Childhood cancer and parental occupation in the Swedish Family-Cancer Database.

We used the nationwide Swedish Family-Cancer Database to analyze the risk for common childhood tumors in offspring in relation to parental occupation recorded in the census of 1960. A total of 8158 cancer cases, diagnosed before age 15 between years 1958 and 1996, were included. Standardized incidence ratios were calculated using 52 different parental occupations. Among the maternal occupations, seven were associated with the risk of cancer in offspring. Assistant nurses had an excess of children with leukemia and connective tissue and colon cancers. Children of female cooks had brain cancers at a rate greater than expected. Fifteen different malignancies were associated with children of male workers. Shoe and leathers workers' children had excesses of many tumors. Among the other paternal occupations associated with childhood tumors, miners, quarrymen, and hairdressers were likely to be exposed to harmful dusts and chemicals.     

Differential loss of humoral immunity against measles,mumps, rubella and varicella-zoster virus in children treated for cancer

BackgroundIntensive chemotherapy in children with cancer results in long-term impairment of humoral immunity. Whereas most studies to date focused on children with acute lymphoblastic leukemia (ALL), little data have been published on patients suffering from Hodgkin disease or from solid tumors. We therefore analyzed the loss of protective immunity (defined as immunity at the time of diagnosis and lack of immunity after completion of therapy) against vaccine-preventable diseases in children treated for various malignancies.MethodsChildren and adolescents <21 years of age at diagnosis and treated between 2001 and 2010 for various malignancies in the Department of Pediatric Hematology and Oncology, University of Frankfurt, were included in the retrospective chart review. Antibody levels against measles, mumps, rubella and varicella-zoster-virus (VZV) were routinely assessed at the time of diagnosis and within 12 months after completion of therapy.ResultsThe study population consisted of 195 children (122 male); 80 patients had ALL, 15 acute myelogenous leukemia (AML), 18 non-Hodgkin lymphoma (NHL), 22 Hodgkin disease, and 60 various solid tumors. Overall, 27%, 47%, 19%, and 17% of the patients lost their humoral immunity against measles, mumps, rubella, and VZV, respectively. The risk of losing protective antibody titers depended on age with a higher risk in younger children. The loss of protective humoral immunity occurred significantly more often in patients with ALL compared to patients with any other underlying malignant disease (hematological malignancies such AML and NHL, Hodgkin disease or solid tumors).ConclusionsOur data demonstrate that a significant number of children lose pre-existing humoral immunity against measles, mumps, rubella, and VZV after completion of chemotherapy. This loss occurs more often in children with ALL than in children with AML, solid tumors and Hodgkin disease. Our results underline the need for post-chemotherapy revaccination of childhood cancer survivors.     

Strontium-90 in deciduous teeth as a factor in early childhood cancer.

Strontium-90 concentrations in deciduous (baby) teeth of 515 children born mainly after the end of worldwide atmospheric nuclear bomb tests in 1980 are found to equal the concentrations in children born during atmospheric tests in the late 1950s. Recent Sr-90 concentrations in the New York-New Jersey-Long Island metropolitan area have exceeded the expected downward trend seen in both baby teeth and adult bone after the 1963 ban on atmospheric testing. Sharp rises and declines are also seen in Miami, Florida. In Suffolk County, Long Island, Sr-90 concentrations in baby teeth were significantly correlated with cancer incidence for children 0 to 4 years of age. A similar correlation of childhood malignancies with the rise and decline of Sr-90 in deciduous teeth occurred during the peak years of fallout in the 1950s and 1960s. Independent support for the relation between nuclear releases and childhood cancer is provided by a significant correlation with total alpha and beta activities in local surface water in Suffolk County. These results strongly support a major role of nuclear reactor releases in the increase of cancer and other immune-system-related disorders in young American children since the early 1980s.     

Cancer near the Three Mile Island nuclear plant: radiation emissions

As a public charge, cancers among the 159,684 residents living within a 10-mile (16-km) radius of the Three Mile Island nuclear plant were studied relative to releases of radiation during the March 28, 1979, accident as well as to routine plant emissions. The principal cancers considered were leukemia and childhood malignancies. Estimates of the emissions delivered to small geographic study tracts were derived from mathematical dispersion models which accounted for modifying factors such as wind and terrain; the model of accident emissions was validated by readings from off-site dosimeters. Incident cancers among area residents for the period 1975-1985 (n = 5,493) were identified by a review of the records at all local and regional hospitals; preaccident and postaccident trends in cancer rates were examined. For accident emissions, the authors failed to find definite effects of exposure on the cancer types and population subgroups thought to be most susceptible to radiation. No associations were seen for leukemia in adults or for childhood cancers as a group. For leukemia in children, the odds ratio was raised, but cases were few (n = 4), and the estimate was highly variable. Moreover, rates of childhood leukemia in the Three Mile Island area are low compared with national and regional rates. For exposure to routine emissions, the odds ratios were raised for childhood cancers as a whole and for childhood leukemia, but confidence intervals were wide and included 1.0. For leukemia in adults, there was a negative trend. Trends for two types of cancer ran counter to expectation. Non-Hodgkin's lymphoma showed raised risks relative to both accident and routine emissions; lung cancer (adjusted only indirectly for smoking) showed raised risks relative to accident emissions, routine emissions, and background gamma radiation. Overall, the pattern of results does not provide convincing evidence that radiation releases from the Three Mile Island nuclear facility influenced cancer risk during the limited period of follow-up.     

Medical complications of anorexia nervosa in children and adolescents

Anorexia nervosa in children and adolescents is still a serious cause of morbidity and mortality which may result in premature death or life-long medical and psychosocial morbidity. This condition can cause significant medical complications in every organ system of the growing and developing body. Although many of these medical complications improve with nutritional rehabilitation and recovery from the disorder some are potentially irreversible. This article summarizes the evidence based literature on medical complications that has been specially studied in child and adolescent population with anorexia nervosa over the past two decades. This review of the literature focuses on the acute symptoms of anorexia nervosa with special emphasis on the fluid and electrolyte levels and refeeding syndrome, and details the cardiovascular complications. Summarizes the special alterations in childhood and adolescent anorexia nervosa such as impaired bone mineral accretion and the possible therapeutic interventions of osteopenia and alterations in linear growth. The reviewed literature suggests that the medical complications in adolescents with anorexia nervosa are different from those reported in the adult population. The unique clinical presentation, the early onset and the unknown impact of these complications underline the need for early identification and early efficient treatment of anorexia nervosa in adolescents. There is an increasing number of evidence that highlight the importance of interdisciplinary teams of healthcare providers in the identification and in the therapy of adolescent anorexia nervosa as well.     

Einfluss von k?rperlicher Aktivit?t und Sport auf die Knochengesundheit im Lebenslauf

Physical activity and exercise are important determinants for metabolic and cardiovascular health. They also play an important role for bone health in childhood, adolescence, and adulthood. This review summarizes results from observational and intervention studies which evaluated the association between physical activity/exercise and bone health in different life course stages. In childhood and adolescence, physical activity and exercise induce improved bone accrual. In adulthood, mainly in postmenopausal women, long-term exercise programs reduce age-related bone loss. Especially weight-bearing activities seem to have an important osteogenic effect. Children and adolescent show a higher bone accrual until 5 years after cessation of an exercise program compared to their peers, who do not participate in an exercise program. In contrast, adults who quit exercising have a higher decrease in bone stiffness compared to adults who never exercised. This effect was particularly seen in postmenopausal women. Continuous physical activity and exercise over the life course and the implementation of exercise programs in schools and community-based intervention programs can help prevent or even reduce osteoporosis and osteoporosis-related fractures. Due to the lack of prospective longitudinal studies, the supposed long-term sustainable protective effect of physical activity and exercise in childhood and adolescent on bone health in later adulthood is not well established.     

Leukemia and non-Hodgkin's lymphoma in childhood and exposure to pesticides: results of a register-based case-control study in Germany

Previous studies have suggested an association between exposure to pesticides and different types of childhood cancer. This paper presents results from a population-based case-control interview study of parents of children less than 15 years of age, which was conducted in the states of West Germany from 1993 to 1997. Cases were 1,184 children with leukemia, 234 with non-Hodgkin's lymphoma, and 940 with a solid tumor; 2,588 controls were also included. Parental occupational exposures were found to be related to childhood cancer regardless of the time period of exposure and the type of cancer. This finding might partially be explained by different recall of past exposures by the parents of cases and controls. Residential use of insecticides was associated with childhood lymphoma: both extermination of insects by professional pest controllers (odds ratio (OR) = 2.6, 95% confidence interval (CI): 1.2, 5.7) and frequency of parental use of household insecticides (p for trend = 0.02) were significant risk factors for this diagnosis. The use of pesticides on farms was weakly related to childhood leukemia (OR = 1.5, 95% CI: 1.0, 2.2), while their use in gardens was not associated with childhood leukemia (OR = 1.0, 95% CI: 0.8, 1.2). The major strengths of this study were the population base and the large number of cases and controls included; a drawback was assessment of exposure on the basis of parental interviews. The data provide some evidence for an increased leukemia risk for children living on farms and for an association between use of household pesticides and risk of childhood leukemia or lymphoma.     

Breastfeeding,Other Early Life Exposures and Childhood Leukemia and Lymphoma

Childhood cancer incidence increases and although rare, it is a leading cause of mortality. Leukemia and lymphoma comprise 40% of all cancers in children but little is known of their etiology. In this study, we examined the associations of breastfeeding and other early life exposures with childhood leukemia and lymphoma. A population-based case–control study carried out in 2011–2013 comprised mothers of 190 incidents (2005–2013) of leukemia/lymphoma cases aged 1–19 yr at diagnosis and 384 population-based controls. Interviews based on a computerized structured questionnaire were conducted with the mothers. Multivariate logistic regression models adjusted for potential confounders assessed the association between breastfeeding patterns and childhood leukemia/lymphoma. Ever breastfeeding category was associated with a 64% decreased risk for childhood leukemia/lymphoma lsqb;odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.22, 0.60lrqb; and similar trends, with a dose–response effect, were observed for any breastfeeding (exclusive and/or partial) category for 6, 12, and 18+ mo. Other infant exposures associated with cancer risk were child iron supplementation (OR = 0.39, 95% CI: 0.26, 0.59), pet ownership (OR = 0.50, 95% CI: 0.33, 0.78), paternal smoking (OR = 1.93, 95% CI: 1.18, 3.15), and having older siblings (OR = 1.18, 95% CI: 1.05, 1.33). Breastfeeding—a controllable and modifiable exposure—is inversely associated with risk for childhood leukemia and lymphoma with a dose–response effect.     

Costs for Childhood and Adolescent Cancer, 90 Days Prediagnosis and 1 Year Postdiagnosis: A Population-Based Study in Ontario,Canada

Background

Childhood and adolescent cancers are uncommon, but they have important economic and health impacts on patients, families, and health care systems. Few studies have measured the economic burden of care for childhood and adolescent cancers.

Fifty years of paediatric malignant bone tumours in the West Midlands,UK, 1957–2006: incidence,treatment and outcome

Parkes SE, Parke S, Manghan DC, Grimer RJ, Davies P, Morland BJ. Fifty years of paediatric malignant bone tumours in the West Midlands, UK, 1957–2006: incidence, treatment and outcome. Paediatric and Perinatal Epidemiology 2010. Malignant bone tumours in the paediatric age group (0–14 years) are uncommon; various aetiological theories exist and few reports of incidence, age and sex distributions have been published. We examined the incidence of childhood malignant bone tumours in one large single region of the UK over an extended period of 50 years. The West Midlands specialist regional children's tumour registry holds data on all malignancies and benign brain tumours in children under 15 years in the West Midlands region, which has a population of around 1 million children. Demographic and clinical data have been abstracted and diagnoses reviewed by a panel of expert pathologists. During the period 1957–2006, 259 cases of malignant paediatric bone tumours were diagnosed. There were 153 osteosarcomas, 78 Ewing sarcomas and 28 other primary bone tumours. The overall age standardised rate was 4.66, with no increase over time, although there was a significant increase in the incidence of Ewing sarcomas in the period 1965–92. Sixty‐eight per cent of tumours were in patients over 10 years, whereas the incidence in patients under 10 years showed a non‐significant increase. Survival rates increased dramatically post‐chemotherapy introduction, with Ewing sarcoma demonstrating better survival overall. This is a large study giving an overview of malignant bone tumours in the childhood population of a single region over an extended period, showing results consistent with national reports. It also examines late effects, which were mostly mobility/orthopaedic, although almost one‐fifth of patients had cardiac problems and five went on to develop second malignancies.     

Acute lymphocytic leukemia in the adolescent: diagnosis, treatment, and outcomes

Leukemia remains the most common cancer in childhood, and while great strides have been made in increasing event-free survival in the past 20 years, patients with high-risk features still pose a challenge for successful disease-free survival. Older children and adolescents are included in that high-risk group. Approximately 80-85% of cases of leukemia in the pediatric population are of the lymphocytic subtype. Overall disease-free survival rates for acute lymphocytic leukemia have increased to 80% for those with standard or low-risk disease and 65-70% for those with high-risk disease. This is a product of both a better understanding of the molecular pathophysiology of ALL and the development of better treatment strategies based on risk. In acute myelogenous leukemia, we have not achieved such success, and disease-free survival rates are in the 30-40% range. This article discusses the diagnosis of leukemia in the adolescent population with attention to pathogenesis, prognostic risk factors, therapy, outcome, and late effects of acute lymphocytic leukemia.     

Second neoplasms in survivors of childhood and adolescent cancer are often treatable.

PURPOSE: To estimate the incidence and types of second neoplasms in survivors of childhood and adolescent cancer, as well as the characteristics of those who developed second neoplasms. METHODS: Survivors who were under age 21 years at initial diagnosis, off therapy, and in remission for 2 years are referred to the Long Term Survivors' Clinic (LTSC) at Children's National Medical Center (CNMC). This review includes patients entered in the clinic database from January 1, 1997 to August 30, 2002. RESULTS: Twenty-three (2.3%) of 987 childhood cancer survivors followed in the LTSC had 26 (2.6%) second and third neoplasms. The mean age was 6.7 years at initial diagnosis, 20.3 years at diagnosis of the second neoplasm, and 20.5 years at diagnosis of the third neoplasm. Of 10 female and 13 male patients, 15 were white, six black, one Hispanic, and one Asian. All but two of the patients received radiation. Nineteen neoplasms, including seven thyroid carcinomas, six central nervous system tumors (three meningiomas), three basal cell carcinomas, two breast cancers, and one soft tissue sarcoma, occurred at sites within or contiguous to radiation sites. Five patients died, but the majority of neoplasms were treatable and most patients had good outcomes. CONCLUSION: Indefinite follow-up in a long-term survivors' clinic is indicated for adolescent and adult survivors of childhood cancer, with routine examination and screening for recurrence of the initial cancer as well as late effects, including second neoplasms.     

Cancer incidence among Hispanic children in the United States.

OBJECTIVE: To directly compare cancer incidence among Hispanic children and non-Hispanic white children in California and Florida, two states in the United States of America that include nearly one in three Hispanic children in the country.METHODS: Cross-sectional data for 1988 through 1998 pertaining to all incident pediatric cancer cases (age < 15 years) with race/ethnicity coded as either Hispanic or non-Hispanic white came from the Florida Cancer Data System database and the California Cancer Registry database. The results were expressed as age-standardized incidence rates, standardized to the world standard million population. Hispanic rates and non-Hispanic white rates were compared using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs.).RESULTS: The SIR for all cancers for Hispanic children compared to non-Hispanic white children was 1.02 (95% CI: 0.99, 1.05). For selected tumor types, SIRs indicated higher incidences among Hispanic children for leukemia (SIR = 1.26; 95% CI: 1.19, 1.34), Hodgkin's lymphoma (SIR = 1.29; 95% CI: 1.08, 1.54), and germ cell tumors (SIR = 1.62; 95% CI: 1.34, 1.96). There were lower incidences for the Hispanic children for central nervous system tumors (SIR = 0.72; 95% CI: 0.66, 0.78) and for sympathetic nervous system tumors (SIR = 0.76; 95% CI: 0.66, 0.87). In terms of interstate differences, the incidence of lymphoma, central nervous system tumors, sympathetic nervous system tumors, and malignant bone tumors was highest among Hispanic youth in Florida; the incidence of hepatic tumors was highest among Hispanic youth in California.CONCLUSIONS: While the overall cancer incidence rate among Hispanic children was similar to that for non-Hispanic white children, significant differences for specific tumor types were identified. Since Hispanic ethnicity may be a confounder for other cancer risk factors (e.g., familial, socioeconomic, or environmental), it is recommended that future research into Hispanic pediatric cancer risk investigate these risk factors.     

The Childhood Cancer Survivor Study: a resource for research of long-term outcomes among adult survivors of childhood cancer

Improvements in the treatment of the cancers occurring among children and adolescents have resulted in a large number of patients achieving long-term survival. Treatment-related factors have been shown to have an impact on subsequent health status and quality of life, although there are limited data on survivors who are now 2 or more decades past treatment. The Childhood Cancer Survivor Study (CCSS) was established as a resource for investigating the long-term outcomes of a cohort of 5-year survivors of pediatric and adolescent cancer, who were diagnosed between 1970 and 1986. The CCSS consists of more than 14,000 active participants, including survivors of leukemia, brain tumors, Hodgkin's disease, non-Hodgkin's lymphoma, Wilms' tumor, neuroblastoma, soft-tissue sarcoma, and bone tumors, who have provided self-reported sociodemographicand health-related information. The survivor population has been found to be at increased risk of a broad spectrum of adverse outcomes, such as late mortality, second cancers, pulmonary complications, pregnancy loss, giving birth to offspring with low birth weights, and decreased educational attainment. The ongoing evaluation of large and diverse cohorts of cancer survivors, through resources such as the CCSS, will aid in further identifying high-risk individuals who should be the target of innovative intervention strategies.     

安徽省肿瘤登记地区2014年儿童肿瘤发病与死亡情况分析

目的 分析安徽省肿瘤登记地区2014年儿童(0~14岁)肿瘤发病与死亡情况,为制定儿童肿瘤的防治措施提供基础数据。方法 对儿童肿瘤资料进行分析,计算肿瘤发病(死亡)率和标化率,并进行城乡和性别之间的比较。结果 2014年安徽省肿瘤登记地区儿童肿瘤粗发病率为9.46/10⁵,中标率为8.90/10⁵;儿童肿瘤粗死亡率为4.02/10⁵,中标率为3.87/10⁵。白血病、中枢神经系统肿瘤、骨癌和淋巴瘤为安徽省儿童肿瘤主要发病与死亡癌种。城市儿童肿瘤发病率与死亡率低于农村,男童肿瘤发病率与死亡率高于女童。结论 要加强白血病、中枢神经系统肿瘤、骨癌和淋巴瘤重点儿童肿瘤的预防与控制工作,针对儿童肿瘤危险因素采取干预措施,减轻儿童肿瘤发病和死亡带来的严重疾病负担。     

Therapeutic Potential of Resveratrol in Lymphoid Malignancies

Natural products have always been sought as a dependable source for the cure of many fatal diseases including cancer. Resveratrol (RSV), a naturally occurring plant polyphenol, has been of recent research interest and is being investigated for its beneficial biological properties that include antioxidant, anti-inflammatory, proapoptotic, and growth inhibitory activities. These effects are mainly mediated by cell cycle arrest, upregulation of proapoptotic proteins, loss of mitochondrial potential, and generation of reactive oxygen species. Among the beneficial properties of RSV, the anticancer property has been of the prime focus and extensively explored during the last few years. Although reports exist on the chemopreventive role of RSV in many solid tumors, limited information is available on the antiproliferative activity of RSV in human lymphoma cells and experimental models. Potential mechanisms for its antiproliferative effect include induction of cell differentiation, apoptosis, and inhibition of DNA synthesis. In this review, the different kinds of lymphoid malignancies and the main mechanisms of cell death induced by resveratrol are discussed. The challenges are limiting in vivo experimental studies involving resveratrol. An attempt for the translation of this compound into a clinical drug also forms a part of this review.     

Pilot study of sodium phenylbutyrate as adjuvant in cyclophosphamide-resistant endemic Burkitt's lymphoma

Burkitt's lymphoma (BL) accounts for the majority of childhood malignancies seen in sub-Saharan Africa. In Malawi, cyclophosphamide (CPM), the mainstay of treatment for endemic BL, is effective in around 50% of cases. Evidence exists in support of an association between activation of replication of Epstein-Barr virus (EBV) in the tumour and response to this chemotheraupeutic agent. Phenylbutyrate (PB), approved for treatment of inborn errors of the urea cycle with minimal toxicity in children, induces EBV replication and cell lysis in BL-derived cell cultures. It has also shown some success as adjuvant in treatment of chronic leukaemia and lymphoma. We tested in African BL patients with CPM-resistant tumours, and thus unlikely to survive, the hypothesis that PB can reverse this resistance. A study of five patients showed PB before CPM to induce shrinkage of CPM-resistant tumours in two of them. Findings suggested that for this effect PB pre-treatment should be given for a week before CPM treatment. A larger study is indicated.     

Benzene as a leukemogenic and carcinogenic agent

Today there seems to be sufficient data to incriminate benzene as a potent carcinogenic agent causing leukemia, malignant lymphoma, multiple myeloma and lung cancer, as well as numerous disorders of the bone marrow depression. Other factors (such as genetic and individual susceptibility) may have a role in the development of these different types of malignancies and hematologic disorders. In this paper, data concerning all these problems are presented and discussed.     

Poliovirus vaccination during pregnancy, maternal seroconversion to simian virus 40, and risk of childhood cancer

Before 1963, poliovirus vaccine produced in the United States was contaminated with simian virus 40 (SV40), which causes cancer in animals. To examine whether early-life SV40 infection can cause human cancer, the authors studied 54,796 children enrolled in the US-based Collaborative Perinatal Project (CPP) in 1959-1966, 52 of whom developed cancer by their eighth birthday. Those children whose mothers had received pre-1963 poliovirus vaccine during pregnancy (22.5% of the children) had an increased incidence of neural tumors (hazard ratio = 2.6, 95% confidence interval: 1.0, 6.7; 18 cases) and hematologic malignancies (hazard ratio = 2.8, 95% confidence interval: 1.2, 6.4; 22 cases). For 50 CPP children with cancer and 200 CPP control children, the authors tested paired maternal serum samples from pregnancy for SV40 antibodies using a virus-like particle enzyme immunoassay and a plaque neutralization assay. Overall, mothers exhibited infrequent, low-level SV40 antibody reactivity, and only six case mothers seroconverted by either assay. Using the two SV40 assays, maternal SV40 seroconversion during pregnancy was not consistently related to children's case/control status or mothers' receipt of pre-1963 vaccine. The authors conclude that an increased cancer risk in CPP children whose mothers received pre-1963 poliovirus vaccine was unlikely to have been due to SV40 infection transmitted from mothers to their children.     

Childhood abuse and adolescent suicidality: a direct link and an indirect link through alcohol and substance misuse

Childhood abuse is responsible for a variety of outcomes that are characterized by maladjustment and maladaption. Two of the most significant results are suicide and alcohol and substance misuse. This paper explores the direct link between childhood abuse and adolescent suicide, the direct link between childhood abuse and adolescent alcohol and substance misuse, the indirect link between childhood abuse and adolescent suicide through alcohol and substance misuse, and finally implications of these links for practitioners working with adolescents who are experiencing or who have experienced childhood abuse. Both suicide and alcohol and substance misuse are prevalent in the adolescent population; however those adolescents who were victims of childhood abuse show an even greater prevalence of both suicidality and substance and alcohol misuse. Additionally adolescents who exhibit alcohol or substance misuse show greater rater of suicidality than those without alcohol and substance misuse. It appears that abuse is a risk factor for eventual suicidality. Practitioners working with children or adolescents who have experienced abuse need to work towards secondary prevention by identifying, predicting and treating those at risk for substance abuse and/or suicide; and those working with adolescents who are already abusing substances and/or are suicidal should work with the adolescent to identify and examine life events such as abuse that may have triggered the chain towards substance misuse and/or suicidal ideation.