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Prevention of childhood leukemia by BCG vaccination in newborns? A population-based case-control study in Lower
R von Kries1, V P Grunert, U Kaletsch
1Institut für Soziale Pädiatrie, Ludwig-Maximilians Universität, München, Germany.
Insights
Bacille Calmette-Guérin (BCG) vaccination in newborns showed a small probability of reducing childhood cancer risk. The study lacked power to rule out a minor, yet significant, risk reduction from BCG immunization.
Area of Science:
- Pediatric Oncology
- Immunology
- Epidemiology
Background:
- Childhood cancer remains a significant health concern globally.
- The bacille Calmette-Guérin (BCG) vaccine is widely administered for tuberculosis prevention.
- Potential non-tuberculosis benefits of BCG vaccination, such as cancer risk modification, warrant investigation.
Purpose of the Study:
- To evaluate the association between neonatal bacille Calmette-Guérin (BCG) vaccination and the risk of developing childhood cancer.
- To determine if BCG vaccination in infancy influences the incidence of leukemia and other childhood cancers.
Main Methods:
- A case-control study was conducted in Lower Saxony, Germany.
- Data included 420 childhood cancer cases and 613 controls.
- Information on BCG vaccination and perinatal history was collected via questionnaires and blinded review of birth records.
Main Results:
- 85% of controls received BCG vaccination as newborns.
- Adjusted odds ratios for BCG vaccination were 0.90 for leukemia and 0.61 for other cancers.
- The study indicated a low probability of a 50% or greater reduction in cancer risk due to neonatal BCG vaccination.
Conclusions:
- The findings suggest that neonatal BCG vaccination likely does not confer a substantial reduction in childhood cancer risk.
- The study's statistical power was insufficient to exclude a smaller, potentially relevant, cancer risk reduction.
- Further research with larger cohorts is needed to definitively assess the impact of BCG vaccination on childhood cancer incidence.
Abstract:
Data from a case-control study in Lower Saxony, Germany, were used to assess whether the risk for childhood cancer may be reduced by bacille Calmette-Guérin (BCG) vaccination in the neonatal period. There were 420 newly diagnosed childhood cancer cases from the German cancer registry and 613 controls eligible for this study. A mailed questionnaire was completed during a telephone interview with parents. Details on the perinatal history were abstracted from the birth charts by nurses blinded to the children's case-control status. Complete information was available for 259 cases and for 323 controls. A total of 85% of the controls had been BCG vaccinated in the newborn period. The adjusted odds ratios for BCG vaccination were 0.90 (95% confidence interval; 0.51-1.61) for leukemia and 0.61 (95% confidence interval; 0.25-1.50) for other cancers. Based on these data the probability of a 50% or more reduction of more reduction of the cancer risk by BCG vaccination in the newborn period is small. The statistical power of this study, however, was not high enough to rule out a smaller, still relevant reduction in cancer risk.
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