Childhood acute lymphoblastic leukaemia and birthweight: insights from a pooled analysis of case-control data from Germany, the United Kingdom and the United States
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Childhood acute lymphoblastic leukaemia and birthweight : insights from a pooled analysis of case-control data from Germany, the United Kingdom and the United States. / Roman, Eve; Lightfoot, Tracy; Smith, Alexandra G; Forman, Michele R; Linet, Martha S; Robison, Les; Simpson, Jill; Kaatsch, Peter; Grell, Kathrine; Frederiksen, Kirsten; Schüz, Joachim.
In: European journal of cancer (Oxford, England : 1990), Vol. 49, No. 6, 04.2013, p. 1437-47.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Childhood acute lymphoblastic leukaemia and birthweight
T2 - insights from a pooled analysis of case-control data from Germany, the United Kingdom and the United States
AU - Roman, Eve
AU - Lightfoot, Tracy
AU - Smith, Alexandra G
AU - Forman, Michele R
AU - Linet, Martha S
AU - Robison, Les
AU - Simpson, Jill
AU - Kaatsch, Peter
AU - Grell, Kathrine
AU - Frederiksen, Kirsten
AU - Schüz, Joachim
N1 - Copyright © 2012 Elsevier Ltd. All rights reserved.
PY - 2013/4
Y1 - 2013/4
N2 - BACKGROUND: Heavy birthweight is one of the few established risk factors for childhood acute lymphoblastic leukaemia (ALL). To provide new insight into this relationship, particularly at the extremes (<1500 and > 4500 g), we pooled data from three of the largest childhood cancer case-control studies ever conducted.METHODS: Birthweight and gestational age on 4075 children with ALL and 12,065 controls were collected during the course of three studies conducted in the USA, the UK and Germany in the 1990s. Information was obtained from mothers at interview, and the impact of bias was evaluated using the UK study which accessed birth registrations of participants and non-participants. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models.RESULTS: Children with ALL were, on average, heavier than controls at all gestations, the disparity being driven by a deficit of low-birthweight at all gestations and an excess of high-birthweight at ≥ 40 weeks. Overall, a 1.2 (95% CI 1.1-1.3) increase in ALL risk per kg increase in birthweight was observed; the ORs rising from 0.2 (0.1-0.7) at ≤ 1500 g through to 1.2 (0.9-1.6) at ≥ 4500 g; and 0.8 (0.7-0.9) <10th centile through to 1.3 (1.1-1.4) ≥ 90th centile.CONCLUSION: Our findings demonstrate the importance of looking across the full birthweight spectrum when examining associations with disease risk. The new observation of a deficit of very-low-birthweight cases at all gestations has aetiological and study design implications for future work examining not only the in utero origins of ALL, but also other childhood and adult cancers.
AB - BACKGROUND: Heavy birthweight is one of the few established risk factors for childhood acute lymphoblastic leukaemia (ALL). To provide new insight into this relationship, particularly at the extremes (<1500 and > 4500 g), we pooled data from three of the largest childhood cancer case-control studies ever conducted.METHODS: Birthweight and gestational age on 4075 children with ALL and 12,065 controls were collected during the course of three studies conducted in the USA, the UK and Germany in the 1990s. Information was obtained from mothers at interview, and the impact of bias was evaluated using the UK study which accessed birth registrations of participants and non-participants. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models.RESULTS: Children with ALL were, on average, heavier than controls at all gestations, the disparity being driven by a deficit of low-birthweight at all gestations and an excess of high-birthweight at ≥ 40 weeks. Overall, a 1.2 (95% CI 1.1-1.3) increase in ALL risk per kg increase in birthweight was observed; the ORs rising from 0.2 (0.1-0.7) at ≤ 1500 g through to 1.2 (0.9-1.6) at ≥ 4500 g; and 0.8 (0.7-0.9) <10th centile through to 1.3 (1.1-1.4) ≥ 90th centile.CONCLUSION: Our findings demonstrate the importance of looking across the full birthweight spectrum when examining associations with disease risk. The new observation of a deficit of very-low-birthweight cases at all gestations has aetiological and study design implications for future work examining not only the in utero origins of ALL, but also other childhood and adult cancers.
KW - Adolescent
KW - Birth Weight
KW - Case-Control Studies
KW - Child
KW - Child, Preschool
KW - Confidence Intervals
KW - Female
KW - Germany
KW - Gestational Age
KW - Great Britain
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Logistic Models
KW - Male
KW - Odds Ratio
KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma
KW - Registries
KW - Risk Factors
KW - United States
KW - Journal Article
KW - Research Support, N.I.H., Extramural
KW - Research Support, Non-U.S. Gov't
U2 - 10.1016/j.ejca.2012.11.017
DO - 10.1016/j.ejca.2012.11.017
M3 - Journal article
C2 - 23266048
VL - 49
SP - 1437
EP - 1447
JO - European Journal of Cancer, Supplement
JF - European Journal of Cancer, Supplement
SN - 0959-8049
IS - 6
ER -
ID: 167889841