Reliability of cancer family history reported by parents in a case-control study of childhood leukemia

Differences in tumor size, clinical, demographic, and socioeconomic profiles of central nervous system tumors among a racially diverse cohort: A retrospective case-control study

Background

One avenue to improve outcomes among brain tumor patients involves the mitigation of healthcare disparities. Investigating clinical differences among brain tumors across socioeconomic and demographic strata, such can aid in healthcare disparity identification and, by extension, outcome improvement.

Methods

Utilizing a racially diverse population from Hawaii, 323 cases of brain tumors (meningiomas, gliomas, schwannomas, pituitary adenomas, and metastases) were matched by age, sex, and race to 651 controls to investigate the associations between tumor type and various demographic, socioeconomic, and medical comorbidities. Tumor size at the time of diagnosis was also compared across demographic groups.

Results

At the time of diagnosis for benign meningiomas, Native Hawaiians and Pacific Islanders (NHPI; P < 0.05), Asians, and Hispanics exhibited nearly two-fold larger tumor volumes than Whites. For gliomas, NHPI similarly presented with larger tumor volumes relative to Whites (P = 0.04) and Asians (P = 0.02), while for vestibular schwannomas, NHPI had larger tumor sizes compared to Asians (P < 0.05). Benign meningiomas demonstrated greater odds of diagnosis (P < 0.05) among Native American or Alaskan Natives, patients comorbid with obesity class I, hypertension, or with a positive Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Malignant meningiomas demonstrated greater odds (P < 0.05) among patients from higher median household income and urban geography. Gliomas overall exhibited increased odds (P < 0.05) of diagnosis among Whites and reduced odds among Asians, with greater comorbidity with obesity class III; for glioblastoma specifically, there were reduced odds of asthma diagnosis. Patients with vestibular schwannomas were at increased odds (P < 0.05) of being from the highest income quartile and having a positive AUDIT-C, yet reduced odds of psychiatric disorders. Pituitary adenomas exhibited reduced odds of diagnosis among Whites, yet greater odds among NHPI, military personnel, obesity class I, and psychiatric disorders. Intracranial metastases were more common in patients with pre-obesity, asthma, a positive AUDIT-C, and living in more affluent regions. Benign meningiomas are most often presented with seizures, while malignant meningiomas have the addition of cognitive difficulty. Gliomas often present with seizures, cognitive difficulty, dizziness/nausea/vomiting (DNV), vestibular schwannomas with DNV, and metastases with seizures.

Conclusion

Brain tumors exhibit unique sociodemographic disparities and clinical comorbidities, which may have implications for diagnosis, treatment, and healthcare policy.

Asthma reduces glioma formation by T cell decorin-mediated inhibition of microglia

To elucidate the mechanisms underlying the reduced incidence of brain tumors in children with Neurofibromatosis type 1 (NF1) and asthma, we leverage Nf1 optic pathway glioma (Nf1^OPG) mice, human and mouse RNAseq data, and two different experimental asthma models. Following ovalbumin or house dust mite asthma induction at 4-6 weeks of age (WOA), Nf1^OPG mouse optic nerve volumes and proliferation are decreased at 12 and 24 WOA, indicating no tumor development. This inhibition is accompanied by reduced expression of the microglia-produced optic glioma mitogen, Ccl5. Human and murine T cell transcriptome analyses reveal that inhibition of microglia Ccl5 production results from increased T cell expression of decorin, which blocks Ccl4-mediated microglia Ccl5 expression through reduced microglia NFκB signaling. Decorin or NFκB inhibitor treatment of Nf1^OPG mice at 4-6 WOA inhibits tumor formation at 12 WOA, thus establishing a potential mechanistic etiology for the attenuated glioma incidence observed in children with asthma.

Family history of cancer and the risk of childhood brain tumors: a pooled analysis of the ESCALE and ESTELLE studies (SFCE)

PURPOSE

Although some specific genetic syndromes such as neurofibromatosis (NF) have been identified as risk factor of childhood brain tumors (CBT), the potential role of inherited susceptibility in CBT has yet to be elucidated.

METHODS

To further investigate this, we conducted a pooled analysis of two nationwide case-control studies ESCALE and ESTELLE. The mothers of 509 CBT cases and 3,102 controls aged under 15 years who resided in France at diagnosis/interview, frequency-matched by age and gender, responded to a telephone interview conducted by trained interviewers. Pooled odds ratio (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regression.

RESULTS

CBT was significantly associated with the family history of cancer in relatives (OR 1.2, 95% CI 1.0-1.5). The OR was slightly higher for maternal relatives than for paternal relatives, and when at least two relatives had a history of cancer. CBT was significantly associated with a family history of brain tumor (OR 2.1, 95% CI 1.3-3.7). This association seemed stronger for first-degree relatives (mother, father, and siblings), for whom, by contrast, no association was seen for cancers other than CBT. No specificity by CBT subtypes or by age of the children were found for any of these findings.

CONCLUSION

Our findings support the hypothesis of a familial susceptibility of CBT, not due to being a known NF carrier.

Family history of cancer and childhood rhabdomyosarcoma: a report from the Children's Oncology Group and the Utah Population Database

Relatively little is known about the epidemiology and factors underlying susceptibility to childhood rhabdomyosarcoma (RMS). To better characterize genetic susceptibility to childhood RMS, we evaluated the role of family history of cancer using data from the largest case–control study of RMS and the Utah Population Database (UPDB). RMS cases (n = 322) were obtained from the Children's Oncology Group (COG). Population-based controls (n = 322) were pair-matched to cases on race, sex, and age. Conditional logistic regression was used to evaluate the association between family history of cancer and childhood RMS. The results were validated using the UPDB, from which 130 RMS cases were identified and matched to controls (n = 1300) on sex and year of birth. The results were combined to generate summary odds ratios (OR^s) and 95% confidence intervals (CI). Having a first-degree relative with a cancer history was more common in RMS cases than controls (OR^s = 1.39, 95% CI: 0.97–1.98). Notably, this association was stronger among those with embryonal RMS (OR^s = 2.44, 95% CI: 1.54–3.86). Moreover, having a first-degree relative who was younger at diagnosis of cancer (<30 years) was associated with a greater risk of RMS (OR^s = 2.37, 95% CI: 1.34–4.18). In the largest analysis of its kind, we found that most children diagnosed with RMS did not have a family history of cancer. However, our results indicate an increased risk of RMS (particularly embryonal RMS) in children who have a first-degree relative with cancer, and among those whose relatives were diagnosed with cancer at <30 years of age.