Epidemiology & Genetics Unit, Department of Health Sciences and Hull & York Medical School, University of York, York, UK.
Cancer Epidemiol. 2009 Nov;33(5):363-7. doi: 10.1016/j.canep.2009.10.012. Epub 2009 Nov 22.
Birth weight has been linked to the risk of developing childhood cancer, in particular childhood leukaemia. However, despite many childhood cancers having a male predominance and boys generally weighing more than girls at birth few studies have reported sex-specific associations. The relationship between birth weight and childhood cancer risk was examined using information from a national case-control study. Children (0-14 years) newly diagnosed with cancer in GB were ascertained between 1991 and 1996 (n=3651) and for comparison, controls matched on sex, month and year of birth were identified from primary care population registers (n=6337). Birth weights were obtained from the Office of National Statistics for all targeted subjects born in England and Wales. Overall, cases were, on average, 30 g heavier at birth than controls (p=0.003) with differences seen by cancer type; those diagnosed with hepatic tumours weighing around 500 g less than controls at birth (p<0.0001) and those with leukaemia being, on average, 50 g heavier than those without (p=0.001). An interaction between birth weight and sex was found for acute leukaemia (chi(2)=11.2, p=0.04) and when data were stratified by sex, an association between high birth weight and risk of ALL was seen with girls (>4000 g, OR 1.86, 95% CI 1.38-2.50, chi(2) for trend 20.2, p<0.0001). Our results support the hypothesis that birth weight is an important determinant for childhood cancer. In addition, the data are consistent with the notion that childhood leukaemia has a prenatal origin.
出生体重与儿童癌症风险相关,尤其是儿童白血病。然而,尽管许多儿童癌症具有男性优势,而且男孩的出生体重通常比女孩重,但很少有研究报告性别特异性关联。本研究使用全国病例对照研究的信息,来检验出生体重与儿童癌症风险之间的关系。1991 年至 1996 年期间,在英国(GB)新诊断出的儿童癌症患者(0-14 岁)(n=3651)被确定为病例,为了进行比较,在初级保健人群登记册中按性别、出生月份和年份匹配了对照组(n=6337)。所有出生于英格兰和威尔士的目标人群的出生体重数据均从国家统计局获得。总体而言,病例组的出生体重比对照组平均重 30 克(p=0.003),不同癌症类型的差异如下:肝肿瘤患儿的出生体重比对照组低约 500 克(p<0.0001),白血病患儿的出生体重比无白血病患儿平均重 50 克(p=0.001)。在急性白血病中发现了出生体重与性别的相互作用(chi(2)=11.2,p=0.04),当按性别分层数据时,发现高出生体重与 ALL 风险之间存在关联,女孩(>4000 克,OR 1.86,95%CI 1.38-2.50,趋势检验的 chi(2)为 20.2,p<0.0001)。我们的结果支持出生体重是儿童癌症的一个重要决定因素的假设。此外,这些数据与儿童白血病具有产前起源的观点一致。