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. 1999 Sep 24;79(1):30–33. doi: 10.1038/sj.bjc.6690007

Higher risk for acute childhood lymphoblastic leukaemia in Swedish population centres 1973-94

U Hjalmars 1, G Gustafsson 2; on behalf of the Swedish Child Leukaemia Group
PMCID: PMC2362158  PMID: 10408689

Abstract

A population-based sample of acute childhood leukaemia cases in Sweden 1973–94 was analysed by a geographical information system (GIS) for spatial leukaemia distribution in relation to population density. The annual incidence rate for acute lymphoblastic leukaemia (ALL) was 3.6, and for acute non-lymphoblastic leukaemia (ANLL) 0.7, cases per 100 000 children. Incidence rates in population centres, constituting 1.3% of Sweden's land area and approximately 80% of the population, compared with the rest of Sweden showed a statistically significant excess of ALL [odds ratio (OR) 1.68; 95% confidence interval (CI) 1.44–1.95], but not ANLL (OR 1.13; 95% CI 0.98–1.32). An increasing trend, however not statistically significant, was found for ALL incidence with both increasing population density in parishes and increasing degree of urbanity in municipalities. These findings support the theories that some environmental factors associated with high population density, such as infectious agents, may be of aetiological importance for childhood acute lymphoblastic leukaemia. © 1999 Cancer Research Campaign

Keywords: epidemiology, childhood leukaemia, geographical information system, population density, infection

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Selected References

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  1. Alexander F. E. The search for causes of the leukaemias. Eur J Cancer. 1995 Jun;31A(6):863–867. doi: 10.1016/0959-8049(95)00023-2. [DOI] [PubMed] [Google Scholar]
  2. Alexander F. E. Viruses, clusters and clustering of childhood leukaemia: a new perspective? Eur J Cancer. 1993;29A(10):1424–1443. doi: 10.1016/0959-8049(93)90016-9. [DOI] [PubMed] [Google Scholar]
  3. Anderson L. J., Parker R. A., Strikas R. A., Farrar J. A., Gangarosa E. J., Keyserling H. L., Sikes R. K. Day-care center attendance and hospitalization for lower respiratory tract illness. Pediatrics. 1988 Sep;82(3):300–308. [PubMed] [Google Scholar]
  4. Bithell J. F. An application of density estimation to geographical epidemiology. Stat Med. 1990 Jun;9(6):691–701. doi: 10.1002/sim.4780090616. [DOI] [PubMed] [Google Scholar]
  5. Greaves M. F., Alexander F. E. An infectious etiology for common acute lymphoblastic leukemia in childhood? Leukemia. 1993 Mar;7(3):349–360. [PubMed] [Google Scholar]
  6. Greaves M. F. Speculations on the cause of childhood acute lymphoblastic leukemia. Leukemia. 1988 Feb;2(2):120–125. [PubMed] [Google Scholar]
  7. Gustafsson G., Wranne L. Svenska barnleukemigruppen 25 å. Flertalet barn med akut lymfatisk leukemi botas. Lakartidningen. 1993 Sep 1;90(35):2883–2886. [PubMed] [Google Scholar]
  8. Harsten G., Prellner K., Heldrup J., Kalm O., Kornfält R. Acute respiratory tract infections in children. A three-year follow-up from birth. Acta Paediatr Scand. 1990 Apr;79(4):402–409. doi: 10.1111/j.1651-2227.1990.tb11484.x. [DOI] [PubMed] [Google Scholar]
  9. Hjalmars U., Kulldorff M., Gustafsson G., Nagarwalla N. Childhood leukaemia in Sweden: using GIS and a spatial scan statistic for cluster detection. 1996 Apr 15-May 15Stat Med. 15(7-9):707–715. doi: 10.1002/(sici)1097-0258(19960415)15:7/9<707::aid-sim242>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  10. Kinlen L. J., Clarke K., Hudson C. Evidence from population mixing in British New Towns 1946-85 of an infective basis for childhood leukaemia. Lancet. 1990 Sep 8;336(8715):577–582. doi: 10.1016/0140-6736(90)93389-7. [DOI] [PubMed] [Google Scholar]
  11. Kinlen L. J. High-contact paternal occupations, infection and childhood leukaemia: five studies of unusual population-mixing of adults. Br J Cancer. 1997;76(12):1539–1545. doi: 10.1038/bjc.1997.592. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Langford I. H., Bentham G. Epidemiology of childhood leukemia. BMJ. 1993 Aug 14;307(6901):445–446. doi: 10.1136/bmj.307.6901.445-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McWhirter W. R., Bacon J. E. Epidemiology of acute lymphoblastic leukaemia of childhood in Brisbane. Med J Aust. 1980 Aug 9;2(3):154–155. doi: 10.5694/j.1326-5377.1980.tb76952.x. [DOI] [PubMed] [Google Scholar]
  14. Moltesen B., Hjuler I. M. Hospitalsindlaeggelse af børn i by og på land. 1. En sammenlignende analyse mellem indlaeggelseshyppighed og levevilkår baseret på registerdata. Ugeskr Laeger. 1991 Oct 28;153(44):3077–3080. [PubMed] [Google Scholar]
  15. Muirhead C. R. Childhood leukemia in metropolitan regions in the United States: a possible relation to population density? Cancer Causes Control. 1995 Sep;6(5):383–388. doi: 10.1007/BF00052177. [DOI] [PubMed] [Google Scholar]
  16. Petersson C., Häkansson A. A prospective study of infectious morbidity and antibiotic consumption among children in different forms of municipal day-care. Scand J Infect Dis. 1989;21(4):449–457. doi: 10.3109/00365548909167451. [DOI] [PubMed] [Google Scholar]
  17. Ross J. A., Davies S. M., Potter J. D., Robison L. L. Epidemiology of childhood leukemia, with a focus on infants. Epidemiol Rev. 1994;16(2):243–272. doi: 10.1093/oxfordjournals.epirev.a036153. [DOI] [PubMed] [Google Scholar]
  18. Strangert K. Respiratory illness in preschool children with different forms of day care. Pediatrics. 1976 Feb;57(2):191–196. [PubMed] [Google Scholar]
  19. Waller L. A., Turnbull B. W., Gustafsson G., Hjalmars U., Andersson B. Detection and assessment of clusters of disease: an application to nuclear power plant facilities and childhood leukaemia in Sweden. Stat Med. 1995 Jan 15;14(1):3–16. doi: 10.1002/sim.4780140103. [DOI] [PubMed] [Google Scholar]
  20. Weinstein H. J. Congenital leukaemia and the neonatal myeloproliferative disorders associated with Down's syndrome. Clin Haematol. 1978 Feb;7(1):147–154. [PubMed] [Google Scholar]

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