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. 1998 Mar;77(5):812–817. doi: 10.1038/bjc.1998.132

Spatial temporal patterns in childhood leukaemia: further evidence for an infectious origin. EUROCLUS project.

F E Alexander 1, P Boyle 1, P M Carli 1, J W Coebergh 1, G J Draper 1, A Ekbom 1, F Levi 1, P A McKinney 1, W McWhirter 1, C Magnani 1, J Michaelis 1, J H Olsen 1, R Peris-Bonet 1, E Petridou 1, E Pukkala 1, L Vatten 1
PMCID: PMC2149966  PMID: 9514063

Abstract

The EUROCLUS project included information on residence at diagnosis for 13351 cases of childhood leukaemia diagnosed in the period 1980-89 in defined geographical regions in 17 countries. A formal algorithm permits identification of small census areas as containing case excesses. The present analysis examines spatial-temporal patterns of the cases (n = 970) within these clustered areas. The objectives were, first, to compare these results with those from an analysis conducted for UK data for the period 1966-83, and, second, to extend them to consider infant leukaemias. A modification of the Knox test investigates, within the small areas, temporal overlap between cases in a subgroup of interest at a putative critical time and all other cases at any time between birth and diagnosis. Critical times were specified in advance as follows: for cases of acute lymphoblastic leukaemia aged 2-4 years, the 18-month period preceding diagnosis; for cases of total leukaemia aged 5-14 years, 1 year before to 1 year after birth; and for infant cases (diagnosed < 1 year), 1 year before to 6 months after birth. Each of the analyses found evidence of excess space-time overlap compared with that expected; these were 10% (P = 0.005), 15% (P= 0.0002) and 26% (P= 0.03) respectively. The results are interpreted in terms of an infectious origin of childhood leukaemia.

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Selected References

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