Marquant Fabienne, Goujon Stéphanie, Faure Laure, Guissou Sandra, Orsi Laurent, Hémon Denis, Lacour Brigitte, Clavel Jacqueline
Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France.
French National Registry of Childhood Haematological Malignancies (NRCH), Villejuif, France.
Paediatr Perinat Epidemiol. 2016 Nov;30(6):612-622. doi: 10.1111/ppe.12313. Epub 2016 Aug 24.
Socio-economic status is related to many life style and environmental factors, some of which have been suggested to influence the risk of childhood cancer. Studies requiring subject participation are usually hampered by selection of more educated parents. To prevent such bias, we used unselected nationwide Geographical Information System (GIS)-based registry data, to investigate the influence of socio-economic disparities on the risk of childhood cancer.
The Geocap study included all French residents diagnosed with cancer aged up to 15 years over the period 2002-2010 (15 111 cases) and 45 000 contemporaneous controls representative of the childhood population. Area socio-economic characteristics used to calculate the European Deprivation Index (EDI) were based on census data collected on the fine scale of the Merged Islet for Statistical Information (IRIS).
Overall, the risk of acute lymphoblastic leukaemia (ALL) was lower in the most deprived quintile than in the other quintiles of EDI (OR 0.80 (95% confidence interval (CI) 0.73, 0.88)). The odds ratio for all the other cancers taken together was close to the null (OR 0.99 (95% CI 0.94, 1.04)).
Living in the most deprived areas was inversely associated with the risk of ALL in childhood. There was no indication that the risk of childhood cancer of any site could be increased by deprivation. Life style or environmental factors potentially underlying the association need further investigation.
社会经济地位与多种生活方式和环境因素相关,其中一些因素被认为会影响儿童患癌症的风险。需要受试者参与的研究通常会因选择受教育程度较高的父母而受到阻碍。为避免此类偏差,我们使用了基于全国范围且未经筛选的地理信息系统(GIS)登记数据,来研究社会经济差异对儿童癌症风险的影响。
地理区域能力研究纳入了2002年至2010年期间所有年龄在15岁及以下被诊断患有癌症的法国居民(15111例病例)以及45000名代表儿童人口的同期对照。用于计算欧洲贫困指数(EDI)的地区社会经济特征基于在合并统计信息岛(IRIS)精细尺度上收集的人口普查数据。
总体而言,在最贫困的五分位数组中患急性淋巴细胞白血病(ALL)的风险低于EDI的其他五分位数组(比值比[OR]为0.80[95%置信区间(CI)为0.73,0.88])。所有其他癌症合并在一起的比值比接近无效值(OR为0.99[95%CI为0.94,1.04])。
生活在最贫困地区与儿童患ALL的风险呈负相关。没有迹象表明贫困会增加儿童任何部位患癌症的风险。该关联潜在的生活方式或环境因素需要进一步研究。