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Risk of childhood cancer for infants with birth defects. I. A record-linkage study, Atlanta, Georgia, 1968-1988
F Mili1, M J Khoury, W D Flanders
1National Center for Environmental Health, Centers for Disease Control, Atlanta, GA.
Insights
Children with serious birth defects have an increased risk of developing certain childhood cancers. This study found a higher incidence of cancer in infants with congenital anomalies, particularly acute leukemia in those with Down's syndrome.
Area of Science:
- Pediatric Oncology
- Birth Defects Research
- Epidemiology
Background:
- Birth defects are common congenital anomalies.
- Childhood cancer is a significant health concern.
- Understanding the relationship between birth defects and cancer is crucial for early detection and prevention.
Purpose of the Study:
- To investigate the association between serious birth defects and the risk of childhood cancer.
- To identify specific birth defects linked to increased cancer incidence.
- To explore potential common mechanisms in teratogenesis and carcinogenesis.
Main Methods:
- Linked population-based birth defect registry data with cancer registry data in Georgia.
- Analyzed cancer diagnoses in children with diagnosed birth defects from 1975 to 1988.
- Calculated standardized incidence ratios (SIR) and confidence intervals (CI) to assess cancer risk.
Main Results:
- 31 out of 19,373 infants with birth defects developed cancer (SIR = 2.2, 95% CI 1.5-3.2).
- Children with Down's syndrome (trisomy 21) had a significantly increased risk of acute leukemia (SIR = 50.8, 95% CI 10.5-148.5).
- Children with pyloric stenosis showed an elevated risk of cancer (SIR = 7.5, 95% CI 2.0-19.3).
Conclusions:
- Selected birth defects are associated with an increased risk of specific childhood cancers.
- Record-linkage studies are valuable for discovering novel associations between congenital anomalies and cancer.
- Further research into common underlying mechanisms may advance understanding of both teratogenesis and carcinogenesis.
Abstract:
To evaluate the risk of childhood cancer among infants with serious birth defects, the authors linked records of the population-based registry of the Georgia Center for Cancer Statistics for 1975 to 1988 with records of the population-based Metropolitan Atlanta Congenital Defects Program for 1968 to 1987. During the study period, birth defects were diagnosed in 19,373 infants younger than 1 year of age, and cancer was diagnosed in 400 children younger than 15 years of age. The observed number of children with a defect who developed cancer was compared with the number expected on the basis of the cancer registry rates. Of the 19,373 children with birth defects, 31 developed cancer (standardized incidence ratio (SIR) = 2.2, 95% confidence interval (CI) 1.5-3.2). Two associations were found: of 532 children with Down's syndrome (trisomy 21), three developed acute leukemia (SIR = 50.8, 95% CI 10.5-148.5) while of 746 children with pyloric stenosis, four developed cancer (SIR = 7.5, 95% CI 2.0-19.3). These data show that children with selected birth defects are at increased risk for specific childhood cancers. Such record-linkage can reveal new associations, which can in turn help researchers understand underlying mechanisms common to teratogenesis and carcinogenesis.