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Hepatoblastoma in the Nordic countries
S de Fine Licht1, L S Schmidt, N H Rod
1Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. sofielie@cancer.dk
International Journal of Cancer
|November 19, 2011
Summary
Hepatoblastoma risk is higher in infants with low birth weight, preterm birth, or low Apgar scores. Intrauterine and neonatal factors appear to influence this rare childhood cancer.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Neonatology
Background:
- The etiology of hepatoblastoma, a rare childhood liver cancer, remains largely unknown.
- Given the young age of diagnosis, research has focused on potential links to birth characteristics.
Purpose of the Study:
- To determine the incidence of hepatoblastoma in Nordic countries.
- To investigate associations between specific birth characteristics and hepatoblastoma risk.
Main Methods:
- Data from national cancer and birth registries in Denmark, Sweden, Norway, and Finland (1985-2006) were analyzed.
- 155 children diagnosed with hepatoblastoma (aged 0-14) were matched with five controls.
- Incidence rates and odds ratios (OR) with 95% confidence intervals (CI) were calculated.
Main Results:
- The overall incidence rate was 1.7 per million person-years, with a male predominance (1.5:1).
- Highest incidence occurred before age 1 (8.3 per million person-years).
- Increased risk was associated with low birth weight (<1,500g; OR=9.5), preterm birth (weeks 22-32; OR=4.5), low Apgar scores (<7 at 1 min; OR=3.1 and 5 min; OR=7.5), and being large for gestational age (OR=2.3).
Conclusions:
- Intrauterine and/or neonatal factors are linked to an elevated risk of hepatoblastoma.
- Low birth weight and perinatal asphyxia requiring neonatal intensive care are potential risk factors.
- These factors may also be a consequence of in utero hepatoblastoma development.
