Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.
Université de Paris, Paris, France.
Cancer Causes Control. 2021 Jul;32(7):693-704. doi: 10.1007/s10552-021-01421-5. Epub 2021 Apr 7.
Several studies have addressed the potential seasonality of childhood acute leukaemia (AL) without conclusive results. Using data from the National Registry of Childhood Cancers over 1990-2014 in mainland France, we investigated the seasonal variations in childhood AL taken together, and lymphoblastic (ALL) and myeloid (AML) leukaemia separately.
Assuming constant variations over 1990-2014, we used a Poisson regression model to evaluate variations in standardized incidence ratios (SIRs) by month of birth or diagnosis. A scan method for temporal cluster detection was used to identify windows of several consecutive months with high or low SIR. The yearly reproducibility of the observed monthly variations was then evaluated.
We included 11,528 AL, of which 9493 ALL and 1,843 AML. No seasonal variation was detected for ALL. With a clear seasonal pattern, differences in AML incidence rates were evidenced between January-April and May-December birth periods (SIR = 0.85, 95% CI 0.77-0.94 and SIR = 1.07, 95% CI 1.01-1.14, respectively). AML incidence variations by month of diagnosis were less clear-cut.
Based on a large number of cases from a high-quality registry, we did not evidence any seasonality in ALL incidence rates but evidenced seasonal variations in AML incidence rates by month of birth.
已有多项研究探讨了儿童急性白血病（AL）的潜在季节性，但结果尚无定论。本研究利用法国 1990 年至 2014 年全国儿童癌症登记处的数据，综合分析了儿童 AL 以及淋巴母细胞性白血病（ALL）和髓系白血病（AML）的季节性变化。
假设 1990 年至 2014 年期间变化稳定，我们采用泊松回归模型按月或诊断月评估标准化发病比（SIR）的变化。采用时间聚类检测扫描法识别 SIR 高或低的连续数月窗口。然后评估观察到的每月变化的年度可重复性。
我们纳入了 11528 例 AL，其中 9493 例 ALL 和 1843 例 AML。未发现 ALL 有季节性变化。AML 的发病存在明显季节性模式，在 1 月至 4 月和 5 月至 12 月出生期间，发病率存在差异（SIR=0.85，95%CI 0.77-0.94 和 SIR=1.07，95%CI 1.01-1.14）。诊断月的 AML 发病变化不明显。
基于高质量登记处的大量病例，我们未发现 ALL 发病率有季节性，但发现 AML 发病率存在季节性变化，与出生月份有关。
