Abstract
Background. Head and neck cancer (HNC) is a significant cause of morbidity and mortality, with over half a million cases worldwide each year. While high fruit and vegetable intake is thought ...to be protective against HNC, it is unclear whether vitamin and mineral supplement intake is associated with decreased risk of these malignancies. Previous case-control studies in the US have suggested vitamin E supplement intake is inversely associated with oral cavity and pharyngeal cancers. In a large randomized controlled trial, supplementation with alpha-tocopheryl acetate and/or beta-carotene was not associated with upper aerodigestive tract cancer incidence; however an inverse association was suggested for early stage laryngeal cancers. Methods. We analyzed individual-level pooled data from 12 case-control studies (7,002 HNC cases and 8,383 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. There were a total of 2,028 oral cavity cancer cases, 2,465 pharyngeal cancer cases, and 874 laryngeal cancer cases. Odds ratios (OR) and 95% confidence intervals (CIs) for ever use of any vitamins, multivitamins, vitamin A, vitamin C, vitamin E, and calcium, beta carotene, iron, selenium, and zinc supplement were assessed. We further examined frequency, duration and cumulative exposure of each vitamin or mineral when possible. All ORs were adjusted for age, sex, race/ethnicity, study center, education level, pack-years of smoking, frequency of alcohol drinking and fruit/vegetable intake. Results. A decreased risk of HNC was observed with ever use of vitamin C (OR=0.76, 95%CI=0.59-0.96) and with ever use of calcium supplements (OR=0.64, 95%CI=0.42-0.97). There did not appear to be any associations between HNC risk and ever use of any vitamins (OR=0.87, 95%CI=0.71-1.06), multiple vitamins (OR=0.99, 95%CI=0.82-1.19), vitamin A (OR=1.04, 95%CI=0.54-1.98), vitamin E (OR=0.71, 95%CI=0.45-1.11), beta-carotene (OR=1.35, 95%CI=0.65-2.81), iron (OR=0.79, 95%CI=0.54-1.16), selenium (OR=1.21, 95%CI=0.35-4.22) or zinc (OR=0.88, 95%CI=0.34-2.26). Dose-response trends were suggested for years of use of vitamin C (p for trend=0.03) and calcium (p<0.01) with decreasing HNC risk, but not for other vitamin or mineral supplement use. Increased cumulative calcium intake (in tablets) was also associated with decreasing HNC risk (p for trend<0.01). Differences by cancer subsite (oral cavity, pharynx, larynx) were not observed. Conclusions. This is the first time that inverse associations were observed for HNC risk with both vitamin C use and with calcium use in an extremely large sample size. The next steps for our pooled analyses will include adjustment on micronutrients from dietary intake and stratification on HPV infection status where possible.
Citation Format: {Authors}. {Abstract title} abstract. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2818.
Summary
Previous studies have suggested a relationship between reproductive history, pregnancy and birth factors, and the risk of neuroblastoma. We conducted a case–control telephone interview study ...that included a total of 504 children under the age of 19 years with newly diagnosed neuroblastoma identified by two national collaborative clinical trials groups, the Children's Cancer Group and the Pediatric Oncology Group. A total of 504 controls, matched to cases on age, were identified by random digit dialling. Conditional logistic regression was used to estimate the matched odds ratio (OR) and 95% confidence interval (CI) with adjustment for household income, and maternal race and education. In addition, case subgroups defined by age at diagnosis, tumour MYCN oncogene amplification status, and stage were evaluated. A suggestive pattern of increased risk was seen for a greater number of prior pregnancies, history of previous miscarriages and induced abortions, with nearly a twofold increase in risk for two or more prior induced abortions (OR = 1.9, 95% CI 1.0,3.7). No association was found for the following diseases or conditions during pregnancy: hepatitis, rubella, measles, mumps, chickenpox, mononucleosis, vaccinations, morning sickness, pre‐eclampsia, bleeding, proteinuria, anaemia, urinary tract infections, heart disease, kidney disease, liver disease and diabetes. A weak association was found for hypertension during pregnancy. Several labour and delivery factors were related to an increased risk, including threatened miscarriage, anaesthetic during labour (specifically epidural) and caesarean delivery. We found associations between premature delivery (<33 weeks: OR = 1.9, 95% CI 0.7,4.8), very low birthweight (<1500 g: OR = 2.6, 95% CI 0.7,10.3) and risk of neuroblastoma. There was no consistent pattern of increased risk found for most factors within subgroups defined by age at diagnosis, stage or MYCN status.
Birth defects among offspring of firemen Olshan, A F; Teschke, K; Baird, P A
American journal of epidemiology,
02/1990, Letnik:
131, Številka:
2
Journal Article
Recenzirano
The authors conducted an exploratory case-control study of paternal employment as a fire fighter and the risk of birth defects among offspring. By means of a population-based registry in British ...Columbia, 22,192 liveborn children with birth defects were identified for the period, 1952-1973. Two comparisons were made to evaluate the risk among offspring of firemen: 1) comparison with the risk among offspring of fathers employed in other occupations using a matched (two per case) control group, and 2) comparison with the risk among offspring of policemen. Among the 20 birth defect groups studied, an association was found for paternal employment as a fire fighter (relative to all other occupations) and increased risks were observed for ventricular septal defects (odds ratio (OR) = 2.70, 95% confidence interval (Cl) 1.02-7.18) and atrial septal defects (OR = 5.91, 95% Cl 1.60-21.83) among offspring. When compared with policemen, firemen had increased risks of having a child with a ventricular septal defect (OR = 4.68, 95% Cl 1.66-13.17) and atrial septal defect (OR = 3.76, 95% Cl 1.40-10.07). Analyses using a pathogenetic classification for these heart defects yielded similar increased odds ratios for firemen.
Defects in the p16INK4a tumor suppressor gene are associated with a host of somatic tumors and with familial tumors. The role of p16 defects in the genesis of head and neck tumors is discussed.
Recent investigations have suggested that drugs that are amines can undergo endogenous or exogenous nitrosation reactions to form N-nitroso compounds. These compounds have been extensively ...characterized in animal models as carcinogens, mutagens and teratogens. In order to examine the possible effects of exposure to nitrosatable drugs during gestation on pregnancy outcome, data were utilized from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke. Pregnancy outcomes for 6061 pregnancies in which the mother ingested a drug known to undergo nitrosation were compared with 6921 randomly sampled pregnancies without such exposure. The major outcome factors of interest were birth defects, fetal, neonatal and infant death and birthweight. Our findings suggest that no significant increases in risk of fetal, neonatal and infant death or low birthweight were associated with nitrosatable drug exposure during pregnancy. However, the risk of a tumour in the offspring of exposed mothers was increased (relative risk, RR = 2.29; 95% Cl 0.99-5.26). Increases in relative risk of major malformations was also observed and this increase was greater when exposure during the first four months of pregnancy was examined separately (RR = 1.33; 1.11-1.58). There were specific individual malformations that were observed to have increased relative risks (for example: eye malformations, hydrocephaly, craniosynostosis and meningomyelocoele/meningocoele) but interpretation was difficult due to multiple comparisons and some of these observations were associated with wide confidence intervals. These types of adverse pregnancy outcomes were consistent with animal study outcomes.
To compare the incidence rates of nasopharyngeal carcinoma (NPC) among US black, white, and Asian/Pacific Islander (Asian) populations, with a focus on those diagnosed before age 20 years and between ...ages 20 and 29 years. Our secondary objective was to determine differences in survival rates between US blacks, whites, and Asians with NPC who were younger than 30 years.
Data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) tumor registry system were used to determine incidence and survival rates for cases of NPC diagnosed in the specified age groups between 1973 and 2002.
Blacks, whites, and Asians younger than 30 years with NPC.
Incidence rates and 2- and 5-year survival rates.
From 1973 to 2002, incidence rates per 1 million persons, adjusted to the 2000 standard population, for blacks, whites, and Asians younger than 20 years with NPC were 1.61 (n=43), 0.61 (n=99), and 0.95 (n=18), respectively. The incidence rate ratio of blacks to Asians younger than 20 years was 1.69 (95% confidence interval CI, 0.96-3.12) (P=.07), while the rate ratio for blacks to whites was 2.66 (95% CI, 1.82-3.85) (P<.001). From ages 20 to 29 years, rates increased slightly in blacks (1.87) and whites (0.96), while increasing dramatically in Asians (7.18). Two- and 5-year relative survival rates in blacks younger than 30 years were 84% and 64%, respectively, with little variation between races in this age group.
Blacks younger than 20 years have increased incidence rates of NPC relative to whites and may be the only group having a higher NPC incidence rate than Asians. Two- and 5-year survival rates of blacks, whites, and Asians younger than 30 years with NPC are similar.
OBJECTIVE. The etiology of acute childhood leukemia is not well understood, particularly among children with Down syndrome, in whom a 10- to 20-fold increased risk of leukemogenesis has been reported ...compared with children without Down syndrome. We explored the association between medical test irradiation, a postulated leukemogenic agent, and acute leukemia among children with Down syndrome. PATIENTS AND METHODS. Children with Down syndrome (controls) were frequency matched on age to children with Down syndrome and leukemia (cases) diagnosed at ages 0 to 19 years during the period 1997-2002 at participating Children's Oncology Group institutions in North America. Telephone interviews were completed with mothers of 158 cases (n = 97 acute lymphoblastic leukemia and n = 61 acute myeloid leukemia) and 173 controls. Paternal interviews were completed with 275 fathers and 40 mothers serving as surrogates. Three irradiation exposure periods were examined: preconception, in utero, and postnatal. Multivariate unconditional logistic regression models were constructed to evaluate the associations of interest, resulting in odds ratios and 95% confidence intervals. RESULTS. There was little evidence that maternal or paternal preconception irradiation exposure, intrauterine exposure, or postnatal exposure contributes to leukemogenesis in children with Down syndrome. Overall, no evidence for an effect of any periconceptional exposure was observed. Similar results were observed among acute lymphoblastic leukemia and acute myeloid leukemia cases analyzed separately. CONCLUSIONS. This was the first study, to our knowledge, to examine such an association among this unique patient population. The results do not provide evidence of a positive association between ionizing radiation exposure and acute leukemia among children with Down syndrome. The absence of an association should be encouraging for concerned parents of children with Down syndrome who undergo a series of diagnostic radiographs in the course of their standard care. KEY WORDS. Down syndrome, leukemia, radiographs, children, epidemiology.
High birth weight (> 4000 g) is a risk factor for childhood leukemia, especially for younger children. Advanced maternal age has also been associated with an increased risk, though less consistently ...than birth weight. Because children with Down syndrome (DS) are at a 20-fold increased risk of developing acute leukemia than the general population, we evaluated maternal and child birth characteristics that may be associated with leukemia in children with DS. A case-control study of DS and acute leukemia was conducted through the Children's Oncology Group in North America. From 1997 to 2002, 158 children ages birth-18 years with DS and acute leukemia (including 61 acute myeloid leukemia (AML) and 97 acute lymphoblastic leukemia (ALL)) were enrolled. Children with DS alone (n= 173) were identified through the cases' pediatric clinics and frequency matched to cases on age. Mothers of cases and controls completed a telephone interview that included questions regarding maternal and birth characteristics. Here, we present data related to singleton pregnancies (165 controls and 151 cases (96 ALL/55AML)). Advanced maternal age (≥ 35 vs. <35) was associated with an elevated risk of leukemia (Odds Ratio (OR)=1.79, 95% Confidence Interval (CI))=1.09–2.94), which was apparent for both ALL and AML. There was also a suggestion of an increased risk for children in the highest tertile (>3260 g) of birth weight (OR=1.56, 95% CI=0.87–2.78) compared to children in the reference group (2850–3260 g). Birth length ≥ 21 inches showed an increased risk for AML cases only (OR=3.06; CI=1.25–7.50). In contrast, increasing birth order was associated with a decreased risk, particularly for AML (OR=0.36; 95% CI 0.14–0.97). This is the first study to evaluate maternal and child birth characteristics in relation to leukemia risk in children with DS. Our results add to the growiA. ng body of evidence that suggests that newborn body size may be related to the underlying etiology of childhood leukemia.
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