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Atre T, Farrokhi A, Jo S, Salitra S, Duque-Afonso J, Cleary ML, Rolf N, Reid GSD. Age and ligand specificity influence the outcome of pathogen engagement on preleukemic and leukemic B-cell precursor populations. Blood Adv 2023; 7:7087-7099. [PMID: 37824841 PMCID: PMC10694525 DOI: 10.1182/bloodadvances.2023010782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
Common infections have long been proposed to play a role in the development of pediatric B-cell acute lymphoblastic leukemia (B-ALL). However, epidemiologic studies report contradictory effects of infection exposure on subsequent B-ALL risk, and no specific pathogen has been definitively linked to the disease. A unifying mechanism to explain the divergent outcomes could inform disease prevention strategies. We previously reported that the pattern recognition receptor (PRR) ligand Poly(I:C) exerted effects on B-ALL cells that were distinct from those observed with other nucleic acid-based PRR ligands. Here, using multiple double-stranded RNA (dsRNA) moieties, we show that the overall outcome of exposure to Poly(I:C) reflects the balance of opposing responses induced by its ligation to endosomal and cytoplasmic receptors. This PRR response biology is shared between mouse and human B-ALL and can increase leukemia-initiating cell burden in vivo during the preleukemia phase of B-ALL, primarily through tumor necrosis factor α signaling. The age of the responding immune system further influences the impact of dsRNA exposure on B-ALL cells in both mouse and human settings. Overall, our study demonstrates that potentially proleukemic and antileukemic effects can each be generated by the stimulation of pathogen recognition pathways and indicates a mechanistic explanation for the contrasting epidemiologic associations reported for infection exposure and B-ALL.
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Affiliation(s)
- Tanmaya Atre
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Ali Farrokhi
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Sumin Jo
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Samuel Salitra
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Jesus Duque-Afonso
- Department of Pathology, School of Medicine, Stanford University, Stanford, CA
| | - Michael L. Cleary
- Department of Pathology, School of Medicine, Stanford University, Stanford, CA
| | - Nina Rolf
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Gregor S. D. Reid
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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2
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Schraw JM, Petridou ET, Bonaventure A, Dockerty JD, Karalexi M, Ntzani E, Infante-Rivard C, Clavel J, Bracci PM, McKean-Cowdin R, Roman E, Kane E, Erdmann F, Schüz J, Mueller BA, Scheurer ME. Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium. Cancer Causes Control 2023; 34:1005-1015. [PMID: 37421504 DOI: 10.1007/s10552-023-01746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE Studies report mixed findings regarding the association of breastfeeding with childhood brain tumors (CBT), the leading causes of cancer-related mortality in young people. Our objective was to determine whether breastfeeding is associated with CBT incidence. METHODS We pooled data on N = 2610 cases with CBT (including 697 cases with astrocytoma, 447 cases with medulloblastoma/primitive neuroectodermal tumor [PNET], 167 cases with ependymoma) and N = 8128 age- and sex-matched controls in the Childhood Cancer and Leukemia International Consortium. We computed unconditional logistic regression models to estimate the odds ratio (OR) and 95% confidence interval (CI) of CBT, astrocytoma, medulloblastoma/PNET, and ependymoma according to breastfeeding status, adjusting for study, sex, mode of delivery, birthweight, age at diagnosis/interview, maternal age at delivery, maternal educational attainment, and maternal race/ethnicity. We evaluated any breastfeeding versus none and breastfeeding ≥ 6 months versus none. We subsequently performed random effects meta-analysis to confirm our findings, identify potential sources of heterogeneity, and evaluate for outliers or influential studies. RESULTS Breastfeeding was reported by 64.8% of control mothers and 64.5% of case mothers and was not associated with CBT (OR 1.04, 95% CI 0.94-1.15), astrocytoma (OR 1.01, 95% CI 0.87-1.17), medulloblastoma/PNET (OR 1.11, 95% CI 0.93-1.32), or ependymoma (OR 1.06, 95% CI 0.81-1.40). Results were similar when we restricted to breastfeeding ≥ 6 months and in meta-analyses. CONCLUSION Our data suggest that breastfeeding does not protect against CBT.
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Affiliation(s)
- Jeremy M Schraw
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | - Audrey Bonaventure
- UMR-1153, CRESS, Université de Paris, INSERM, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Maria Karalexi
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | - Evangelia Ntzani
- Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110, Ioannina, Greece
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Jacqueline Clavel
- UMR-1153, CRESS, Université de Paris, INSERM, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
- National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, Villejuif, and CHU de Nancy, Vandoeuvre-Lès-Nancy, France
| | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Hellen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | | | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Friederike Erdmann
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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3
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Gong QQ, Quan DD, Guo C, Zhang C, Zhang ZJ. Association between maternal breastfeeding and risk of systemic neoplasms of offspring. Ital J Pediatr 2022; 48:98. [PMID: 35710389 PMCID: PMC9205047 DOI: 10.1186/s13052-022-01292-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 06/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Breastfeeding might prevent childhood cancer by stimulating the immune system. Methods The following databases, including PubMed, Embase, and Cochrane Library, were searched from inception to January 10, 2021. Results In dose-dependent manner, there was a statistically significant inverse association between any breastfeeding and the incidence of childhood cancer. There was no evidence that breastfeeding was inversely related to childhood cancer of the skeletal, reproductive, or sensory systems. However, breastfeeding was inversely associated with the incidence of hematological malignancies and cancers of the nervous and urinary systems. Among hematological malignancies, the relationship was significant for acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML), but not for acute non-lymphocytic leukemia (ANLL), Hodgkin’s lymphoma (HL), or non-HL. Conclusions The evidences demonstrated that breastfeeding have a potential protective role in preventing selective childhood cancer growth, especially for ALL, AML, cancer of nervous and urinary systems. This study recommended that breastfeeding be extended for as long as possible or maintained for at least 6 months to prevent selective childhood cancer growth. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01292-9.
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Affiliation(s)
- Qin-Qin Gong
- Center of Women's Health Sciences, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China
| | - Dan-Dan Quan
- Department of Obstetrics and Gynecology, The People's Hospital of China Three Gorges University, The First Hospital of Yichang, Yichang, 443000, China
| | - Chong Guo
- Department of Gynaecology and Obstetrics, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China
| | - Chao Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No.32, South Renmin Road, Shiyan, 442000, China.
| | - Zhi-Jun Zhang
- Center for Reproductive Medicine, Taihe Hospital, Hubei University of Medicine, No.32, South Renmin Road, Shiyan, 442000, China.
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McCullough LE, Maliniak ML, Amin AB, Baker JM, Baliashvili D, Barberio J, Barrera CM, Brown CA, Collin LJ, Freedman AA, Gibbs DC, Haddad MB, Hall EW, Hamid S, Harrington KRV, Holleman AM, Kaufman JA, Khan MA, Labgold K, Lee VC, Malik AA, Mann LM, Marks KJ, Nelson KN, Quader ZS, Ross-Driscoll K, Sarkar S, Shah MP, Shao IY, Smith JP, Stanhope KK, Valenzuela-Lara M, Van Dyke ME, Vyas KJ, Lash TL. Epidemiology beyond its limits. SCIENCE ADVANCES 2022; 8:eabn3328. [PMID: 35675391 PMCID: PMC9176748 DOI: 10.1126/sciadv.abn3328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
In 1995, journalist Gary Taubes published an article in Science titled "Epidemiology faces its limits," which questioned the utility of nonrandomized epidemiologic research and has since been cited more than 1000 times. He highlighted numerous examples of research topics he viewed as having questionable merit. Studies have since accumulated for these associations. We systematically evaluated current evidence of 53 example associations discussed in the article. Approximately one-quarter of those presented as doubtful are now widely viewed as causal based on current evaluations of the public health consensus. They include associations between alcohol consumption and breast cancer, residential radon exposure and lung cancer, and the use of tanning devices and melanoma. This history should inform current debates about the reproducibility of epidemiologic research results.
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Affiliation(s)
- Lauren E. McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Maret L. Maliniak
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Avnika B. Amin
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julia M. Baker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Davit Baliashvili
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Barberio
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chloe M. Barrera
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Lindsay J. Collin
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Alexa A. Freedman
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - David C. Gibbs
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Maryam B. Haddad
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Eric W. Hall
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Sarah Hamid
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Aaron M. Holleman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John A. Kaufman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mohammed A. Khan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Katie Labgold
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Veronica C. Lee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amyn A. Malik
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Laura M. Mann
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin J. Marks
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin N. Nelson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zerleen S. Quader
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | | | - Monica P. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Iris Y. Shao
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jonathan P. Smith
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Kaitlyn K. Stanhope
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Marisol Valenzuela-Lara
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Miriam E. Van Dyke
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kartavya J. Vyas
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Timothy L. Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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5
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Schraw JM, Rodriguez KB, Scheurer ME, Foster JH, Lupo PJ. Associations of demographic and perinatal factors with childhood neuroblastoma in Texas, 1995–2011. Cancer Epidemiol 2022; 78:102165. [DOI: 10.1016/j.canep.2022.102165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/25/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
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6
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Schraw JM, Bailey HD, Bonaventure A, Mora AM, Roman E, Mueller BA, Clavel J, Petridou ET, Karalexi M, Ntzani E, Ezzat S, Rashed WM, Marcotte EL, Spector LG, Metayer C, Kang AY, Magnani C, Miligi L, Dockerty JD, Mejίa-Aranguré JM, Nuñez Enriquez JC, Infante-Rivard C, Milne E, Scheurer ME. Infant Feeding Practices And Childhood Acute Leukemia: Findings From The Childhood Cancer & Leukemia International Consortium. Int J Cancer 2022; 151:1013-1023. [PMID: 35532209 DOI: 10.1002/ijc.34062] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 11/08/2022]
Abstract
Increasing evidence suggests that breastfeeding may protect from childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). However, most studies have limited their analyses to any breastfeeding, and only a few data have examined exclusive breastfeeding, or other exposures such as formula milk. We performed pooled analyses and individual participant data meta-analyses of data from sixteen studies (N=17,189 controls; N=10,782 ALL and N=1,690 AML cases) from the Childhood Leukemia International Consortium (CLIC) to characterize the associations of breastfeeding duration with ALL and AML, as well as exclusive breastfeeding duration and age at introduction to formula with ALL. In unconditional multivariable logistic regression analyses of pooled data, we observed decreased odds of ALL among children breastfed 4-6 months (0.88, 95% CI 0.81-0.96) or 7-12 months (OR 0.85, 0.79-0.92). We observed a similar inverse association between breastfeeding ≥4 months and AML (0.82, 95% CI 0.71-0.95). Odds of ALL were reduced among children exclusively breastfed 4-6 months (OR 0.73, 95% CI 0.63-0.85) or 7-12 months (OR 0.70, 95% CI 0.53-0.92). Random effects meta-analyses produced similar estimates, and findings were unchanged in sensitivity analyses adjusted for race/ethnicity or mode of delivery, restricted to children diagnosed ≥1 year of age, or diagnosed with B-ALL. Our pooled analyses indicate that longer breastfeeding is associated with decreased odds of ALL and AML. Few risk factors for ALL and AML have been described, therefore our findings highlight the need to promote breastfeeding for leukemia prevention.
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Affiliation(s)
- Jeremy M Schraw
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX, USA.,Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Helen D Bailey
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Audrey Bonaventure
- CRESS, Université de Paris, INSERM UMR-1153, Epidemiology of childhood and adolescent cancers team, Villejuif, France
| | - Ana M Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jacqueline Clavel
- CRESS, Université de Paris, INSERM UMR-1153, Epidemiology of childhood and adolescent cancers team, Villejuif, France.,National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, Villejuif, and CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Eleni T Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Society for Social Pediatrics and Health Promotion, Greece
| | - Maria Karalexi
- Hellenic Society for Social Pediatrics and Health Promotion, Greece
| | - Evangelia Ntzani
- Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.,Department of Hygeine and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Sameera Ezzat
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Cairo, Egypt
| | - Wafaa M Rashed
- Research Department, Children's Cancer Hospital-57357, Cairo, Egypt
| | - Erin L Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Alice Y Kang
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, SCDU Epidemiologia del Tumori, Universitá del Piemonte Orientale, Novara, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch-Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Juan Manuel Mejίa-Aranguré
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Juan Carlos Nuñez Enriquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX, USA.,Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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7
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Onyije FM, Olsson A, Baaken D, Erdmann F, Stanulla M, Wollschläger D, Schüz J. Environmental Risk Factors for Childhood Acute Lymphoblastic Leukemia: An Umbrella Review. Cancers (Basel) 2022; 14:382. [PMID: 35053543 PMCID: PMC8773598 DOI: 10.3390/cancers14020382] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 02/05/2023] Open
Abstract
Leukemia is the most common type of cancer among children and adolescents worldwide. The aim of this umbrella review was (1) to provide a synthesis of the environmental risk factors for the onset of childhood acute lymphoblastic leukemia (ALL) by exposure window, (2) evaluate their strength of evidence and magnitude of risk, and as an example (3) estimate the prevalence in the German population, which determines the relevance at the population level. Relevant systematic reviews and pooled analyses were identified and retrieved through PubMed, Web of Science databases and lists of references. Only two risk factors (low doses of ionizing radiation in early childhood and general pesticide exposure during maternal preconception/pregnancy) were convincingly associated with childhood ALL. Other risk factors including extremely low frequency electromagnetic field (ELF-MF), living in proximity to nuclear facilities, petroleum, benzene, solvent, and domestic paint exposure during early childhood, all showed some level of evidence of association. Maternal consumption of coffee (high consumption/>2 cups/day) and cola (high consumption) during pregnancy, paternal smoking during the pregnancy of the index child, maternal intake of fertility treatment, high birth weight (≥4000 g) and caesarean delivery were also found to have some level of evidence of association. Maternal folic acid and vitamins intake, breastfeeding (≥6 months) and day-care attendance, were inversely associated with childhood ALL with some evidence. The results of this umbrella review should be interpreted with caution; as the evidence stems almost exclusively from case-control studies, where selection and recall bias are potential concerns, and whether the empirically observed association reflect causal relationships remains an open question. Hence, improved exposure assessment methods including accurate and reliable measurement, probing questions and better interview techniques are required to establish causative risk factors of childhood leukemia, which is needed for the ultimate goal of primary prevention.
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Affiliation(s)
- Felix M. Onyije
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
| | - Dan Baaken
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany; (D.B.); (D.W.)
| | - Friederike Erdmann
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany; (D.B.); (D.W.)
| | - Martin Stanulla
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany;
| | - Daniel Wollschläger
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany; (D.B.); (D.W.)
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
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8
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Children’s Health Capital Investment: Effects of U.S. Infant Breastfeeding on Teenage Obesity. ECONOMETRICS 2021. [DOI: 10.3390/econometrics9040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity, as a health and social problem with rising prevalence and soaring economic cost, is increasingly drawing scholarly and public policy attention. While many studies have suggested that infant breastfeeding protects against childhood obesity, empirical evidence on this causal relationship is fragile. Using the health capital development theory, this study exploited multiple data sources from the U.S. and a three-way error components model (ECM) with a jackknife resampling plan to estimate the effect of in-hospital breastfeeding initiation and breastfeeding for durations of 3, 6, and 12 months on the prevalence of obesity during teenage years. The main finding was that a 1% rise in the in-hospital breastfeeding initiation rate reduces the teenage obesity prevalence rate by 1.7% (9.6% of a standard deviation). The magnitude of this effect declines as the infant breastfeeding duration lengthens—e.g., the 12-month infant breastfeeding duration rate is associated with a 0.53% (3.7% of a standard deviation) reduction in obesity prevalence in the teenage years (9th to 12th grades). The study findings agree with both the behavioral and physiological theories on the long-term effects of breastfeeding, and have timely implications for public policies promoting infant breastfeeding to reduce the economic burden of teenage and later adult-stage obesity prevalence rates.
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Digitale JC, Chang PW, Li SX, Kuzniewicz MW, Newman TB. The effect of hospital phototherapy on early breastmilk feeding. Paediatr Perinat Epidemiol 2021; 35:717-725. [PMID: 34184759 DOI: 10.1111/ppe.12794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/20/2021] [Accepted: 05/08/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND The effect of phototherapy on breastmilk feeding is unclear. OBJECTIVE To estimate the effect of inpatient phototherapy on breastmilk feeding at 2-month well-child visits. METHODS We performed a retrospective cohort study using electronic health record data. From births at 16 Kaiser Permanente Northern California hospitals (2013-2017), we identified a cohort of infants ≥ 35 weeks' gestation with total serum bilirubin levels close to the American Academy of Pediatrics 2004 phototherapy threshold during their birth hospitalisation. We compared self-reported breastmilk feeding at 2-month well-child visits among those who had and had not received birth hospitalisation phototherapy, adjusting for bilirubin levels and other confounding variables. We used multiple imputation (K = 200) to address missing data. RESULTS Approximately a quarter of infants in the cohort (24.5%) received phototherapy during their birth hospitalisation. At the 2-month visit, exclusive breastmilk feeding was less common (RR 0.91, 95% interval [CI] 0.88, 0.95) among those who received phototherapy (41.3%) than those who did not (45.2%). However, no association remained after adjusting for potential confounders (RR 0.99, 95% CI 0.95, 1.04; average treatment effect on the treated [ATET] -0.2%, 95% CI -2.0%, 1.5%). In contrast, any breastmilk feeding was similar between infants who did (76.8%) and did not get phototherapy (77.9%). After adjusting for confounders, phototherapy had a slightly positive association with any breastmilk feeding at 2 months (RR 1.02, 95% CI 1.00, 1.04). Among infants who received phototherapy, the proportion being fed any breastmilk at the 2-month visit was an estimated 1.6 percentage points higher than it would have been if they had not received phototherapy (ATET 1.6%, 95% CI 0.1%, 3.1%). Multiple imputation results were similar. CONCLUSIONS Birth hospitalisation phototherapy can be delivered in a way that does not adversely affect breastmilk feeding at 2 months.
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Affiliation(s)
- Jean C Digitale
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Pearl W Chang
- Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
| | - Sherian X Li
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Michael W Kuzniewicz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.,Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Thomas B Newman
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA.,Department of Pediatrics, University of California, San Francisco, CA, USA
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Graus TM, Brandstetter S, Seelbach-Göbel B, Melter M, Kabesch M, Apfelbacher C, Fill Malfertheiner S. Breastfeeding behavior is not associated with health literacy: evidence from the German KUNO-Kids birth cohort study. Arch Gynecol Obstet 2021; 304:1161-1168. [PMID: 33904955 PMCID: PMC8490221 DOI: 10.1007/s00404-021-06038-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Despite the health benefits of full breastfeeding for both infants and mothers, less than 50% of mothers in Germany practice this method for at least 4 months after childbirth. Because of the growing importance of health literacy to improve public health, we investigated the role of maternal health literacy in breastfeeding behavior. METHODS We analyzed the data of 1172 mother-child dyads of the KUNO-Kids health study of the University Children's and Maternity Hospital Regensburg. Maternal health literacy was assessed with the HLS-EU-Q47 questionnaire (sub-index health care) up to 48 h after childbirth. Outcome was analyzed 6 months after childbirth and categorized into full breastfeeding for less than 4 months or for at least 4 months. The association between breastfeeding and maternal health literacy was calculated with univariable and multivariable logistic regression analyses. RESULTS 38.8% of mothers showed inadequate or limited health literacy. 75.9% of mothers had fully breastfed their child for at least 4 months. Univariable logistic regression analysis showed that health literacy and full breastfeeding for at least 4 months were not associated (OR = 0.995 [CI 0.977-1.015], p = 0.60). After adjusting for all potentially confounding variables with a significant association (p ≤ 0.05) on both health literacy and breastfeeding, the multivariable model showed no association between health literacy and breastfeeding (OR = 0.984 [CI 0.963-1.007], p = 0.170). CONCLUSION Surprisingly, we found no association between health literacy and breastfeeding behavior in our study. Therefore, future research with comparable measurements of health literacy and breastfeeding is required to validate this result and to identify reasons for early breastfeeding cessation.
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Affiliation(s)
- Teresa M Graus
- University Department of Gynecology and Obstetrics, Hospital St. Hedwig of the Order of St. John, University Medical Center Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany
- The Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Birgit Seelbach-Göbel
- University Department of Gynecology and Obstetrics, Hospital St. Hedwig of the Order of St. John, University Medical Center Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany
| | - Michael Melter
- University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany
| | - Michael Kabesch
- University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany
- The Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto Von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Sara Fill Malfertheiner
- University Department of Gynecology and Obstetrics, Hospital St. Hedwig of the Order of St. John, University Medical Center Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany.
- The Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.
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11
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Hauer J, Fischer U, Borkhardt A. Toward prevention of childhood ALL by early-life immune training. Blood 2021; 138:1412-1428. [PMID: 34010407 PMCID: PMC8532195 DOI: 10.1182/blood.2020009895] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/21/2021] [Indexed: 11/21/2022] Open
Abstract
B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is the most common form of childhood cancer. Chemotherapy is associated with life-long health sequelae and fails in ∼20% of cases. Thus, prevention of leukemia would be preferable to treatment. Childhood leukemia frequently starts before birth, during fetal hematopoiesis. A first genetic hit (eg, the ETV6-RUNX1 gene fusion) leads to the expansion of preleukemic B-cell clones, which are detectable in healthy newborn cord blood (up to 5%). These preleukemic clones give rise to clinically overt leukemia in only ∼0.2% of carriers. Experimental evidence suggests that a major driver of conversion from the preleukemic to the leukemic state is exposure to immune challenges. Novel insights have shed light on immune host responses and how they shape the complex interplay between (1) inherited or acquired genetic predispositions, (2) exposure to infection, and (3) abnormal cytokine release from immunologically untrained cells. Here, we integrate the recently emerging concept of "trained immunity" into existing models of childhood BCP-ALL and suggest future avenues toward leukemia prevention.
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Affiliation(s)
- Julia Hauer
- National Center for Tumor Diseases (NCT), Dresden, Germany
- Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ute Fischer
- Department for Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; and
- German Cancer Consortium (DKTK), partnering site Essen/Düsseldorf, Germany
| | - Arndt Borkhardt
- Department for Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; and
- German Cancer Consortium (DKTK), partnering site Essen/Düsseldorf, Germany
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12
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Randhawa JK, Kim ME, Polski A, Reid MW, Mascarenhas K, Brown B, Fabian ID, Kaliki S, Stacey AW, Burner E, Sayegh CS, Poblete RA, Ji X, Zou Y, Sultana S, Rashid R, Sherief ST, Cassoux N, Garcia J, Coronado RD, López AMZ, Ushakova T, Polyakov VG, Roy SR, Ahmad A, Reddy MA, Sagoo MS, Al Harby L, Astbury NJ, Bascaran C, Blum S, Bowman R, Burton MJ, Gomel N, Keren-Froim N, Madgar S, Zondervan M, Berry JL. The Effects of Breastfeeding on Retinoblastoma Development: Results from an International Multicenter Retinoblastoma Survey. Cancers (Basel) 2021; 13:4773. [PMID: 34631159 PMCID: PMC7611784 DOI: 10.3390/cancers13194773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022] Open
Abstract
The protective effects of breastfeeding on various childhood malignancies have been established but an association has not yet been determined for retinoblastoma (RB). We aimed to further investigate the role of breastfeeding in the severity of nonhereditary RB development, assessing relationship to (1) age at diagnosis, (2) ocular prognosis, measured by International Intraocular RB Classification (IIRC) or Intraocular Classification of RB (ICRB) group and success of eye salvage, and (3) extraocular involvement. Analyses were performed on a global dataset subgroup of 344 RB patients whose legal guardian(s) consented to answer a neonatal questionnaire. Patients with undetermined or mixed feeding history, family history of RB, or sporadic bilateral RB were excluded. There was no statistically significant difference between breastfed and formula-fed groups in (1) age at diagnosis (p = 0.20), (2) ocular prognosis measures of IIRC/ICRB group (p = 0.62) and success of eye salvage (p = 0.16), or (3) extraocular involvement shown by International Retinoblastoma Staging System (IRSS) at presentation (p = 0.74), lymph node involvement (p = 0.20), and distant metastases (p = 0.37). This study suggests that breastfeeding neither impacts the sporadic development nor is associated with a decrease in the severity of nonhereditary RB as measured by age at diagnosis, stage of disease, ocular prognosis, and extraocular spread. A further exploration into the impact of diet on children who develop RB is warranted.
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Affiliation(s)
- Jasmeen K. Randhawa
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mary E. Kim
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ashley Polski
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mark W. Reid
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
| | | | - Brianne Brown
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, Hyderabad 500034, India;
| | - Andrew W. Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA;
| | - Elizabeth Burner
- Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Caitlin S. Sayegh
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Roy A. Poblete
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (X.J.); (Y.Z.)
| | - Yihua Zou
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (X.J.); (Y.Z.)
| | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh; (S.S.); (R.R.)
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh; (S.S.); (R.R.)
| | - Sadik Taju Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa 3614, Ethiopia;
| | | | | | - Rosdali Diaz Coronado
- Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru; (R.D.C.); (A.M.Z.L.)
| | | | - Tatiana Ushakova
- N.N. Blokhin National Medical Research Center, Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, Oncology of Russian Federation, 115478 Moscow, Russia; (T.U.); (V.G.P.)
- Medical Academy of Postgraduate Education, 125445 Moscow, Russia
| | - Vladimir G. Polyakov
- N.N. Blokhin National Medical Research Center, Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, Oncology of Russian Federation, 115478 Moscow, Russia; (T.U.); (V.G.P.)
- Medical Academy of Postgraduate Education, 125445 Moscow, Russia
| | - Soma Rani Roy
- Chittagong Eye Infirmary & Training Complex, Chittagong 4202, Bangladesh;
| | - Alia Ahmad
- The Children’s Hospital and the Institute of Child Health, Lahore 54000, Pakistan;
| | - M. Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK; (M.A.R.); (M.S.S.); (L.A.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Mandeep S. Sagoo
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK; (M.A.R.); (M.S.S.); (L.A.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- UCL Institute of Ophthalmology, London EC1V 2PD, UK
| | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK; (M.A.R.); (M.S.S.); (L.A.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- UCL Institute of Ophthalmology, London EC1V 2PD, UK
| | - Nicholas John Astbury
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
| | - Sharon Blum
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
- Ophthalmology Department, Great Ormond Street Children’s Hospital, London WC1N 3JH, UK
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
- UCL Institute of Ophthalmology, London EC1V 2PD, UK
| | - Nir Gomel
- Tel Aviv Sourasky Medical Center, Division of Ophthalmology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 39040, Israel;
| | - Naama Keren-Froim
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Shiran Madgar
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
| | - Jesse L. Berry
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
- Correspondence:
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13
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Su Q, Sun X, Zhu L, Yan Q, Zheng P, Mao Y, Ye D. Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis. BMC Med 2021; 19:90. [PMID: 33845843 PMCID: PMC8042913 DOI: 10.1186/s12916-021-01950-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/24/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The aim of this study was to quantitatively summarize the available evidence on the association of breastfeeding with the risk of childhood cancer. METHODS A literature search of PubMed and Embase databases was performed to identify eligible observational studies published from inception to July 17, 2020. The categorical and dose-response meta-analysis was conducted by pooling relative risk (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression and stratification analysis. Sensitivity analysis and publication bias test were also carried out. RESULTS Forty-five articles involving 475,579 individuals were included in the meta-analysis. Among the thirty-three studies on the association between breastfeeding and risk of childhood leukemia, the pooled risk estimates were 0.77 (95% CI, 0.65-0.91) and 0.77 (95% CI 0.63-0.94) for ever versus non/occasional breastfeeding and longest versus shortest breastfeeding duration group, respectively. There was clear indication for non-linear dose-response relationship between breastfeeding duration and the risk of childhood leukemia (P non-linear < 0.001). The most protective effect (OR, 0.66, 95% CI 0.62-0.70) was observed at a breastfeeding duration of 9.6 months. Four studies examined, the association between breastfeeding and risk of childhood neuroblastoma, and significant inverse associations were consistently observed in both the comparisons of ever breastfeeding versus non/occasional breastfeeding (OR = 0.59, 95% CI 0.44-0.81) and longest versus shortest breastfeeding (OR = 0.61, 95% CI 0.44-0.83). However, no associations of breastfeeding with risk of other cancers were found. CONCLUSIONS Our study supports a protective role of breastfeeding on the risk of childhood leukemia, also suggesting a non-linear dose-response relationship. Further studies are warranted to confirm the association between breastfeeding and risk of childhood neuroblastoma.
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Affiliation(s)
- Qing Su
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Xiaohui Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Liwen Zhu
- Department of Hematology and Oncology, Children's hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Qin Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Peiwen Zheng
- Department of Medical Adiministration, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Yingying Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China.
| | - Ding Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China.
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Kendall GM, Little MP, Wakeford R. A review of studies of childhood cancer and natural background radiation. Int J Radiat Biol 2021; 97:769-781. [PMID: 33395329 PMCID: PMC10686050 DOI: 10.1080/09553002.2020.1867926] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE The projected existence and magnitude of carcinogenic effects of ionizing radiation at low doses and low-dose rates is perhaps the most important issue in radiation protection today. Studies of childhood cancer and natural background radiation have the potential to throw direct light on this question, into a dose range below a few tens of mSv. This paper describes the studies that have been undertaken and their context, discusses some problems that arise and summarizes the present position. CONCLUSIONS Many such studies have been undertaken, but most were too small to have a realistic chance of detecting the small effects expected from such low doses, based on risk projections from higher exposures. Case-control or cohort studies are to be preferred methodologically to ecological studies but can be prone to problems of registration/participation bias. Interview-based studies of the requisite size would be prohibitively expensive and would undoubtedly also run into problems of participation bias. Register-based studies can be very large and are free of participation bias. However, they need to estimate the radiation exposure of study subjects using models rather than individual measurements in the homes of those concerned. At present, no firm conclusions can be drawn from the studies that have been published to date. Further data and perhaps pooled studies offer a way forward.
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Affiliation(s)
- Gerald M Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, UK
| | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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15
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Stanulla M, Erdmann F, Kratz CP. Risikofaktoren für Krebserkrankungen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ZusammenfassungDie Ursachen von Krebs im Kindes- und Jugendalter sind weitestgehend unbekannt. Beispiele für konsistent beobachtete Risikofaktoren, die in umfangreichen epidemiologischen Untersuchungen identifiziert wurden, sind Strahlenexposition, Chemotherapie, niedriges und hohes Geburtsgewicht, höheres Alter der Mutter, Geschlecht und das Vorhandensein angeborener Anomalien. Diese Faktoren erklären jedoch nur einen geringen Anteil aller inzidenten Fälle. Die derzeit vielversprechendsten Ansätze zur Verbesserung des Verständnisses über die Ursachen von Krebserkrankungen im Kindes- und Jugendalter stammen von genetischen Analysen. Abgesehen von den durch genomweite Assoziationsstudien identifizierten Allelen mit geringem Krebsrisiko wurde festgestellt, dass seltene Keimbahnvarianten, die Krebsprädispositionsyndrome verursachen, mit einem erhöhten Risiko für die Entwicklung von Krebs im Kindes- und Jugendalter verbunden sind. Dieser Beitrag fasst das aktuelle Wissen über die exogenen und endogenen Ursachen von Krebserkrankungen in den frühen Lebensjahren zusammen und gibt einen Ausblick darauf, wie stetig wachsendes Wissen in diesem Bereich zukünftige präventive, diagnostische und therapeutische Strategien beeinflussen könnte.
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16
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Kim KU, Kim WH, Jeong CH, Yi DY, Min H. More than Nutrition: Therapeutic Potential of Breast Milk-Derived Exosomes in Cancer. Int J Mol Sci 2020; 21:E7327. [PMID: 33023062 PMCID: PMC7582863 DOI: 10.3390/ijms21197327] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022] Open
Abstract
Human breast milk (HBM) is an irreplaceable source of nutrition for early infant growth and development. Breast-fed children are known to have a low prevalence and reduced risk of various diseases, such as necrotizing enterocolitis, gastroenteritis, acute lymphocytic leukemia, and acute myeloid leukemia. In recent years, HBM has been found to contain a microbiome, extracellular vesicles or exosomes, and microRNAs, as well as nutritional components and non-nutritional proteins, including immunoregulatory proteins, hormones, and growth factors. Especially, the milk-derived exosomes exert various physiological and therapeutic function in cell proliferation, inflammation, immunomodulation, and cancer, which are mainly attributed to their cargo molecules such as proteins and microRNAs. The exosomal miRNAs are protected from enzymatic digestion and acidic conditions, and play a critical role in immune regulation and cancer. In addition, the milk-derived exosomes are developed as drug carriers for delivering small molecules and siRNA to tumor sites. In this review, we examined the various components of HBM and their therapeutic potential, in particular of exosomes and microRNAs, towards cancer.
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Affiliation(s)
- Ki-Uk Kim
- College of Pharmacy, Chung-Ang University, Seoul 06974, Korea; (K.-U.K.); (W.-H.K.); (C.H.J.)
| | - Wan-Hoon Kim
- College of Pharmacy, Chung-Ang University, Seoul 06974, Korea; (K.-U.K.); (W.-H.K.); (C.H.J.)
| | - Chi Hwan Jeong
- College of Pharmacy, Chung-Ang University, Seoul 06974, Korea; (K.-U.K.); (W.-H.K.); (C.H.J.)
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul 06974, Korea
- Department of Pediatrics, Chung-Ang University Hospital, Seoul 06973, Korea
| | - Hyeyoung Min
- College of Pharmacy, Chung-Ang University, Seoul 06974, Korea; (K.-U.K.); (W.-H.K.); (C.H.J.)
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17
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Is it compatible with breastfeeding? www.e-lactancia.org: Analysis of visits, user profile and most visited products. Int J Med Inform 2020; 141:104199. [DOI: 10.1016/j.ijmedinf.2020.104199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/08/2020] [Accepted: 05/24/2020] [Indexed: 12/12/2022]
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18
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Lupo PJ, Spector LG. Cancer Progress and Priorities: Childhood Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:1081-1094. [DOI: 10.1158/1055-9965.epi-19-0941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/18/2019] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
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Han MA, Storman D, Al-Rammahy H, Tang S, Hao Q, Leung G, Kandi M, Moradi R, Bartoszko JJ, Arnold C, Rehman N, Guyatt G. Impact of maternal reproductive factors on cancer risks of offspring: A systematic review and meta-analysis of cohort studies. PLoS One 2020; 15:e0230721. [PMID: 32226046 PMCID: PMC7105118 DOI: 10.1371/journal.pone.0230721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/06/2020] [Indexed: 02/05/2023] Open
Abstract
Background A number of studies have reported on associations between reproductive factors, such as delivery methods, number of birth and breastfeeding, and incidence of cancer in children, but systematic reviews addressing this issue to date have important limitations, and no reviews have addressed the impact of reproductive factors on cancer over the full life course of offspring. Methods We performed a comprehensive search in MEDLINE, and Embase up to January 2020 and Web of Science up to 2018 July, including cohort studies reporting the association between maternal reproductive factors of age at birth, birth order, number of births, delivery methods, and breastfeeding duration and cancer in children. Teams of two reviewers independently extracted data and assessed risk of bias. We conducted random effects meta-analyses to estimate summary relative estimates, calculated absolute differences between those with and without risk factors, and used the GRADE approach to evaluate the certainty of evidence. Results For most exposures and most cancers, we found no suggestion of a causal relation. We found low to very low certainty evidence of the following very small possible impact: higher maternal age at birth with adult multiple myeloma and lifetime uterine cervix cancer incidence; lower maternal age at birth with childhood overall cancer mortality (RR = 1.15, 95% CI = 1.01–1.30; AR/10,000 = 1, 95% CI = 0 to 2), adult leukemia and lifetime uterine cervix cancer incidence; higher birth order with adult melanoma, cervix uteri, corpus uteri, thyroid cancer incidence, lifetime lung, corpus uteri, prostate, testis, sarcoma, thyroid cancer incidence; larger number of birth with childhood brain (RR = 1.27, 95% CI = 1.06–1.52; AR/10,000 = 1, 95% CI = 0 to 2), leukemia (RR = 2.11, 95% CI = 1.62–2.75; AR/10,000 = 9, 95% CI = 5 to 14), lymphoma (RR = 4.66, 95% CI = 1.40–15.57; AR/10,000 = 11, 95% CI = 1 to 44) incidence, adult stomach, corpus uteri cancer incidence and lung cancer mortality, lifetime stomach, lung, uterine cervix, uterine corpus, multiple myeloma, testis cancer incidence; Caesarean delivery with childhood kidney cancer incidence (RR = 1.25, 95% CI = 1.01–1.55; AR/10,000 = 0, 95% CI = 0 to 1); and breastfeeding with adult colorectal cancer incidence. Conclusion Very small impacts existed between a number of reproductive factors and cancer incidence and mortality in children and the certainty of evidence was low to very low primarily due to observational design.
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Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
- * E-mail:
| | - Dawid Storman
- Department of Hygiene and Dietetics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Husam Al-Rammahy
- Life Sciences—Department of Biomedical and Molecular Sciences, Queen's University at Kingston, Kingston, Canada
| | - Shaowen Tang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiukui Hao
- The center of Gerontology and Geriatrics, National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gareth Leung
- Department of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maryam Kandi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Romina Moradi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jessica J. Bartoszko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Callum Arnold
- Division of Infectious Diseases, the Hospital for Sick Children, Toronto, Canada
| | - Nadia Rehman
- Department of Continuing Education, McMaster University, Hamilton, Canada
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Bauer H, Rios P, Schleiermacher G, Valteau-Couanet D, Bertozzi AI, Thebaud E, Gandemer V, Pellier I, Verschuur A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study. Cancer Causes Control 2020; 31:491-501. [PMID: 32144681 DOI: 10.1007/s10552-020-01288-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT. METHODS The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11 years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI). RESULTS High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed. CONCLUSIONS Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.
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Affiliation(s)
- Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | | | - Dominique Valteau-Couanet
- Children and Adolescent Cancerology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
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21
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Ledesma-Martínez E, Aguíñiga-Sánchez I, Weiss-Steider B, Rivera-Martínez AR, Santiago-Osorio E. Casein and Peptides Derived from Casein as Antileukaemic Agents. JOURNAL OF ONCOLOGY 2019; 2019:8150967. [PMID: 31582978 PMCID: PMC6754885 DOI: 10.1155/2019/8150967] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/20/2019] [Accepted: 08/04/2019] [Indexed: 12/20/2022]
Abstract
Milk is a heterogeneous lacteal secretion mixture of numerous components that exhibit a wide variety of chemical and functional activities. Casein, the main protein in milk, is composed of α-, β-, and κ-caseins, each of which is important for nutritional value and for promoting the release of cytokines, also are linked to the regulation of haematopoiesis and immune response and inhibit the proliferation and induce the differentiation of leukaemia cells. It has been shown that the digestive process of caseins leads to the release of bioactive peptides that are involved in the regulation of blood pressure and the inhibition or activation of the immune response by serving as agonists or antagonists of opioid receptors, thus controlling the expression of genes that exert epigenetic control. Later, they bind to opioid receptor, block nuclear factor κ-beta, increase the redox potential, and reduce oxidative stress and the pro-inflammatory agents that favour an antioxidant and anti-inflammatory environment. Therefore, the bioactive peptides of casein could be compounds with antileukaemia potential. This review provides a summary of current knowledge about caseins and casein peptides on the immune system as well as their roles in the natural defence against the development of leukaemia and as relevant epigenetic regulators that can help eradicate leukaemia.
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Affiliation(s)
- Edgar Ledesma-Martínez
- Haematopoiesis and Leukaemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, 09230 Mexico City, Mexico
| | - Itzen Aguíñiga-Sánchez
- Haematopoiesis and Leukaemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, 09230 Mexico City, Mexico
| | - Benny Weiss-Steider
- Haematopoiesis and Leukaemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, 09230 Mexico City, Mexico
| | - Ana Rocío Rivera-Martínez
- Haematopoiesis and Leukaemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, 09230 Mexico City, Mexico
| | - Edelmiro Santiago-Osorio
- Haematopoiesis and Leukaemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, 09230 Mexico City, Mexico
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Rafieemehr H, Calhor F, Esfahani H, Ghorbani Gholiabad S. Risk of Acute Lymphoblastic Leukemia: Results of a Case-Control Study. Asian Pac J Cancer Prev 2019; 20:2477-2483. [PMID: 31450923 PMCID: PMC6852832 DOI: 10.31557/apjcp.2019.20.8.2477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Indexed: 01/06/2023] Open
Abstract
Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Different
environmental factors might be effective in the occurrence of this malignancy during childhood. The aim of this study
was to find environmental risk factors in childhood ALL in Hamadan, Iran. Methods: This case-control study was
done in 2015-2018 on 125 children younger than 15 years of age suffering from ALL. Patients were matched with
130 controls with respect to age, gender, and residence location. The identification of risk factors for ALL was sought
based on the comparison of studied variables between case and control individuals. Results: A statistically significant
increased risk for ALL was found with regard to type of delivery (OR: 0.43, 95% CI: 0.20 - 0.92, p˂0.02), childcare
(OR: 4.58, 95% CI: 0.95 - 22.20, p˂0.04), birth weight (OR: 1.44, 95% CI: 1.53 - 2.21, p˂0.006), father’s education
level (OR: 2.67, 95% CI: 1.10 - 6.45, p˂0.02), and father’s job (OR: 0.2 95% CI: 0.08 - 0.51, p˂0.001). Also observed
were increased odds for ALL regarding male gender, mother’s high education level, mother’s freelance job, and medium
or high family income. No association with ALL incidence was observed for age, gender, breastfeeding, mother’s age
at pregnancy, malignancy in first- or second-degree relatives, or mother’s use of hair dye during pregnancy (p> 0.05).
Conclusion: This study showed that father’s education level, father’s job, delivery type, birth weight, and childcare
can play a role in the incidence of childhood ALL.
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Affiliation(s)
- Hassan Rafieemehr
- Department of Medical Laboratory Sciences, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Fereshteh Calhor
- Students Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Esfahani
- Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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Zur Hausen H, Bund T, de Villiers EM. Infectious Agents in Bovine Red Meat and Milk and Their Potential Role in Cancer and Other Chronic Diseases. Curr Top Microbiol Immunol 2019; 407:83-116. [PMID: 28349283 DOI: 10.1007/82_2017_3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Red meat and dairy products have frequently been suggested to represent risk factors for certain cancers, chronic neurodegenerative diseases, and autoimmune and cardiovascular disorders. This review summarizes the evidence and investigates the possible involvement of infectious factors in these diseases. The isolation of small circular single-stranded DNA molecules from serum and dairy products of Eurasian Aurochs (Bos taurus)-derived cattle, obviously persisting as episomes in infected cells, provides the basis for further investigations. Gene expression of these agents in human cells has been demonstrated, and frequent infection of humans is implicated by the detection of antibodies in a high percentage of healthy individuals. Epidemiological observations suggest their relationship to the development multiple sclerosis, to heterophile antibodies, and to N-glycolylneuraminic acid (Neu5Gc) containing cell surface receptors.
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Affiliation(s)
- Harald Zur Hausen
- Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Timo Bund
- Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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Williams LA, Yang JJ, Hirsch BA, Marcotte EL, Spector LG. Is There Etiologic Heterogeneity between Subtypes of Childhood Acute Lymphoblastic Leukemia? A Review of Variation in Risk by Subtype. Cancer Epidemiol Biomarkers Prev 2019; 28:846-856. [PMID: 30770347 PMCID: PMC6500468 DOI: 10.1158/1055-9965.epi-18-0801] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/19/2018] [Accepted: 02/05/2019] [Indexed: 02/07/2023] Open
Abstract
Although substantial advances in the identification of cytogenomic subtypes of childhood acute lymphoblastic leukemia (ALL) have been made in recent decades, epidemiologic research characterizing the etiologic heterogeneity of ALL by subtype has not kept pace. The purpose of this review is to summarize the current literature concerning subtype-specific epidemiologic risk factor associations with ALL subtype defined by immunophenotype (e.g., B-cell vs. T-cell) and cytogenomics (including gross chromosomal events characterized by recurring numerical and structural abnormalities, along with cryptic balanced rearrangements, and focal gene deletions). In case-control analyses investigating nongenetic risk factors, home paint exposure is associated with hyperdiploid, MLL-rearranged, and ETV6-RUNX1 subtypes, yet there are few differences in risk factor associations between T- and B-ALL. Although the association between maternal smoking and ALL overall has been null, maternal smoking is associated with an increasing number of gene deletions among cases. GWAS-identified variants in ARID5B have been the most extensively studied and are strongly associated with hyperdiploid B-ALL. GATA3 single nucleotide variant rs3824662 shows a strong association with Ph-like ALL (OR = 3.14). However, there have been relatively few population-based studies of adequate sample size to uncover risk factors that may define etiologic heterogeneity between and within the currently defined cytogenomic ALL subtypes.
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Affiliation(s)
- Lindsay A Williams
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jun J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Betsy A Hirsch
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Erin L Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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25
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Bonaventure A, Orsi L, Rudant J, Goujon-Bellec S, Leverger G, Baruchel A, Bertrand Y, Nelken B, Pasquet M, Michel G, Sirvent N, Chastagner P, Ducassou S, Thomas C, Besse C, Hémon D, Clavel J. Genetic polymorphisms of Th2 interleukins, history of asthma or eczema and childhood acute lymphoid leukaemia: Findings from the ESCALE study (SFCE). Cancer Epidemiol 2018; 55:96-103. [PMID: 29883839 DOI: 10.1016/j.canep.2018.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Previous studies on the putative role of allergy in the aetiology of childhood leukaemia have reported contradictory results. The present study aimed to analyse the relation between a medical history of asthma or eczema and childhood acute lymphoid leukaemia (ALL) in light of potential candidate gene-environment interactions. METHODS Analyses were based on a subset of 434 cases of ALL and 442 controls successfully genotyped and of European ancestry children enrolled in a French population-based case-control study conducted in 2003-2004. Information about medical history was obtained during a standardized interview with the mothers. Candidate polymorphisms in genes of the Th2 cytokines IL4, IL10, IL13 and IL4-receptor, were genotyped or imputed. RESULTS None of the variant alleles were directly associated with childhood acute lymphoid leukaemia. A medical history of asthma or eczema was reported more often in the control group (OR = 0.7 [0.5-1.0]). This association was mostly seen in the group of children not carrying the IL13-rs20541 variant allele (Interaction Odds Ratio IOR 1.9, p-interaction = 0.07) and in those carrying the IL10 triple variant haplotype (IOR 0.5, p-interaction = 0.04). No interaction was observed with the candidate polymorphisms in IL4 and IL4R. CONCLUSION This study provides a new insight into the relationship between allergic symptoms and childhood acute lymphoid leukaemia, by suggesting this inverse association could be limited to children carrying certain genetic polymorphisms. If confirmed, these results could help better understand the biological mechanisms involved in the development of childhood acute lymphoid leukaemia.
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Affiliation(s)
- A Bonaventure
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France; Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - L Orsi
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France
| | - J Rudant
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France
| | - S Goujon-Bellec
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France
| | - G Leverger
- AP-HP, Hôpital Armand Trousseau, Université Paris 6 Pierre et Marie Curie, Paris, France
| | - A Baruchel
- AP-HP, Hôpital Robert Debré, Université Paris 7 Denis Diderot, Paris, France
| | - Y Bertrand
- Institut d'Hémato-Oncologie Pédiatrique, Lyon, France
| | - B Nelken
- CHU de Lille, Hôpital Jeanne de Flandre, Lille, France
| | - M Pasquet
- Hôpital des Enfants, Toulouse, France
| | - G Michel
- AP-HM, Hôpital la Timone, Marseille, France
| | - N Sirvent
- Hôpital Arnaud de Villeneuve, CHRU, Montpellier, France
| | | | - S Ducassou
- Haematology and Oncology, Childrens' Hospital, Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - C Thomas
- Service d'onco-hématologie pédiatrique, CHU de Nantes, France
| | - C Besse
- Commissariat à l'Energie Atomique (CEA) Genomics Institute-Centre National de Génotypage, Evry Cedex, France
| | - D Hémon
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France
| | - J Clavel
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France
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Bovbjerg ML, Hill JA, Uphoff AE, Rosenberg KD. Women Who Bedshare More Frequently at 14 Weeks Postpartum Subsequently Report Longer Durations of Breastfeeding. J Midwifery Womens Health 2018; 63:418-424. [DOI: 10.1111/jmwh.12753] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 11/28/2022]
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27
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Lupatsch JE, Bailey HD, Lacour B, Dufour C, Bertozzi AI, Leblond P, Faure-Conter C, Pellier I, Freycon C, Doz F, Puget S, Ducassou S, Orsi L, Clavel J. Childhood brain tumours, early infections and immune stimulation: A pooled analysis of the ESCALE and ESTELLE case-control studies (SFCE, France). Cancer Epidemiol 2017; 52:1-9. [PMID: 29128708 DOI: 10.1016/j.canep.2017.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies have investigated whether early infections and factors potentially related to early immune stimulation might be involved in the aetiology of childhood brain tumours (CBT). In this study, we investigated the associations between CBT with early day-care attendance, history of early common infections, atopic conditions (asthma/wheezing, eczema, allergic rhinitis), early farm residence/visits and contact with animals. METHODS We pooled data from two nationwide French case-control studies, the ESCALE and ESTELLE studies. Children with a CBT diagnosed between 1 and 14 years of age were identified directly from the French National Registry of Childhood Cancers, while population controls were recruited from telephone subscribers. Odds-ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression adjusted for potential confounders. RESULTS The analyses included 469 cases and 2719 controls. We found no association between attending a day-care centre (OR: 0.9, 95%CI: 0.7-1.2) or having had repeated common infections (OR: 0.9, 95%CI: 0.7-1.2) in the first year of life and the risk of CBT. There was also no association with a history of asthma/wheezing (OR: 0.8, 95%CI: 0.56-1.1). Farm visits (OR: 0.6, 95%CI: 0.5-0.8) as well as contact with pets (OR: 0.8, 95%CI: 0.6-1.0) in the first year of life were inversely associated with CBT. CONCLUSIONS Our findings suggest a protective effect of early farm visits and contact with pets, but not with other markers of early immune stimulation. This might be related to immune stimulation but needs further investigation.
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Affiliation(s)
- Judith E Lupatsch
- UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
| | - Helen D Bailey
- UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France
| | - Brigitte Lacour
- UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France; RNCE - National Registry of Childhood Cancers, Inserm, Villejuif and CHU de Nancy, France
| | - Christelle Dufour
- Gustave Roussy, Département de cancérologie de l'enfant et de l'adolescent, Villejuif, France
| | | | - Pierre Leblond
- Pediatric Oncology Unit, Oscar Lambret Comprehensive Cancer Center, Lille, France
| | - Cécile Faure-Conter
- Institut d'hématologie et d'oncologie pédiatrique, IHOPe, Centre Léon Bérard, Lyon, France
| | | | - Claire Freycon
- Clinique de pédiatrie, Hôpital Couple Enfant, CHU Grenoble-Alpes, Grenoble, France
| | - François Doz
- Oncology Center SIREDO (Care Innovation Research in Children, Adolescents and Young Adults Cancer), Institut Curie and Université Paris Descartes, Paris, France
| | - Stéphanie Puget
- Service de neurochirurgie pédiatrique, Hôpital Necker-Enfants malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Stéphane Ducassou
- Service d'onco-hématologie pédiatrique, Hôpital Pellegrin Tripode, Bordeaux, France
| | - Laurent Orsi
- UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France
| | - Jacqueline Clavel
- UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France; RNCE - National Registry of Childhood Cancers, Inserm, Villejuif and CHU de Nancy, France
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A Meta-Analysis of Prenatal and Maternal Risk Factors for Childhood Leukemia in Iran, Case-Control Studies Approach. JOURNAL OF PEDIATRICS REVIEW 2017. [DOI: 10.5812/jpr.14674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hwee J, Tait C, Sung L, Kwong JC, Sutradhar R, Pole JD. A systematic review and meta-analysis of the association between childhood infections and the risk of childhood acute lymphoblastic leukaemia. Br J Cancer 2017; 118:127-137. [PMID: 29065105 PMCID: PMC5765221 DOI: 10.1038/bjc.2017.360] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 01/02/2023] Open
Abstract
Background: To determine whether childhood infections were associated with the development of childhood acute lymphoblastic leukaemia (ALL). Methods: We included studies that assessed any infection in childhood prior to the diagnosis of ALL in children aged 0–19 years compared to children without cancer. The primary analysis synthesised any infection against the odds of ALL, and secondary analyses assessed the frequency, severity, timing of infections, and specific infectious agents against the odds of ALL. Subgroup analyses by data source were investigated. Results: In our primary analysis of 12 496 children with ALL and 2 356 288 children without ALL from 38 studies, we found that any infection was not associated with ALL (odds ratio (OR)=1.10, 95% CI: 0.95–1.28). Among studies with laboratory-confirmed infections, the presence of infections increased the odds of ALL by 2.4-fold (OR=2.42, 95% CI: 1.54–3.82). Frequency, severity, and timing of infection were not associated with ALL. Conclusions: The hypothesis put forward by Greaves and others about an infectious aetiology are neither confirmed nor refuted and the overall evidence remains inadequate for good judgement. The qualitative difference in the subgroup effects require further study, and future research will need to address the challenges in measuring infectious exposures.
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Affiliation(s)
- Jeremiah Hwee
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, ON, Canada
| | - Christopher Tait
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, ON, Canada
| | - Lillian Sung
- Division of Haematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada.,Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Toronto, ON, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON Canada.,Public Health Ontario, Toronto, ON, Canada.,Toronto Western Family Health Team, University Health Network, Toronto, ON, Canada
| | - Rinku Sutradhar
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, ON, Canada
| | - Jason D Pole
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, ON, Canada.,Pediatric Oncology Group of Ontario, 480 University Avenue, Suite 1014, Toronto, ON, Canada
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30
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Mangrio E, Persson K, Bramhagen AC. Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: a systematic review. Scand J Caring Sci 2017; 32:451-465. [DOI: 10.1111/scs.12489] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/03/2017] [Indexed: 01/17/2023]
Affiliation(s)
| | - Karin Persson
- Department of Care Science; Malmö University; Malmö Sweden
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31
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Karimi M, Haghighat M, Dialameh Z, Tahmasbi L, Parand S, Bardestani M. Breastfeeding as a Protective Effect Against Childhood Leukemia and Lymphoma. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017; 18:e29771. [PMID: 28144455 PMCID: PMC5253205 DOI: 10.5812/ircmj.29771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/20/2015] [Accepted: 08/20/2015] [Indexed: 12/02/2022]
Abstract
Background Over the past several years, breastfeeding has been associated with many benefits as well as protective effects against many diseases. There is limited evidence for the relationship between breastfeeding and the incidence of leukemia. Objectives In this study, we evaluate the correlation of childhood leukemia and lymphoma with breastfeeding duration in children in southern Iran. Patients and methods Through this case control study, we compared 123 patients with leukemia and lymphoma to a control group of 137 healthy children. Statistical analysis was done using the Chi-square test and t-test as well as logistic regression methods. A P-value of less than 0.05 was considered significant. Results Our findings showed that breastfeeding duration had no significant difference between cases and controls. However, the rural living percentage in patients with leukemia and lymphoma was higher than in the control group (39.8% versus 14.6% [P < 0.001 and OR = 3.87]) and parents’ exposure to chemical materials during the war between Iran and Iraq was higher in sick patients (6.5% versus 0% [OR = 20.2%]). Conclusions The current study showed that breastfeeding duration has no protective effect against childhood leukemia and lymphoma. In addition, we suggest that some factors such as living in a rural area, smoking during pregnancy, parents’ exposure to chemical materials and low socioeconomic status can increase the incidence rate of childhood leukemia and lymphoma.
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Affiliation(s)
- Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding Author: Mehran Karimi, Pediatric Hematology-Oncology Hematology Research Center, Nemazee hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7116473239, Fax: +98-7113239, E-mail:
| | - Mahmoud Haghighat
- Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Zahra Dialameh
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Leila Tahmasbi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Shirin Parand
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Marzieh Bardestani
- Department of Library and Information Science, College of Humanities, Khouzestan Science and research Branch, Islamic Azad University, Ahvaz, IR Iran
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Bailey HD, Rios P, Lacour B, Guerrini‐Rousseau L, Bertozzi A, Leblond P, Faure‐Conter C, Pellier I, Freycon C, Michon J, Puget S, Ducassou S, Orsi L, Clavel J. Factors related to pregnancy and birth and the risk of childhood brain tumours: The ESTELLE and ESCALE studies (SFCE, France). Int J Cancer 2017; 140:1757-1769. [DOI: 10.1002/ijc.30597] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/22/2016] [Accepted: 12/09/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Helen D. Bailey
- INSERM, Université Paris‐Descartes, Université Sorbonne‐Paris‐Cité, CRESS‐EPICEA Epidémiologie des cancers de l'enfant et de l'adolescentParis France
| | - Paula Rios
- INSERM, Université Paris‐Descartes, Université Sorbonne‐Paris‐Cité, CRESS‐EPICEA Epidémiologie des cancers de l'enfant et de l'adolescentParis France
| | - Brigitte Lacour
- INSERM, Université Paris‐Descartes, Université Sorbonne‐Paris‐Cité, CRESS‐EPICEA Epidémiologie des cancers de l'enfant et de l'adolescentParis France
- RNCE ‐ National Registry of Childhood Cancers, Inserm, Villejuif and CHU de Nancy France
| | - Léa Guerrini‐Rousseau
- Département de cancérologie de l'enfant et de l'adolescentGustave RoussyVillejuif France
| | | | - Pierre Leblond
- Pediatric Oncology Unit, Oscar Lambret Comprehensive Cancer CenterLille France
| | - Cécile Faure‐Conter
- Institut d'hématologie et d'oncologie pédiatrique, IHOPe, Centre Léon BérardLyon France
| | - Isabelle Pellier
- Hématologie Oncologie et Immunologie pédiatrique, Inserm UMR U1232, CHU d'AngersAngers France
| | - Claire Freycon
- Clinique de pédiatrieHôpital Couple Enfant, CHU Grenoble‐AlpesGrenoble France
| | - Jean Michon
- Département de Pédiatrie ‐Adolescents et Jeunes Adultes, Institut CurieParis France
| | - Stéphanie Puget
- Service de neurochirurgie pédiatrique, Hôpital Necker‐Enfants malades, Université Paris Descartes, Sorbonne Paris CitéParis France
| | - Stéphane Ducassou
- Service d'onco‐hématologie pédiatrique, Hôpital Pellegrin TripodeBordeaux France
| | - Laurent Orsi
- INSERM, Université Paris‐Descartes, Université Sorbonne‐Paris‐Cité, CRESS‐EPICEA Epidémiologie des cancers de l'enfant et de l'adolescentParis France
| | - Jacqueline Clavel
- INSERM, Université Paris‐Descartes, Université Sorbonne‐Paris‐Cité, CRESS‐EPICEA Epidémiologie des cancers de l'enfant et de l'adolescentParis France
- RNCE ‐ National Registry of Childhood Cancers, Inserm, Villejuif and CHU de Nancy France
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Dessypris N, Karalexi MA, Ntouvelis E, Diamantaras AA, Papadakis V, Baka M, Hatzipantelis E, Kourti M, Moschovi M, Polychronopoulou S, Sidi V, Stiakaki E, Petridou ET. Association of maternal and index child's diet with subsequent leukemia risk: A systematic review and meta analysis. Cancer Epidemiol 2017; 47:64-75. [PMID: 28130996 DOI: 10.1016/j.canep.2017.01.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 01/05/2017] [Accepted: 01/07/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Exploring the effect of maternal and/or childhood diet on offspring leukemogenesis is challenging, given differences in food group categories, their potentially variable impact depending on time window of exposure and the multiple leukemia subtypes. We opted to quantitatively synthesize published data on the association of maternal/child diet with leukemia risk. METHODS Medline was searched until June 30th, 2016 for eligible articles on the association of childhood leukemia with consumption of (i) food groups, excluding alcoholic and non-alcoholic beverages, and (ii) specific dietary supplements before/during index pregnancy and childhood. RESULTS Eighteen studies of case-control design (N=11,720 cases/18,721 controls) were included, of which nine assessed maternal dietary components, five index child's and four both, mainly focusing on acute lymphoblastic leukemia (ALL). Statistically significant inverse estimates for ALL were found (2 studies, 413 cases, 490 controls) for fruit (OR: 0.81, 95% CI: 0.67, 0.99); vegetables (OR: 0.51, 95% CI: 0.28, 0.94); legumes (OR: 0.76, 95% CI: 0.62, 0.94); fish (OR: 0.27, 95% CI: 0.14, 0.53, among the 0-4year old; 2 studies 215 cases, 215 controls); preconception folic acid supplementation (OR: 0.69, 95%CI: 0.50-0.95; published meta analysis plus 2 studies, 3511 cases, 6816 controls); and use of vitamins during pregnancy (OR: 0.81, 95%CI: 0.74-0.88; published meta analysis plus one study, 5967 cases, 8876 controls). The associations (2 studies) of the remaining food groups and maternal dietary supplements consumption during pregnancy as well as of childhood diet and supplements intake (2-4 studies) were non significant. CONCLUSIONS Maternal consumption of specific food groups comprising"healthy" items of the Mediterranean diet, preconception use of folic acid and intake of vitamins during pregnancy were associated with decreased ALL risk. Further research is needed, however preferably with homogeneous dietary information and data on immunophenotypic/cytogenetic subtypes to also explore the interaction of specific macro- and micronutrients intake with gene polymorphisms.
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Affiliation(s)
- Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Evangelos Ntouvelis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Andreas-Antonios Diamantaras
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece; Neurologische Klinik, Klinikum Mittelbaden Rastatt, Rastatt, Germany
| | - Vassilios Papadakis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Margarita Baka
- Department of Pediatric Hematology-Oncology, "Pan.&Agl. Kyriakou" Children's Hospital, Athens, Greece
| | - Emmanuel Hatzipantelis
- 2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece
| | - Maria Kourti
- Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece
| | - Maria Moschovi
- Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Sophia Polychronopoulou
- Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Vasiliki Sidi
- Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
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Schraw JM, Scheurer ME, Forman MR. A Vulnerable Age for the Introduction of Solid Foods in Pediatric Acute Lymphoblastic Leukemia. Nutr Cancer 2017; 69:261-266. [PMID: 28094567 DOI: 10.1080/01635581.2017.1263749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is little research concerning infant formula or the age at introduction to solid foods and pediatric acute lymphoblastic leukemia (ALL). The purpose of this case-control study was to estimate the association of age at introduction of solids and pediatric ALL. METHODS 171 ALL cases aged 0-14 years were recruited at Texas Children's Cancer Center and matched on sex, age, and ethnicity to 342 population-based controls. Data were collected on infant feeding and known risk factors for ALL. Multivariable logistic regression was used to model the odds ratio of ALL by quartile of age at introduction of solids with the first/earliest quartile (0-4 months) as the reference group. RESULTS In adjusted models, the odds ratio of ALL among children in quartile 3 (7-9 months) was 4.08, 95% confidence interval (CI) 1.42-11.71; for children in quartile 4 (≥10 months) the odds ratio (OR) was 6.03, 95% CI 2.06-17.72. For each additional month of milk formula feeding, the OR of ALL was 1.16, 95% CI 1.08-1.25. CONCLUSIONS These results suggest a window when later introduction to solids is positively associated with ALL and recommend compliance with the American Academy of Pediatrics guidelines.
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Affiliation(s)
- Jeremy M Schraw
- a Department of Nutritional Sciences , University of Texas at Austin , Austin , Texas , USA
| | - Michael E Scheurer
- b Department of Pediatrics , Baylor College of Medicine , Houston , Texas , USA
| | - Michele R Forman
- a Department of Nutritional Sciences , University of Texas at Austin , Austin , Texas , USA
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Mahon J, Claxton L, Wood H. Modelling the cost-effectiveness of human milk and breastfeeding in preterm infants in the United Kingdom. HEALTH ECONOMICS REVIEW 2016; 6:54. [PMID: 27909996 PMCID: PMC5133212 DOI: 10.1186/s13561-016-0136-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 11/16/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To estimate the cost savings and health benefits in the UK NHS that could be achieved if human milk usage in the NICU was increased. METHODS A systematic review established the disease areas with the strong sources of evidence of the short, medium and long-term benefits of human milk for preterm infants as opposed to the use of formula milk. The analysis assessed the economic impact of reducing rates of necrotising enterocolitis, sepsis, sudden infant death syndrome, leukaemia, otitis media, obesity and neurodevelopmental impairment. RESULTS Based on the number of preterm babies born in 2013, if 100% of premature infants being fed mother's milk could be achieved in the NICU, the total lifetime cost savings to the NHS due to improved health outcomes is estimated to be £46.7 million (£30.1 million in the first year) with a total lifetime QALY gain of 10,594, There would be 238 fewer deaths due to neonatal infections and SIDS, resulting in a reduction of approximately £153.4 million in lifetime productivity. Sensitivity analyses indicated that results were robust to a wide range of inputs. CONCLUSIONS This analysis established that increasing the use of human milk in NICUs in the UK would lead to cost savings to the NHS. More research is needed on the medium and long term health and economic outcomes associated with breastfeeding preterm infants, and the differences between mother's own and donor breast milk.
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Affiliation(s)
- James Mahon
- York Health Economics Consortium, Enterprise House Innovation Way, University of York, Heslington, York, YO10 5NQ UK
| | - Lindsay Claxton
- York Health Economics Consortium, Enterprise House Innovation Way, University of York, Heslington, York, YO10 5NQ UK
| | - Hannah Wood
- York Health Economics Consortium, Enterprise House Innovation Way, University of York, Heslington, York, YO10 5NQ UK
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Schüz J, Erdmann F. Environmental Exposure and Risk of Childhood Leukemia: An Overview. Arch Med Res 2016; 47:607-614. [PMID: 28476188 DOI: 10.1016/j.arcmed.2016.11.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 11/23/2016] [Indexed: 01/24/2023]
Abstract
Childhood leukemia is the most common cancer diagnosed in children worldwide. However, only a few causes have been established so far, mainly some genetic syndromes and high doses of ionizing radiation. Major efforts have been undertaken to study the relationship between environmental factors and the risk of childhood leukemia, inspired by geographical variation in incidence rates. Some evidence has emerged for parental occupational exposures to pesticides, whereas there is less evidence for an association with postnatal pesticide exposure. Diagnostic radiation and radon exposure have been suggested but there remains a lack of convincing studies. Extremely low-frequency magnetic fields consistently showed a small increase in risk in numerous studies, but bias and confounding cannot be ruled out as possible explanations. From among factors other than environmental and radiation-related, the most promising candidate is abnormal patterns to common infections, but which children are most at risk and the pathways are not fully understood. In conclusion, although childhood leukemia shows some distinct incidence patterns by sex, age, and geography suggesting a role of the environment in its etiology, no major environmental risk factors including radiation have been established as major contributors to the global childhood leukemia burden. Due to the young age at diagnosis and evidence of chromosomal damage before birth in many of the affected children, parental exposures remain of high interest. Although cure rates of childhood leukemia are high in economically developed countries, because of the adverse late effects of the disease and its treatment, identification of modifiable risk factors for implementing primary prevention remains the ultimate goal.
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Affiliation(s)
- Joachim Schüz
- International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France.
| | - Friederike Erdmann
- International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France; Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark
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Holman DM, Buchanan ND. Opportunities During Early Life for Cancer Prevention: Highlights From a Series of Virtual Meetings With Experts. Pediatrics 2016; 138:S3-S14. [PMID: 27940972 PMCID: PMC5890502 DOI: 10.1542/peds.2015-4268c] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 01/26/2023] Open
Abstract
Compelling evidence suggests that early life exposures can affect lifetime cancer risk. In 2014, the Centers for Disease Control and Prevention's (CDC's) Cancer Prevention Across the Lifespan Workgroup hosted a series of virtual meetings with select experts to discuss the state of the evidence linking factors during the prenatal period and early childhood to subsequent risk of both pediatric and adult cancers. In this article, we present the results from a qualitative analysis of the meeting transcripts and summarize themes that emerged from our discussions with meeting participants. Themes included the state of the evidence linking early life factors to cancer risk, research gaps and challenges, the level of evidence needed to support taking public health action, and the challenges of communicating complex, and sometimes conflicting, scientific findings to the public. Opportunities for collaboration among public health agencies and other stakeholders were identified during these discussions. Potential next steps for the CDC and its partners included advancing and building upon epidemiology and surveillance work, developing and using evidence from multiple sources to inform decision-making, disseminating and communicating research findings in a clear and effective way, and expanding collaborations with grantees and other partners. As the science on early life factors and cancer risk continues to evolve, there are opportunities for collaboration to translate science into actionable public health practice.
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Affiliation(s)
- Dawn M. Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha D. Buchanan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Palmeira P, Carneiro-Sampaio M. Immunology of breast milk. Rev Assoc Med Bras (1992) 2016; 62:584-593. [DOI: 10.1590/1806-9282.62.06.584] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/26/2016] [Indexed: 12/14/2022] Open
Abstract
Summary In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Colostrum is the most potent natural immune booster known to science. Breastfeeding protects infants against infections mainly via secretory IgA (SIgA) antibodies, but also via other various bioactive factors. It is striking that the defense factors of human milk function without causing inflammation; some components are even anti-inflammatory. Protection against infections has been well evidenced during lactation against, e.g., acute and prolonged diarrhea, respiratory tract infections, including otitis media, urinary tract infection, neonatal septicemia, and necrotizing enterocolitis. The milk’s immunity content changes over time. In the early stages of lactation, IgA, anti-inflammatory factors and, more likely, immunologically active cells provide additional support for the immature immune system of the neonate. After this period, breast milk continues to adapt extraordinarily to the infant’s ontogeny and needs regarding immune protection and nutrition. The need to encourage breastfeeding is therefore justifiable, at least during the first 6 months of life, when the infant’s secretory IgA production is insignificant.
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Rios P, Bailey HD, Orsi L, Lacour B, Valteau-Couanet D, Levy D, Corradini N, Leverger G, Defachelles AS, Gambart M, Sirvent N, Thebaud E, Ducassou S, Clavel J. Risk of neuroblastoma, birth-related characteristics, congenital malformations and perinatal exposures: A pooled analysis of the ESCALE and ESTELLE French studies (SFCE). Int J Cancer 2016; 139:1936-48. [DOI: 10.1002/ijc.30239] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/07/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Paula Rios
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA); Villejuif France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS); Paris France
| | - Helen D Bailey
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA); Villejuif France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS); Paris France
| | - Laurent Orsi
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA); Villejuif France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS); Paris France
| | - Brigitte Lacour
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA); Villejuif France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS); Paris France
- CHU Nancy, Registre National Des Tumeurs Solides De L'Enfant; Vandœuvre-lès-Nancy France
| | | | - Dominique Levy
- Institut Curie, Département D'Oncologie Pédiatrique, Adolescents Et Jeunes Adultes; Paris France
| | - Nadège Corradini
- Centre Léon Bérard; Institut D'Hématologie Et D'Oncologie Pédiatrique; Lyon France
| | - Guy Leverger
- Hôpital Armand-Trousseau; Assistance Publique - Hôpitaux De Paris, Service D'Oncohématologie Pédiatrique; Paris France
| | | | - Marion Gambart
- Hôpital Des Enfants, Sce D'Hématologie Oncologie Pédiatrique; Toulouse France
| | - Nicolas Sirvent
- Service d'Hémato-Oncologie Pédiatrique; Hôpital Arnaud De Villeneuve Montpellier France
| | - Estelle Thebaud
- Hôpital De La Mère Et L'enfant, Service D'Oncologie Pédiatrique; Nantes France
| | - Stéphane Ducassou
- Service D'Oncohématologie Pédiatrique, Hôpital Pellegrin Tripode; Bordeaux France
| | - Jacqueline Clavel
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA); Villejuif France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS); Paris France
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40
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Amitay EL, Dubnov Raz G, Keinan-Boker L. Breastfeeding, Other Early Life Exposures and Childhood Leukemia and Lymphoma. Nutr Cancer 2016; 68:968-77. [PMID: 27352124 DOI: 10.1080/01635581.2016.1190020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Childhood cancer incidence increases and although rare, it is a leading cause of mortality. Leukemia and lymphoma comprise 40% of all cancers in children but little is known of their etiology. In this study, we examined the associations of breastfeeding and other early life exposures with childhood leukemia and lymphoma. A population-based case-control study carried out in 2011-2013 comprised mothers of 190 incidents (2005-2013) of leukemia/lymphoma cases aged 1-19 yr at diagnosis and 384 population-based controls. Interviews based on a computerized structured questionnaire were conducted with the mothers. Multivariate logistic regression models adjusted for potential confounders assessed the association between breastfeeding patterns and childhood leukemia/lymphoma. Ever breastfeeding category was associated with a 64% decreased risk for childhood leukemia/lymphoma lsqb;odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.22, 0.60lrqb; and similar trends, with a dose-response effect, were observed for any breastfeeding (exclusive and/or partial) category for 6, 12, and 18+ mo. Other infant exposures associated with cancer risk were child iron supplementation (OR = 0.39, 95% CI: 0.26, 0.59), pet ownership (OR = 0.50, 95% CI: 0.33, 0.78), paternal smoking (OR = 1.93, 95% CI: 1.18, 3.15), and having older siblings (OR = 1.18, 95% CI: 1.05, 1.33). Breastfeeding-a controllable and modifiable exposure-is inversely associated with risk for childhood leukemia and lymphoma with a dose-response effect.
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Affiliation(s)
- Efrat Lev Amitay
- a School of Public Health , University of Haifa , Haifa , Israel
| | - Gal Dubnov Raz
- b Exercise, Lifestyle and Nutrition Clinic , The Edmond and Lily Safra Children's Hospital, Sheba Medical Center , Ramat Gan , Israel.,c Israel Center for Disease Control , Ministry of Health , Ramat Gan , Israel
| | - Lital Keinan-Boker
- c Israel Center for Disease Control , Ministry of Health , Ramat Gan , Israel.,d School of Public Health , Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa , Israel
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Reported associations between asthma and acute lymphoblastic leukemia: insights from a hybrid simulation study. Eur J Epidemiol 2016; 31:593-602. [PMID: 26861154 DOI: 10.1007/s10654-016-0126-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 02/02/2016] [Indexed: 02/07/2023]
Abstract
Numerous studies have reported a protective association between asthma and acute lymphoblastic leukemia (ALL), but the causal structure of this association remains unclear. We present a hybrid simulation to examine the compatibility of this association with uncontrolled confounding by infection or another unmeasured factor. We generated a synthetic cohort using inputs on the interrelations of asthma, ALL, infections, and other suggested risk factors from the literature and the Danish National Birth Cohort. We computed odds ratios (ORs) between asthma and ALL in the synthetic cohort with and without adjustment for infections and other (including unmeasured) confounders. Only if infection was an extremely strong risk factor for asthma (OR of 10) and an extremely strong protective factor against ALL (OR of 0.1) was the asthma-ALL association compatible with the literature (OR of 0.78). Similarly, strong uncontrolled confounding by an unmeasured factor could downwardly bias the asthma-ALL association, but not enough to replicate findings in the literature. This investigation illustrates that the reported protective association between asthma and ALL is unlikely to be entirely due to uncontrolled confounding by infections or an unmeasured confounder alone. Simulation can be used to advance our understanding of risk factors for rare outcomes as demonstrated by this study.
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Yi X, Zhu J, Zhu X, Liu GJ, Wu L. Breastfeeding and thyroid cancer risk in women: A dose-response meta-analysis of epidemiological studies. Clin Nutr 2015; 35:1039-46. [PMID: 26732028 DOI: 10.1016/j.clnu.2015.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 11/22/2015] [Accepted: 12/03/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND & AIMS The association between breastfeeding and thyroid cancer risk is not consistent from epidemiological studies. To better clarify the association including assessing a potential dose-response relationship, we conducted a comprehensive meta-analysis. METHODS We searched PubMed (MEDLINE) up to November 2015 for prospective studies or case-control studies that evaluated the association between breastfeeding and risk of thyroid cancer. Effect estimates were pooled using a fixed-effects model. RESULTS Nine reports (2 prospective studies, 6 case-control studies and 1 pooled analysis of 14 case-control studies) involving 2423 cases and 350,081 non-cases were identified. After pooling relevant studies, there was a significant inverse association between ever breastfeeding and risk of thyroid cancer (RR = 0.91, 95% CI 0.83-0.99), with minor heterogeneity (I(2) = 10.1%). The dose-response analysis revealed a significant linear relationship between the duration of breastfeeding and risk of thyroid cancer. The summary RR for an increment of 1 month of breastfeeding with risk of thyroid cancer was 0.983 (95% CI 0.98-0.99). When focusing on cohort studies, a more prominent linear dose-response relationship was detected, with the combined RR for every increment of 1 month of breastfeeding to be 0.965 (95% CI 0.96-0.97). CONCLUSIONS This meta-analysis suggests that breastfeeding is potentially inversely associated with thyroid cancer risk. Also longer duration of breastfeeding may further decreases thyroid cancer risk. If validated in large-scale prospective studies, our findings may have implications for impacting women's decision in breastfeeding.
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Affiliation(s)
- Xingyang Yi
- Department of Neurology, The People's Hospital of Deyang City, Deyang 618000, Sichuan, China
| | - Jingjing Zhu
- Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, MN, 55455, USA; Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Xiao Zhu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan 523808, China
| | - Guang Jian Liu
- Department of Neurology, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan City, Hubei Province 442000, China.
| | - Lang Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA; Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55905, USA.
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Scoccianti C, Key TJ, Anderson AS, Armaroli P, Berrino F, Cecchini M, Boutron-Ruault MC, Leitzmann M, Norat T, Powers H, Schüz J, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Breastfeeding and cancer. Cancer Epidemiol 2015; 39 Suppl 1:S101-6. [PMID: 26116994 DOI: 10.1016/j.canep.2014.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/24/2014] [Accepted: 12/05/2014] [Indexed: 01/09/2023]
Abstract
Breast cancer is the most frequent cancer in women, and incidence rates have been rising in European Union (EU) countries over recent decades due in part to a sharp decline in breastfeeding practices. Evidence for a protective association between breastfeeding and the risk of breast cancer at all ages is convincing, and modest protective relationships between breastfeeding and the risk of endometrial and ovarian cancers have been suggested. The reduction in breast cancer risk is estimated at 2% for an increase of 5 months of lifetime breastfeeding. The longer women breastfeed, the more they are protected against breast cancer. In addition, breastfeeding is associated with several health benefits for both the mother and the breastfed child. Taking all this evidence into account, the 4th edition of the European Code against Cancer recommends: "Breastfeeding reduces the mother's cancer risk. If you can, breastfeed your baby".
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Paola Armaroli
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin, Italy
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775, Paris Cedex 16, France
| | | | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Mortazavi H, Tashvighi M, Azizian M, Khalighi HR, Sabour S, Movahhedian A, Baharvand M. Evaluation of Relationship Between Demographics and Dental Status in a Defined Group of Iranian Paediatric Patients Undergoing Cancer Therapy. J Clin Diagn Res 2015; 9:ZC80-3. [PMID: 26501019 DOI: 10.7860/jcdr/2015/11976.6521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 07/14/2015] [Indexed: 11/24/2022]
Abstract
CONTEXT Cancer is a major cause of death in children under 15 years of age. AIMS This study aimed to evaluate relationship between demographics and dental status in a defined group of Iranian paediatric patients undergoing cancer therapy. SETTINGS AND DESIGN This cross-sectional study was accomplished on 161 subjects age ranging 8-12 years. There were 76 cancerous patients hospitalized at Mahak Hospital (one of the major children's cancer centers in Tehran) as the study group and 85 healthy children attending at Dental School, International Branch of Shahid Beheshti University of Medical Sciences, Tehran, Iran from 2012 to 2013. MATERIALS AND METHODS Demographics were gathered by using data-form. Oral examination and DMFT Index were used to describe teeth status in all teeth and in the first permanent molars. According to Becker's definition, "D" stands for untreated decayed teeth, "M" indicates missing teeth, and "F" shows Filled teeth. It is noteworthy that full coverage crowns are considered as "F" in this Index. STATISTICAL ANALYSIS Chi-square, Mann-Whitney U, Student's t-tests and Logistic Regression were used for data analysis. RESULTS The most frequent type of cancer was acute lymphoblastic/lymphocytic leukemia (33.3%). Patients were significantly shorter than controls (p=0.03), and their fathers and mothers were of lower educational achievement (p=0.01, p= 0.001). Although DMFT of all dentition showed significantly higher score in cancerous children (p=0.001), DMFT of four first permanent molars (left, right, upper, and lower) was borderline significantly higher in patients (p= 0.06). Moreover, frequency of cancer was borderline significantly higher in children with lower birth order (p= 0.05). According to Logistic Regression, in as much as patients grew elder 1 year, DMFT index increased 1.5 units. CONCLUSION Patients under cancer therapy were shorter than healthy ones, and their parents were of lower educational levels. In addition, their teeth status was poorer than controls.
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Affiliation(s)
- Hamed Mortazavi
- Associate Professor, Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Maryam Tashvighi
- Assistant Professor, Department of Hematology and Oncology, Medical School. Azad University , Qom, Iran
| | | | - Hamid Reza Khalighi
- Assistant Professor, Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Siamak Sabour
- Associate Professor, Department of Clinical Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Amir Movahhedian
- Dental Student, Department of Oral Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Maryam Baharvand
- Associate Professor, Department of Oral Medicine, Dental School, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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45
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Rudant J, Lightfoot T, Urayama KY, Petridou E, Dockerty JD, Magnani C, Milne E, Spector LG, Ashton LJ, Dessypris N, Kang AY, Miller M, Rondelli R, Simpson J, Stiakaki E, Orsi L, Roman E, Metayer C, Infante-Rivard C, Clavel J. Childhood acute lymphoblastic leukemia and indicators of early immune stimulation: a Childhood Leukemia International Consortium study. Am J Epidemiol 2015; 181:549-62. [PMID: 25731888 DOI: 10.1093/aje/kwu298] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 09/29/2014] [Indexed: 01/04/2023] Open
Abstract
The associations between childhood acute lymphoblastic leukemia (ALL) and several proxies of early stimulation of the immune system, that is, day-care center attendance, birth order, maternally reported common infections in infancy, and breastfeeding, were investigated by using data from 11 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980-2010). The sample included 7,399 ALL cases and 11,181 controls aged 2-14 years. The data were collected by questionnaires administered to the parents. Pooled odds ratios and 95% confidence intervals were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Day-care center attendance in the first year of life was associated with a reduced risk of ALL (odds ratio = 0.77, 95% confidence interval: 0.71, 0.84), with a marked inverse trend with earlier age at start (P < 0.0001). An inverse association was also observed with breastfeeding duration of 6 months or more (odds ratio = 0.86, 95% confidence interval: 0.79, 0.94). No significant relationship with a history of common infections in infancy was observed even though the odds ratio was less than 1 for more than 3 infections. The findings of this large pooled analysis reinforce the hypothesis that day-care center attendance in infancy and prolonged breastfeeding are associated with a decreased risk of ALL.
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Ajrouche R, Rudant J, Orsi L, Petit A, Baruchel A, Lambilliotte A, Gambart M, Michel G, Bertrand Y, Ducassou S, Gandemer V, Paillard C, Saumet L, Blin N, Hémon D, Clavel J. Childhood acute lymphoblastic leukaemia and indicators of early immune stimulation: the Estelle study (SFCE). Br J Cancer 2015; 112:1017-26. [PMID: 25675150 PMCID: PMC4366894 DOI: 10.1038/bjc.2015.53] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/04/2015] [Accepted: 01/12/2015] [Indexed: 11/29/2022] Open
Abstract
Background: Factors related to early stimulation of the immune system (breastfeeding, proxies for exposure to infectious agents, normal delivery, and exposure to animals in early life) have been suggested to decrease the risk of childhood acute lymphoblastic leukaemia (ALL). Methods: The national registry-based case–control study, ESTELLE, was carried out in France in 2010–2011. Population controls were frequency matched with cases on age and gender. The participation rates were 93% for cases and 86% for controls. Data were obtained from structured telephone questionnaires administered to mothers. Odds ratios (OR) were estimated using unconditional regression models adjusted for age, gender, and potential confounders. Results: In all, 617 ALL and 1225 controls aged ⩾1 year were included. Inverse associations between ALL and early common infections (OR=0.8, 95% confidence interval (CI): 0.6, 1.0), non-first born (⩾3 vs 1; OR=0.7, 95% CI: 0.5, 1.0), attendance of a day-care centre before age 1 year (OR=0.7, 95% CI: 0.5, 1.0), breastfeeding (OR=0.8, 95% CI: 0.7, 1.0), and regular contact with pets (OR=0.8, 95% CI: 0.7, 1.0) in infancy were observed. Conclusions: The results support the hypothesis that conditions promoting the maturation of the immune system in infancy have a protective role with respect to ALL.
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Affiliation(s)
- R Ajrouche
- 1] Epidemiology of childhood and adolescent cancers, CRESS, INSERM U1153, Villejuif, France [2] Paris-Sud University, Le Kremlin Bicêtre, France
| | - J Rudant
- 1] Epidemiology of childhood and adolescent cancers, CRESS, INSERM U1153, Villejuif, France [2] Paris-Descartes University, Paris, France [3] RNHE-National Registry of Childhood Hematopoietic Malignancies, Villejuif, France
| | - L Orsi
- 1] Epidemiology of childhood and adolescent cancers, CRESS, INSERM U1153, Villejuif, France [2] Paris-Descartes University, Paris, France
| | - A Petit
- 1] AP-HP, Hôpital Armand Trousseau, Paris, France [2] Université Paris 6 Pierre et Marie Curie, Paris, France
| | - A Baruchel
- 1] AP-HP, Hôpital Robert Debré, Paris, France [2] Université Paris 7, Paris, France
| | | | - M Gambart
- Hôpital des Enfants, Toulouse, France
| | - G Michel
- AP-HM, Hôpital la Timone, Marseille, France
| | - Y Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - S Ducassou
- Hôpital Pellegrin Tripode, Bordeaux, France
| | | | - C Paillard
- Hôpital de Hautepierre, Strasbourg, France
| | - L Saumet
- Hôpital Arnaud de Villeneuve, Montpellier, France
| | - N Blin
- Hôpital Mère-Enfant, CHU-Nantes, Nantes, France
| | - D Hémon
- 1] Epidemiology of childhood and adolescent cancers, CRESS, INSERM U1153, Villejuif, France [2] Paris-Descartes University, Paris, France
| | - J Clavel
- 1] Epidemiology of childhood and adolescent cancers, CRESS, INSERM U1153, Villejuif, France [2] Paris-Descartes University, Paris, France [3] RNHE-National Registry of Childhood Hematopoietic Malignancies, Villejuif, France
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Greenop KR, Bailey HD, Miller M, Scott RJ, Attia J, Ashton LJ, Downie P, Armstrong BK, Milne E. Breastfeeding and nutrition to 2 years of age and risk of childhood acute lymphoblastic leukemia and brain tumors. Nutr Cancer 2015; 67:431-41. [PMID: 25646650 DOI: 10.1080/01635581.2015.998839] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Acute lymphoblastic leukemia (ALL) and childhood brain tumors (CBT) are 2 of the most common forms of childhood cancer, but little is known of their etiology. In 2 nationwide case-control studies we investigated whether breastfeeding, age of food introduction, or early diet are associated with the risk of these cancers. Cases aged 0-14 years were identified from Australian pediatric oncology units between 2003 and 2007 (ALL) and 2005 and 2010 (CBT) and population-based controls through nationwide random-digit dialing. Mothers completed questionnaires giving details of infant feeding up to the age of 2 yr. Data from 322 ALL cases, 679 ALL controls, 299 CBT cases, and 733 CBT controls were analysed using unconditional logistic regression. Breastfeeding was associated with a reduced risk of ALL [odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.32, 0.84), regardless of duration. Introduction of artificial formula within 14 days of birth was positively associated with ALL (OR = 1.57, 95% CI: 1.03, 2.37), as was exclusive formula feeding to 6 mo (OR = 1.81, 95% CI: 1.07, 3.05). No associations were seen between breastfeeding or formula use and risk of CBT. Our results suggest that breastfeeding and delayed introduction of artificial formula may reduce the risk of ALL but not CBT.
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Affiliation(s)
- Kathryn R Greenop
- a Telethon Kids Institute , University of Western Australia , Perth , Western Australia , Australia
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Mezei G, Sudan M, Izraeli S, Kheifets L. Epidemiology of childhood leukemia in the presence and absence of Down syndrome. Cancer Epidemiol 2014; 38:479-89. [DOI: 10.1016/j.canep.2014.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/10/2014] [Accepted: 07/11/2014] [Indexed: 02/05/2023]
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Wang KL, Liu CL, Zhuang Y, Qu HY. Breastfeeding and the risk of childhood Hodgkin lymphoma: a systematic review and meta-analysis. Asian Pac J Cancer Prev 2014; 14:4733-7. [PMID: 24083735 DOI: 10.7314/apjcp.2013.14.8.4733] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Numerous observational epidemiological studies have evaluated associations between breastfeeding and the risk of childhood Hodgkin lymphoma; however, the existing results are inconsistent. We therefore conducted a systematic review and meta-analysis. METHODS Medical literature was searched in the Pubmed and Embase databases to identify all English-language relevant studies up to April 10, 2013. Reference lists were thereafter hand-searched for additional articles. Studies that reported relative risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were included. This meta-analysis was conducted in accordance with the guidelines for the meta-analysis of observational studies in epidemiology. RESULTS We finally included 10 case-control studies in our meta-analysis, involving 1,618 childhood Hodgkin lymphoma cases and 8,181 controls. Overall, we did found a borderline significant association between breastfeeding and reduced risk of childhood Hodgkin lymphoma comparing ever breastfed children to never breastfed children (pooled OR =0.79; 95%CI, 0.58-1.08; P=0.13), with limited evidence for between-study heterogeneity (P =0.12, I2 = 35.70%). CONCLUSION There is limited evidence for an inverse association between breastfeeding and risk of childhood Hodgkin lymphoma.
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Affiliation(s)
- Ke-Lai Wang
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China E-mail :
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50
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Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons. Soc Sci Med 2014; 109:55-65. [PMID: 24698713 DOI: 10.1016/j.socscimed.2014.01.027] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 01/16/2014] [Accepted: 01/18/2014] [Indexed: 11/23/2022]
Abstract
Breastfeeding rates in the U.S. are socially patterned. Previous research has documented startling racial and socioeconomic disparities in infant feeding practices. However, much of the empirical evidence regarding the effects of breastfeeding on long-term child health and wellbeing does not adequately address the high degree of selection into breastfeeding. To address this important shortcoming, we employ sibling comparisons in conjunction with 25 years of panel data from the National Longitudinal Survey of Youth (NLSY) to approximate a natural experiment and more accurately estimate what a particular child's outcome would be if he/she had been differently fed during infancy. Results from standard multiple regression models suggest that children aged 4 to 14 who were breast- as opposed to bottle-fed did significantly better on 10 of the 11 outcomes studied. Once we restrict analyses to siblings and incorporate within-family fixed effects, estimates of the association between breastfeeding and all but one indicator of child health and wellbeing dramatically decrease and fail to maintain statistical significance. Our results suggest that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status.
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