Janitz Amanda E, Neas Barbara R, Campbell Janis E, Pate Anne E, Stoner Julie A, Magzamen Sheryl L, Peck Jennifer D
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
School of Nursing and Allied Health Sciences, Southwestern Oklahoma State University, Weatherford, Oklahoma.
Birth Defects Res A Clin Mol Teratol. 2016 Jul;106(7):633-42. doi: 10.1002/bdra.23494. Epub 2016 Mar 4.
Data-linkage studies have reported an association between congenital anomalies and childhood cancer. However, few studies have focused on the differences in the effect of congenital anomalies on cancer as a function of attained age. We aimed to examine associations between anomalies and childhood cancer as a function of attained age among children born in Oklahoma.
Data were obtained from the Oklahoma State Department of Health from 1997 to 2009 (n = 591,235). We linked Vital Statistics records for singleton deliveries to the Oklahoma Birth Defects Registry and the Oklahoma Central Cancer Registry using name and birth date. To assess the relation between anomalies and childhood cancer, we used Cox regression analysis allowing for a nonproportional hazards for anomalies as a function of age.
There were 23,368 (4.0%) children with anomalies and 531 (0.1%) children with cancer. When considering 3-year age intervals, we detected an increased hazard of any childhood cancer in children with anomalies compared with those without anomalies before 1 year of age (hazard ratio, 14.1; 95% confidence interval, 8.3-23.7) and at 3 years of age (hazard ratio, 2.3; 95% confidence interval, 1.6-3.2). The increased hazard declined with increasing time since birth, with the effect diminished by 6 years of age.
Our results were consistent with previous studies indicating an increased rate of childhood cancer among children with anomalies at younger ages. Furthermore, our study added a methodological refinement of assessing the effect of anomalies as a function of attained age. Birth Defects Research (Part A) 106:633-642, 2016. © 2016 Wiley Periodicals, Inc.
数据关联研究报告了先天性异常与儿童癌症之间的关联。然而，很少有研究关注先天性异常对癌症影响随年龄增长的差异。我们旨在研究俄克拉荷马州出生儿童中，先天性异常与儿童癌症之间随年龄增长的关联。
数据来自1997年至2009年俄克拉荷马州卫生部（n = 591,235）。我们使用姓名和出生日期将单胎分娩的生命统计记录与俄克拉荷马州出生缺陷登记处和俄克拉荷马州中央癌症登记处相链接。为了评估先天性异常与儿童癌症之间的关系，我们使用Cox回归分析，该分析考虑了先天性异常随年龄变化的非比例风险。
有23,368名（4.0%）儿童患有先天性异常，531名（0.1%）儿童患有癌症。当按3岁年龄间隔考虑时，我们发现先天性异常儿童在1岁前（风险比，14.1；95%置信区间，8.3 - 23.7）和3岁时（风险比，2.3；95%置信区间，1.6 - 3.2）患任何儿童癌症的风险高于无先天性异常的儿童。随着出生后时间的增加，风险增加的幅度下降，到6岁时影响减弱。
我们的结果与先前的研究一致，表明年龄较小的先天性异常儿童患儿童癌症的几率增加。此外，我们的研究在评估先天性异常随年龄增长的影响方面增加了方法上的改进。《出生缺陷研究（A部分）》106:633 - 642，2016年。© 2016威利期刊公司。
