Abstract
A nationwide case-control study was conducted in New Zealand, to test hypotheses about the role of infections in the aetiology of childhood leukaemia. Children aged 0–14 years with leukaemia were matched on age and sex to controls selected from birth records. Case ascertainment was virtually complete and 121 (92%) of 131 eligible case families took part. The participation rate among the 303 first-choice eligible controls was 69%. Home interviews and serological tests were conducted. Adjusted relative risks were estimated by logistic regression. There was an increased risk of leukaemia in relation to reported influenza infection of the child during the first year of life (adjusted odds ratio 6.8, 95% confidence interval 1.8–25.7). This could be a chance finding due to multiple comparisons, and it should be tested elsewhere. Some key variables relevant to Greaves' hypothesis were not associated with B-cell precursor acute lymphoblastic leukaemia (numbers of infections and vaccinations, firstborn status, attendance at preschool groups), although a small effect could not be ruled out with a study of this size. Leukaemia risk was higher among children in poorer social circumstances, and this was true for all eligible children as well as for the participants. © 1999 Cancer Research Campaign
Keywords: epidemiology, leukaemia, infection, vaccination, case-control studies, influenza
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Selected References
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- Bithell J. F., Draper G. J., Gorbach P. D. Association between malignant disease in children and maternal virus infections. Br Med J. 1973 Mar 24;1(5855):706–708. doi: 10.1136/bmj.1.5855.706. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dockerty J. D., Elwood J. M., Skegg D. C., Herbison G. P. Electromagnetic field exposures and childhood cancers in New Zealand. Cancer Causes Control. 1998 May;9(3):299–309. doi: 10.1023/a:1008825220759. [DOI] [PubMed] [Google Scholar]
- Fedrick J., Alberman E. D. Reported influenza in pregnancy and subsequent cancer in the child. Br Med J. 1972 May 27;2(5812):485–488. doi: 10.1136/bmj.2.5812.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Greaves M. F. Speculations on the cause of childhood acute lymphoblastic leukemia. Leukemia. 1988 Feb;2(2):120–125. [PubMed] [Google Scholar]
- Hamajima N., Hirose K., Inoue M., Takezaki T., Kuroishi T., Tajima K. Case-control studies: matched controls or all available controls? J Clin Epidemiol. 1994 Sep;47(9):971–975. doi: 10.1016/0895-4356(94)90111-2. [DOI] [PubMed] [Google Scholar]
- 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]
- Kinlen L. Evidence for an infective cause of childhood leukaemia: comparison of a Scottish new town with nuclear reprocessing sites in Britain. Lancet. 1988 Dec 10;2(8624):1323–1327. doi: 10.1016/s0140-6736(88)90867-7. [DOI] [PubMed] [Google Scholar]
- Maldonado G., Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol. 1993 Dec 1;138(11):923–936. doi: 10.1093/oxfordjournals.aje.a116813. [DOI] [PubMed] [Google Scholar]
- Neglia J. P., Severson R. K., Linet M. S. A reply to M. F. Greaves: toward a testable etiology of childhood acute lymphoblastic leukemia. Leukemia. 1990 Jul;4(7):517–522. [PubMed] [Google Scholar]