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Parodi S, Seniori Costantini A, Crosignani P, Fontana A, Miligi L, Nanni O, Piro S, Ramazzotti V, Rodella S, Tumino R, Vindigni C, Vineis P, Stagnaro E. Childhood infectious diseases and risk of non-Hodgkin's lymphoma according to the WHO classification: A reanalysis of the Italian multicenter case-control study. Int J Cancer 2019; 146:977-986. [PMID: 31077355 DOI: 10.1002/ijc.32393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 12/26/2022]
Abstract
Since 1960, incidence of non-Hodgkin's lymphoma (NHL) has been increasing in most industrialized countries, but causes of this trend remain unclear. A role of the decreased exposure to infectious agents during childhood has been proposed. Our study evaluates the association between common childhood infectious diseases and the risk of NHL and its major subtypes by a reanalysis of the Italian multicenter case-control study. After exclusion of next-of-kin interviews, 1,193 cases, diagnosed between 1990 and 1993, and 1,708 population-based controls were included in the analyses. OR estimates were obtained by logistic regression, adjusting for gender, age, residence area, education, smoking habit and exposure to radiations, pesticides and aromatic hydrocarbons. Among B-cell lymphomas (n = 1,102) an inverse association was observed for rubella (OR = 0.80, 95% CI: 0.65-0.99), pertussis (OR = 0.74, 95% CI: 0.62-0.88) and any infection (OR = 0.75, 95% CI: 0.61-0.93). A negative trend by number of infections was observed, which was more evident among mature B-cell lymphoma (OR = 0.66 for three infections or more, 95% CI: 0.48-0.90). Our results indicate a potential protective role of common childhood infections in the etiology of B-cell NHL.
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Affiliation(s)
- Stefano Parodi
- Epidemiology and Biostatistics Unit, Scientific Directorate, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Adele Seniori Costantini
- Unit of Occupational and Environmental Epidemiology, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | | | | | - Lucia Miligi
- Unit of Occupational and Environmental Epidemiology, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Oriana Nanni
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Piro
- Unit of Occupational and Environmental Epidemiology, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Valerio Ramazzotti
- Epidemiology and Cancer Registry Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Stefania Rodella
- Healthcare Development and Evaluation Unit, Agency for Health and Social Care, Bologna, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale, Ragusa, Italy
| | - Carla Vindigni
- Pathology Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Paolo Vineis
- MRC/PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Emanuele Stagnaro
- Clinical Epidemiology, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
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Schmidt S, Mor A, Schønheyder H, Sørensen H, Dekkers O, Cronin-Fenton D. Herpes zoster as a marker of occult cancer: A systematic review and meta-analysis. J Infect 2017; 74:215-235. [DOI: 10.1016/j.jinf.2016.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 01/14/2023]
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Chronic diseases, medical history and familial cancer, and risk of leukemia and non-Hodgkin’s lymphoma in an adult population: a case–control study. Cancer Causes Control 2015; 26:993-1002. [DOI: 10.1007/s10552-015-0592-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 04/22/2015] [Indexed: 12/17/2022]
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Investigating the relationship between mortality from respiratory diseases and childhood acute lymphoblastic leukaemia in Hungary. Pathol Oncol Res 2014; 21:53-7. [PMID: 24806976 DOI: 10.1007/s12253-014-9786-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
Abstract
Our aim was to investigate the ecological association between death from infectious disease of the respiratory system and the risk of acute lymphoid leukaemia (ALL) in children aged less than 7 years. Poisson regression analyses were carried out using overall data and gender-specific models. The study included 176 cases (92(52.3 %) boys and 84 (47.7 %) girls) of ALL in those aged 0-6 years in South Hungary. Eight cases were diagnosed before the age of 1 year. A significant risk of ALL disease was observed with higher levels of mortality from the chronic respiratory diseases (p = 0.035) and pneumonia (p = 0.010) among children aged 2-5 years (Odds Ratio for trend was 1.001 and 95%CI [1.000-1.002] and Odds ratio for trend was 1.013 and 95%CI [1.003-1.023], respectively). Significantly increased risk of childhood ALL was detected among children under 1 year of age residing in areas around birth with higher levels of mortality from influenza (Odds Ratio (OR) for trend was 1.05; 95%CI [1.01-1.09]; p = 0.012). This risk was also detected in girls (p < 0.001), but not in boys (p = 0.43). Our findings provide new evidence that will help to understand the different pattern of female and male childhood ALL occurrence , but further studies are needed using detailed individual medical history to clarify the role of influenza and other infectious diseases in the etiology of childhood ALL and to explain gender-specific effects.
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Fernández-Prada M, Martínez-Diz S, Colina López A, Almagro Nievas D, Martínez Romero B, Huertas Martínez J. [Scarlet fever outbreak in a public school in Granada in 2012]. An Pediatr (Barc) 2013; 80:249-53. [PMID: 23831204 DOI: 10.1016/j.anpedi.2013.05.020] [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: 03/07/2013] [Revised: 05/17/2013] [Accepted: 05/21/2013] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Scarlet fever is a streptococcal disease characterized by a skin rash in children. It can be endemic, epidemic or sporadic. In April 2012, the headmaster of a primary school in Granada reported an outbreak of scarlet fever in the school. OBJECTIVE To describe an outbreak of scarlet fever, analyse its epidemiological and clinical characteristics, and present the preventive measures taken to control it. PATIENTS AND METHODS A case-control study was conducted using an ad hoc questionnaire, developed for this purpose. The R program, Epidat 3.1 and Microsoft Excel were used for the statistics analysis. RESULTS There were 13 cases and 30 controls. The attack rate was 3.9%. There was a statistically significant difference for the variable "relative affected". CONCLUSION There has been a confirmed outbreak of person-to-person transmitted scarlet fever, and the main risk factor was having a relative with tonsillitis.
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Affiliation(s)
- M Fernández-Prada
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario San Cecilio, Granada, España.
| | - S Martínez-Diz
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen de las Nieves, Granada, España
| | - A Colina López
- Unidad de Gestión Clínica, Churriana de la Vega, Granada, España
| | - D Almagro Nievas
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Distrito Sanitario Granada-Metropolitano, Granada, España
| | - B Martínez Romero
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen de las Nieves, Granada, España
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Parodi S, Crosignani P, Miligi L, Nanni O, Ramazzotti V, Rodella S, Costantini AS, Tumino R, Vindigni C, Vineis P, Stagnaro E. Childhood infectious diseases and risk of leukaemia in an adult population. Int J Cancer 2013; 133:1892-9. [PMID: 23575988 DOI: 10.1002/ijc.28205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 03/28/2013] [Indexed: 11/08/2022]
Abstract
Our study is aimed at investigating the association between common childhood infectious diseases (measles, chickenpox, rubella, mumps and pertussis) and the risk of developing leukaemia in an adult population. A reanalysis of a large population-based case-control study was carried out. Original data included 1,771 controls and 649 leukaemia cases from 11 Italian areas. To contain recall bias, the analysis was restricted to subjects directly interviewed and with a good quality interview (1,165 controls and 312 cases). Odds ratios (ORs) and their related 95% confidence intervals (95% CIs) were estimated by unconditional polychotomous logistic regression model adjusting for age, gender and occupational and lifestyle exposures. A protective effect of at least one infection (OR = 0.66, 95% CI: 0.45-0.97), measles (OR = 0.57, 95% CI: 0.39-0.82) and pertussis (OR = 0.66, 95% CI: 0.45-0.98) was observed for chronic lymphoid leukaemia (CLL). The number of infections was strongly inversely associated with the risk of CLL (p = 0.002, test for trend). With regard to the other types of leukaemia, only a protective effect of pertussis was observed for AML (OR = 0.52, 95% CI: 0.32-0.87). Our results pointed out a protective role of childhood infectious diseases on the risk of CLL in adults. Although a specific antioncogenic effect of some infectious disease, especially measles, cannot be ruled out, the observed decrease of risk with increasing number of infections suggests that a more general "hygiene hypothesis" could be the most likely explanation of the detected association. The protective role of pertussis remains to be elucidated.
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Affiliation(s)
- Stefano Parodi
- Unit of Epidemiology, Biostatistics and Clinical Trials, IRCCS AOU San Martino-IST, Genoa, Italy
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