Population mixing for leukaemia, lymphoma and CNS tumours in teenagers and young adults in England, 1996–2005

BMC Cancer

Richard G Feltbower¹  Susan V Picton²  Sally E Kinsey²  Roger C Parslow¹  Patricia McKinney¹  Daniel P Stark³  Marlous van Laar¹ 

[1]Division of Epidemiology and Biostatistics, School of Medicine, Worsley Building, Clarendon Way, University of Leeds, Leeds LS2 9JT, UK

[2]Regional Department of Paediatric Oncology and Haematology, Martin Wing, D Floor, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK

[3]St James’s Institute of Oncology, Bexley Wing, Level 04, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK

关键词: Central nervous system tumours;    Lymphoma;    Leukaemia;    Oncology;    Adolescent;    Teenage and young adult;    Aetiology;    Population mixing;   

Others  :  1121043
DOI  :  10.1186/1471-2407-14-698

 received in 2014-02-26, accepted in 2014-09-17,  发布年份 2014

【 摘 要 】

Background

Little aetiological epidemiological research has been undertaken for major cancers occurring in teenagers and young adults (TYA). Population mixing, as a possible proxy for infectious exposure, has been well researched for childhood malignancies. We aimed to investigate effects of population mixing in this older age group using an English national cancer dataset.

Methods

Cases of leukaemia, lymphoma and central nervous system (CNS) tumours amongst 15–24 year olds in England (diagnosed 1996–2005) were included in the study. Data were obtained by ward of diagnosis and linked to 1991 census variables including population mixing (Shannon index); data on person-weighted population density and deprivation (Townsend score) were also used and considered as explanatory variables. Associations between TYA cancer incidence and census variables were investigated using negative binomial regression, and results presented as incidence rate ratios (IRR) with 95% confidence intervals (CI).

Results

A total of 6251 cases of leukaemia (21%), lymphoma (49%) and CNS tumours (30%) were analysed. Higher levels of population mixing were associated with a significant decrease in the incidence of CNS tumours (IRR = 0.83, 95% CI = 0.75-0.91), accounted for by astrocytomas and ‘other CNS tumours’; however, there was no association with leukaemia or lymphoma. Incidence of CNS tumours and lymphoma was 3% lower in more deprived areas (IRR = 0.97, 95% CI = 0.96-0.99 and IRR = 0.97, 95% CI =0.96-0.98 respectively). Population density was not associated with the incidence of leukaemia, lymphoma or CNS tumours.

Conclusions

Our results suggest a possible role for environmental risk factors with population correlates in the aetiology of CNS tumours amongst TYAs. Unlike studies of childhood cancer, associations between population mixing and the incidence of leukaemia and lymphoma were not observed.

【 授权许可】

   
2014 van Laar et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Kinlen L: Evidence for an infective cause of childhood leukaemia: comparison of a Scottish new town with nuclear reprocessing sites in Britain. Lancet 1988, 332(8624):1323-1327.
• [2]Dickinson H, Hammal D, Bithell J, Parker L: Population mixing and childhood leukaemia and non-Hodgkin's lymphoma in census wards in England and Wales, 1966–87. Br J Cancer 2002, 86(9):1411-1413.
• [3]Law GR, Parslow RC, Roman E: Childhood cancer and population mixing. Am J Epidemiol 2003, 158(4):328-336.
• [4]Greaves M: Aetiology of acute leukaemia. Lancet 1997, 349(9048):344-349.
• [5]Anderson RM, May R: Immunisation and herd immunity. Lancet 1990, 335(8690):641-645.
• [6]Parslow RC, Law GR, Feltbower R, Kinsey SE, McKinney PA: Population mixing, childhood leukaemia, CNS tumours and other childhood cancers in Yorkshire. Eur J Cancer 2002, 38(15):2033-2040.
• [7]Basta NO, James PW, Craft AW, McNally RJQ: Season of birth and diagnosis for childhood cancer in Northern England, 1968–2005. Paediatr Perinat Epidemiol 2010, 24(3):309-318.
• [8]McNally RJQ, Eden TOB: An infectious aetiology for childhood acute leukaemia: a review of the evidence. Br J Haematol 2004, 127(3):243-263.
• [9]Simpson J, Smith A, Ansell P, Roman E: Childhood leukaemia and infectious exposure: a report from the United Kingdom Childhood Cancer Study (UKCCS). Eur J Cancer 2007, 43(16):2396-2403.
• [10]Chang JS, Tsai C-R, Tsai Y-W, Wiemels JL: Medically diagnosed infections and risk of childhood leukaemia: a population-based case–control study. Int J Epidemiology 2012, 41(4):1050-1059.
• [11]Stiller C, Kroll M, Boyle P, Feng Z: Population mixing, socioeconomic status and incidence of childhood acute lymphoblastic leukaemia in England and Wales: analysis by census ward. Br J Cancer 2008, 98(5):1006-1011.
• [12]Hjalgrim H, Engels E: Infectious aetiology of Hodgkin and non-Hodgkin lymphomas: a review of the epidemiological evidence. J Intern Med 2008, 264(6):537-548.
• [13]McNally RJQ, Stiller C, Vincent TJ, Murphy MFG: Cross-space-time clustering of childhood cancer in Great Britain: Evidence for a common aetiology. Int J Cancer 2014, 134(1):136-143.
• [14]McNally RJ, James PW, Picton SV, McKinney PA, van Laar M, Feltbower RG: Space-time clustering of childhood central nervous system tumours in Yorkshire, UK. BMC Cancer 2012, 12(1):13. BioMed Central Full Text
• [15]Ortega-García JA, López-Hernández FA, Fuster-Soler JL, Martínez-Lage JF: Space–time clustering in childhood nervous system tumors in the Region of Murcia, Spain, 1998–2009. Childs Nerv Syst 2011, 27(11):1903-1911.
• [16]Schmidt L, Grell K, Frederiksen K, Johansen C, Schmiegelow K, Schüz J: Seasonality of birth in children with central nervous system tumours in Denmark, 1970–2003. Br J Cancer 2009, 100(1):185-187.
• [17]McNally RJ, Alston RD, Eden TO, Kelsey AM, Birch JM: Further clues concerning the aetiology of childhood central nervous system tumours. Eur J Cancer 2004, 40(18):2766-2772.
• [18]Harding N, Birch J, Hepworth S, McKinney P: Infectious exposure in the first year of life and risk of central nervous system tumors in children: analysis of day care, social contact, and overcrowding. Cancer Causes Control 2009, 20(2):129-136.
• [19]McNally RJQ: Are early infectious exposures involved in the etiology of childhood CNS tumors? Expert Rev Neurother 2010, 10(11):1663-1665.
• [20]Schmidt L, Kamper-Jørgensen M, Schmiegelow K, Johansen C, Lähteenmäki P, Träger C, Stokland T, Grell K, Gustafson G, Kogner P: Infectious exposure in the first years of life and risk of central nervous system tumours in children: analysis of birth order, childcare attendance and seasonality of birth. Br J Cancer 2010, 102(11):1670-1675.
• [21]Birch JM, Alston RD, Quinn M, Kelsey AM: Incidence of malignant disease by morphological type, in young persons aged 12–24 years in England, 1979–1997. Eur J Cancer 2003, 39(18):2622-2631.
• [22]Bleyer WA: Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Med Pediatr Oncol 2002, 38:1-10.
• [23]Alston RD, Rowan S, Eden TOB, Moran A, Birch JM: Cancer incidence patterns by region and socioeconomic deprivation in teenagers and young adults in England. Br J Cancer 2007, 96:1760-1766.
• [24]Birch JM, Alston RD, Kelsey AM, Quinn MJ, Babb P, McNally RJQ: Classification and incidence of cancers in adolescents and young adults in England 1979–1997. Br J Cancer 2002, 87(11):1267.
• [25]van Laar M, Kinsey SE, Picton SV, Feltbower RG: First description of seasonality of birth and diagnosis amongst teenagers and young adults aged 15–24 with cancer in England, 1996–2005. BMC Cancer 2013, 13:365-374. BioMed Central Full Text
• [26]Rhodes C, Anderson R: Persistence and dynamics in lattice models of epidemic spread. J Theor Biol 1996, 180(2):125-133.
• [27]Miller GA: Note on the bias of information estimates. Inf Theory Psychol 1955, 2:95-100.
• [28]Office of Population Censuses and Surveys: Census: special migration statistics (Great Britain). ESRC/JISC Census Programme 1991.
• [29]Dorling D, Atkins D, Office of Population Censuses & Surveys [OPCS]: Population density, change and concentration in Great Britain 1971, 1981 and 1991. In Studies on Medical & Population Subjects No. 58. London: HM Stationery Office; 1995.
• [30]Townsend P, Phillimore P, Beattie A: Health and deprivation: inequality and the North. London: Croom Helm; 1988.
• [31]Akaike H: Information theory and an extension of the maximum likelihood principle. In Second International Symposium on Information Theory. Edited by Petrov BN, Czàke F. Budapest: Akademiai Kiadó; 1973.
• [32]Feltbower RG, Manda SOM, Gilthorpe MS, Greaves MF, Parslow RC, Kinsey SE, Bodansky HJ, McKinney PA: Detecting small-area similarities in the epidemiology of childhood acute lymphoblastic leukemia and diabetes mellitus, type 1: a Bayesian approach. Am J Epidemiol 2005, 161(12):1168-1180.
• [33]McKinney P, Alexander F, Cartwright R, Scott C, Staines A: Acute lymphoblastic leukaemia incidence in the UK by immunophenotype. Leukemia 1993, 7(10):1630-1634.
• [34]Marks DI, Paietta EM, Moorman AV, Richards SM, Buck G, DeWald G, Ferrando A, Fielding AK, Goldstone AH, Ketterling RP: T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics, and outcome from the large randomized prospective trial (UKALL XII/ECOG 2993). Blood 2009, 114(25):5136-5145.
• [35]Greaves MF, Janossy G, Peto J, Kay H: Immunologically defined subclasses of acute lymphoblastic leukaemia in children: their relationship to presentation features and prognosis. Br J Haematol 1981, 48:179-197.
• [36]Taylor JC, Law GR, Boyle PJ, Feng Z, Gilthorpe MS, Parslow RC, Rudge G, Feltbower RG: Does population mixing measure infectious exposure in children at the community level? Eur J Epidemiol 2008, 23(9):593-600.
• [37]Greaves M: Science, medicine, and the future: childhood leukaemia. BMJ 2002, 324(7332):283-287.
• [38]McNally R, Cairns D, Eden O, Alexander F, Taylor G, Kelsey A, Birch J: An infectious aetiology for childhood brain tumours? Evidence from space–time clustering and seasonality analyses. Br J Cancer 2002, 86(7):1070-1077.
• [39]Love S, Louis DN, Ellison D: Greenfield’s neuropathology. 8th edition. Boca Raton: CRC Press; 2008.
• [40]Piantadosi S, Byar DP, Green SB: The ecological fallacy. Am J Epidemiol 1988, 127(5):893-904.