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儿童癌症的季节性。

Seasonality in Pediatric Cancer.

机构信息

Division of Hematology Oncology, Department of Pediatrics, IWK Health Centre, 5850/5980 University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada.

Perinatal Epidemiology Research Unit, Departments of Pediatrics and Obstetrics & Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Indian J Pediatr. 2018 Sep;85(9):785-787. doi: 10.1007/s12098-017-2561-4. Epub 2017 Dec 14.

Abstract

Although seasonal trends in incidence and diagnosis of pediatric cancers have been widely investigated, the results have been inconclusive. A consistent seasonal trend may possibly provide etiological insights into pediatric cancers. This study aims to determine if there is a seasonal variation in cancer diagnoses in the pediatric population at the IWK Health Centre, a tertiary care center serving three Canadian provinces: Nova Scotia, New Brunswick, and Prince Edward Island. All pediatric cancer patients aged 0-20 y diagnosed from 1995 to 2015 at the center were included in this study. The annual data was divided into four seasonal periods (December to February, March to May, June to August, and September to November). The cancer diagnoses were categorized as leukemia, lymphoma, sarcoma, brain tumors, and miscellaneous. Seasonal variation was assessed by a harmonic function in a Poisson regression model. The amplitude of multiplicative change in the incidence rate caused by the seasonal variation is expressed as the incidence rate ratio (IRR). For all cancer diagnoses for the entire cohort of 1200 patients, the IRR was 1.03 [95% confidence interval (CI) 0.96-1.13]. None of the IRRs for the cancer groups indicated a statistically significant seasonality of cancer diagnosis: Leukemia 1.11 (95% CI 0.96-1.28); Lymphoma 1.17 (95% CI 0.93-1.47); Sarcoma 1.29 (95% CI 0.99-1.69); Brain tumors 1.16 (95% CI 0.97-1.38); Miscellaneous 1.09 (95% CI 0.93-1.27). The present study did not show a seasonal variation in the various cancer types in the pediatric population at the IWK.

摘要

尽管儿童癌症的发病和诊断季节性趋势已被广泛研究,但结果尚无定论。一致的季节性趋势可能为儿童癌症的病因提供线索。本研究旨在确定在 IWK 健康中心,一家为三个加拿大省:新斯科舍省、新不伦瑞克省和爱德华王子岛提供服务的三级保健中心,儿科人群中的癌症诊断是否存在季节性变化。本研究纳入了该中心 1995 年至 2015 年间诊断为 0-20 岁的所有儿科癌症患者。将年度数据分为四个季节性时期(12 月至 2 月、3 月至 5 月、6 月至 8 月和 9 月至 11 月)。癌症诊断分为白血病、淋巴瘤、肉瘤、脑肿瘤和其他。采用泊松回归模型中的谐波函数评估季节性变化。季节性变化引起的发病率变化的倍增幅度表示为发病率比(IRR)。对于整个 1200 例患者队列的所有癌症诊断,IRR 为 1.03(95%置信区间 0.96-1.13)。癌症组的任何 IRR 均未表明癌症诊断具有统计学意义的季节性:白血病 1.11(95%置信区间 0.96-1.28);淋巴瘤 1.17(95%置信区间 0.93-1.47);肉瘤 1.29(95%置信区间 0.99-1.69);脑肿瘤 1.16(95%置信区间 0.97-1.38);其他 1.09(95%置信区间 0.93-1.27)。本研究未显示 IWK 儿科人群中各种癌症类型的季节性变化。

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