Li F P, Jamison D S, Meadows A T
J Natl Cancer Inst. 1986 Jan;76(1):31-6.
Usefulness of an etiologic questionnaire was examined in an interview study of 503 children with cancer. The medical records of the children were abstracted, and their parents responded to a questionnaire-interview to identify genetic and environmental causes of cancer. Among 1,123 siblings of the index patients, 10 developed cancer as compared with 2 expected on the basis of cancer rates for the general population. Cancer risk factors were identified in individual patients with predisposing genetic and congenital disorders: neurofibromatosis (brain tumor), hereditary immunodeficiency (lymphoma), Down's syndrome (leukemia), XY gonadal dysgenesis (germ cell tumor), giant nevus (melanoma), and meningocele (sacral teratocarcinoma). Environmental causes of childhood cancer were difficult to discern because prior exposures were numerous, diverse, and usually ill defined. The questionnaire yielded more data than the medical record on gestational and family history and helped identify patients with exceptionally high cancer risk for additional investigation. Although the findings provide anecdotal confirmation of several associations, few original etiologic hypotheses were generated for formal testing with conventional epidemiologic techniques.
在一项对503名癌症患儿的访谈研究中，对一份病因调查问卷的实用性进行了检验。提取了这些患儿的病历，并且他们的父母对一份问卷调查访谈做出回应，以确定癌症的遗传和环境病因。在索引患者的1123名兄弟姐妹中，有10人患癌，而根据一般人群的癌症发病率预期为2人。在患有易患遗传和先天性疾病的个体患者中确定了癌症风险因素：神经纤维瘤病（脑肿瘤）、遗传性免疫缺陷（淋巴瘤）、唐氏综合征（白血病）、XY性腺发育不全（生殖细胞瘤）、巨大痣（黑色素瘤）和脑脊膜膨出（骶尾部畸胎癌）。儿童癌症的环境病因难以辨别，因为既往接触因素众多、多样且通常定义不明确。该问卷在妊娠和家族史方面提供的数据比病历更多，并有助于识别癌症风险特别高的患者以便进行进一步调查。尽管这些发现为若干关联提供了轶事性证实，但几乎没有产生可用于用传统流行病学技术进行正式检验的原始病因假说。
