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An exploratory analysis of risk factors for childhood malignant germ-cell tumors: report from the Childrens Cancer Group (Canada, United States)

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A study of 105 patients with childhood malignant germ-cell tumors (MGCT) and 639 community controls was conducted utilizing a large epidemiologic database collected by the Childrens Cancer Group from 25 member institutions in the United States and Canada. This study was designed to explore the risk factors of this malignancy whose etiology remains poorly understood. A structured, self-administered questionnaire was used to collect exposure information, and data were analyzed using an unconditional logistic regression model with adjustment for relevant confounders. Consistent with the findings from studies of adult MGCT, gestational age was associated inversely with risk of MGCT, with a 70 to 75 percent reduction in risk for children born at term compared with those born pre-term. Parental, particularly maternal, self-reported exposure to chemicals or solvents (odds ratio [OR]=4.6, 95 percent confidence interval [CI]=1.9–11.3) and OR=2.2, CI=1.1–4.7 for maternal and paternal exposure, respectively) and plastic or resin fumes (OR=12.0, CI=1.9–7.5.0 [maternal] and OR=2.5, CI=1.0–6.5 [paternal]) were associated with elevated risk of MGCT. New findings, not reported previously, include a positive relationship of MGCT risk with birthweight and prolonged breastfeeding, an inverse association between MGCT risk and number of cigarettes smoked by the mother during pregnancy, and a 3.1-fold increased risk (CI=1.5–6.6) associated with maternal urinary infections during index pregnancy. Although these findings need confirmation from future studies, they suggest a potential influence of in utero exposure to maternal endogenous hormones, parental environmental exposures, and maternal diseases during pregnancy in the development of childhood MGCT.

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Authors
  1. Xiao Ou Shu
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  2. Mark E. Nesbit
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  3. Jonathan D. Buckley
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  4. Mark D. Krailo
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  5. Leslie L. Robison
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Additional information

Drs Shu, Nesbit, and Robison are affiliated with the Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA. Drs Buckley and Krailo are affiliated with the Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, CA, USA. Contributing Childrens Cancer Group Investigators, Institutions, and Grant Numbers are given in the Appendix. Address correspondence to Dr Shu, Childrens Cancer Group, P.O. Box 60012, Arcadia, CA 91066-6012, USA. Grant support is from the US National Cancer Institute and the US Department of Health and Human Services.

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Shu, X.O., Nesbit, M.E., Buckley, J.D. et al. An exploratory analysis of risk factors for childhood malignant germ-cell tumors: report from the Childrens Cancer Group (Canada, United States). Cancer Causes Control 6, 187–198 (1995). https://doi.org/10.1007/BF00051790

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  • DOI: https://doi.org/10.1007/BF00051790

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