Cancer and Population Studies Group, Queensland Institute of Medical Research, Royal Brisbane Hospital, QLD, Australia.
Int J Cancer. 2013 Dec 15;133(12):2953-60. doi: 10.1002/ijc.28300. Epub 2013 Jun 29.
A small proportion of childhood cancer is attributable to known hereditary syndromes, but whether there is any familial component to the remainder remains uncertain. We explored familial aggregation of cancer in a population-based case-control study using genealogical record linkage and designed to overcome limitations of previous studies. Subjects were selected from the Utah Population Database. We compared risk of cancer in adult first-degree relatives of children who were diagnosed with cancer with the risk in relatives of children who had not had a cancer diagnosed. We identified 1,894 childhood cancer cases and 3,788 controls; 7,467 relatives of cases and 14,498 relatives of controls were included in the analysis. Relatives of children with cancer had a higher risk of cancer in adulthood than relatives of children without cancer [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.11-1.56]; this was restricted to mothers and siblings and was not evident in fathers. Familial aggregation appeared stronger among relatives of cases diagnosed before 5 years of age (OR 1.48, 95% CI 1.13-1.95) than among relatives of cases who were older when diagnosed (OR 1.22, 95% CI 0.98-1.51). These findings provide evidence of a generalized excess of cancer in the mothers and siblings of children with cancer. The tendency for risk to be higher in the relatives of children who were younger at cancer diagnosis should be investigated in other large data sets. The excesses of thyroid cancer in parents of children with cancer and of any cancer in relatives of children with leukemia merit further investigation.
一小部分儿童癌症归因于已知的遗传性综合征，但其余部分是否存在家族成分仍不确定。我们使用系谱记录链接在基于人群的病例对照研究中探讨了癌症的家族聚集性，并设计该研究以克服以往研究的局限性。研究对象选自犹他州人口数据库。我们比较了诊断患有癌症的儿童的一级亲属患癌症的风险与未诊断出癌症的儿童的亲属的风险。我们确定了 1894 例儿童癌症病例和 3788 例对照病例；纳入了 7467 例病例亲属和 14498 例对照亲属进行分析。癌症患儿的亲属在成年后患癌症的风险高于无癌症患儿的亲属（比值比[OR] 1.31，95%置信区间[CI] 1.11-1.56）；这种情况仅限于母亲和兄弟姐妹，而在父亲中并不明显。与诊断年龄较大的病例（OR 1.22，95%CI 0.98-1.51）相比，5 岁以下诊断的病例（OR 1.48，95%CI 1.13-1.95）的亲属中家族聚集现象更为明显。这些发现为癌症患儿的母亲和兄弟姐妹中普遍存在癌症过度发生提供了证据。在癌症诊断时年龄较小的患儿亲属中风险更高的趋势应在其他大型数据集进行调查。癌症患儿父母的甲状腺癌发病率过高和白血病患儿亲属的任何癌症发病率过高都值得进一步研究。
