict of interest

None of the authors declared any conflict of interest.

Human and animal rights

The study did not involve personal contact with human subjects and no animals. The study is based on record linkage of various registers in Denmark and was therefore approved by “Datatilsynet” (the Danish Data Protection Board). No informed consent from individuals was required.


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Joachim Schüz
    • 1
    Email author
  • George Luta
    • 2
  • Friederike Erdmann
    • 1
  • Gilles Ferro
    • 1
  • Andrea Bautz
    • 3
  • Sofie Bay Simony
    • 4
  • Susanne Oksbjerg Dalton
    • 4
  • Tracy Lightfoot
    • 1
    • 5
  • Jeanette Falck Winther
    • 3
  1. 1.Section of Environment and RadiationInternational Agency for Research on Cancer (IARC)LyonFrance
  2. 2.Department of Biostatistics, Bioinformatics and BiomathematicsGeorgetown UniversityWashingtonUSA
  3. 3.Survivorship Unit, Childhood Cancer Survivorship Research GroupDanish Cancer Society Research CenterCopenhagenDenmark
  4. 4.Survivorship Unit, Social Inequality in Survivorship GroupDanish Cancer Society Research CenterCopenhagenDenmark
  5. 5.Epidemiology and Cancer Statistics Group, Department of Health SciencesUniversity of YorkYorkUK

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