Bjørge Tone, Cnattingius Sven, Lie Rolv Terje, Tretli Steinar, Engeland Anders
Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, N-5018 Bergen, Norway.
Cancer Epidemiol Biomarkers Prev. 2008 Mar;17(3):500-6. doi: 10.1158/1055-9965.EPI-07-2630. Epub 2008 Feb 22.
Cancer and birth defects may share factors that influence risk. A malformation may involve physiologic changes or changes in lifestyle that might affect cancer risks.
In Norway and Sweden, the population-based medical birth and cancer registries were linked to identify subsequent cancer occurrence in children with birth defects and among their parents and siblings. Altogether, 5.2 million children and their families were included. The standardized incidence ratio (SIR) served as a measure of relative risk.
There was an increased overall cancer risk in individuals with birth defects in the two countries [SIR, 1.7; 95% confidence interval (95% CI), 1.6-1.9], and the increased risk remained into early adulthood. Individuals with malformations in the nervous system were at increased risk of developing cancer in the brain/nervous system (Norway: SIR, 58; 95% CI, 41-80; Sweden: SIR, 8.3; 95% CI, 4.0-15), individuals with Down syndrome were at an increased risk of leukemia (Norway: SIR, 36; 95% CI, 26-48; Sweden: SIR, 36; 95% CI, 28-46), and there was an increased overall cancer risk for individuals with multiple birth defects (Norway: SIR, 5.5; 95% CI, 3.3-8.7; Sweden: SIR, 3.6; 95% CI, 2.2-5.4). There was no increased overall cancer risk among mothers (SIR, 1.0; 95% CI, 1.0-1.0), fathers (SIR, 1.0; 95% CI, 0.9-1.0), and siblings (SIR, 1.0; 95% CI, 0.9-1.1) of children with birth defects.
We observed an increased overall cancer risk in individuals with birth defects. The highest risks were seen for individuals with malformations in the nervous system, Down syndrome, and multiple defects. No increased overall cancer risk was seen among their parents or siblings.
癌症和出生缺陷可能有共同的风险影响因素。一种畸形可能涉及生理变化或生活方式的改变，而这些可能会影响癌症风险。
在挪威和瑞典，将基于人群的医学出生登记和癌症登记相链接，以确定有出生缺陷的儿童及其父母和兄弟姐妹随后患癌症的情况。总共纳入了520万儿童及其家庭。标准化发病比（SIR）用作相对风险的衡量指标。
在这两个国家，有出生缺陷的个体总体患癌风险增加[SIR，1.7；95%置信区间（95%CI），1.6 - 1.9]，且这种增加的风险一直持续到成年早期。神经系统有畸形的个体患脑/神经系统癌症的风险增加（挪威：SIR，58；95%CI，41 - 80；瑞典：SIR，8.3；95%CI，4.0 - 15），唐氏综合征患者患白血病的风险增加（挪威：SIR，36；95%CI，26 - 48；瑞典：SIR，36；95%CI，28 - 46），有多种出生缺陷的个体总体患癌风险增加（挪威：SIR，5.5；95%CI，3.3 - 8.7；瑞典：SIR，3.6；95%CI，2.2 - 5.4）。有出生缺陷儿童的母亲（SIR，1.0；95%CI，1.0 - 1.0）、父亲（SIR，1.0；95%CI，0.9 - 1.0）和兄弟姐妹（SIR，1.0；95%CI，0.9 - 1.1）总体患癌风险没有增加。
我们观察到有出生缺陷的个体总体患癌风险增加。神经系统有畸形、唐氏综合征和有多种缺陷的个体风险最高。在他们的父母或兄弟姐妹中未观察到总体患癌风险增加。
