Clavel Jacqueline
Inserm, UMR-S754, IFR 69, épidémiologie environnementale des cancers, Registre national des hémopathies malignes de l'enfant, 94807 Villejuif Cedex.
Rev Prat. 2007 May 31;57(10):1061, 1064, 1067-9.
In industrial countries, 1 child out of 500 develops a cancer before the age of 15 years, and before the age of 6 years for almost half of them. In France, incidence rates were stable over the 15 last years with around 1500 cases each year. A very small fraction of cases is attributable to known risk factors, including heritable cancers or cancers in children with heritable predisposing diseases, cancers induced by high doses of ionizing radiation of medical or accidental origin, by chemotherapeutic or immunosuppressive drugs. Responsibility of Epstein Barr virus in a fraction of Hodgkin's and Burkitt's lymphomas is also established, even though little is still known on the cofactors involved in industrial countries. Other virus could cause leukaemia, as suggested by localized increases in incidence in various conditions of population mixing. Conversely, there is some evidence that early common infections could be protective toward leukaemia risk, probably through their contribution to the maturation of the immune system. Several agents are suspected to induce chemical cancers, particularly pesticides, which are consistently reported in childhood leukaemia and brain tumours. It is more and more likely that genetic factors may modulate risk induced of environmental factors.
在工业化国家，每500名儿童中有1名在15岁前患癌症，其中近一半在6岁前发病。在法国，过去15年发病率保持稳定，每年约有1500例病例。极小一部分病例可归因于已知风险因素，包括遗传性癌症或患有遗传性易感疾病儿童的癌症、由高剂量医疗或意外来源的电离辐射、化疗或免疫抑制药物诱发的癌症。尽管在工业化国家，对于与爱泼斯坦-巴尔病毒相关的辅助因素仍知之甚少，但该病毒在一部分霍奇金淋巴瘤和伯基特淋巴瘤中的作用也已得到证实。其他病毒可能导致白血病，不同人群混合情况下发病率的局部上升表明了这一点。相反，有证据表明，早期常见感染可能对白血病风险具有保护作用，这可能是通过它们对免疫系统成熟的促进作用实现的。有几种物质被怀疑会诱发化学致癌，特别是农药，儿童白血病和脑肿瘤中经常有农药的报道。遗传因素越来越有可能调节环境因素诱发的风险。
