Olshan A F, Breslow N E, Falletta J M, Grufferman S, Pendergrass T, Robison L L, Waskerwitz M, Woods W G, Vietti T J, Hammond G D
Department of Epidemiology, University of North Carolina, Chapel Hill.
Cancer. 1993 Aug 1;72(3):938-44. doi: 10.1002/1097-0142(19930801)72:3<938::aid-cncr2820720345>3.0.co;2-c.
Previous epidemiologic studies have indicated that several factors may be associated with an increased risk of Wilms tumor including paternal occupational exposures, maternal exposure during pregnancy to cigarettes, coffee or tea, oral contraceptives, hormonal pregnancy tests, hair-coloring products, maternal hypertension, vaginal infection during pregnancy, and higher birth weight of the child. The current study examines the nonoccupational risk factors using questionnaire data from a large national collaborative clinical trial.
Parents of 200 children registered with the National Wilms Tumor Study and 233 matched controls, identified using telephone random-digit dialing, completed a self-administered questionnaire about a variety of risk factors.
As opposed to some previous studies, no association was found for mother's smoking during pregnancy (10+ cigarettes per day; odds ratio [OR] = 0.73; 95% confidence interval [CI] = 0.40-1.34), maternal consumption of coffee or tea during pregnancy (4+ cups per day; OR = 1.31; CI = 0.57-3.01), or hypertension during pregnancy (OR = 0.96; CI = 0.45-2.06). In addition, no association was found in this study for hormone exposure during pregnancy, hair dye use, vaginal infection during pregnancy, or high birth weight. A previously unreported association with a history of household insect extermination was found (OR = 2.16; CI = 1.24-3.75).
In general, the study failed to confirm most of the previously reported maternal risk factors for Wilms tumor. Understanding the possible role of paternal exposures may be the best objective for further research on potential risk factors for Wilms tumor.
先前的流行病学研究表明，几种因素可能与肾母细胞瘤风险增加有关，包括父亲的职业暴露、母亲孕期接触香烟、咖啡或茶、口服避孕药、激素妊娠试验、染发剂产品、母亲高血压、孕期阴道感染以及孩子出生体重较高。本研究使用来自一项大型全国性协作临床试验的问卷数据来检验非职业性风险因素。
200名登记参加国家肾母细胞瘤研究的儿童的父母以及通过电话随机拨号识别出的233名匹配对照，完成了一份关于各种风险因素的自填式问卷。
与先前的一些研究不同，本研究未发现孕期母亲吸烟（每天10支以上香烟；优势比[OR]=0.73；95%置信区间[CI]=0.40-1.34）、孕期母亲饮用咖啡或茶（每天4杯以上；OR=1.31；CI=0.57-3.01）或孕期高血压（OR=0.96；CI=0.45-2.06）之间存在关联。此外，本研究未发现孕期激素暴露、使用染发剂、孕期阴道感染或出生体重高之间存在关联。发现了一种与家庭灭虫史的先前未报告的关联（OR=2.16；CI=1.24-3.75）。
总体而言，该研究未能证实先前报道的大多数肾母细胞瘤母亲风险因素。了解父亲暴露的可能作用可能是肾母细胞瘤潜在风险因素进一步研究的最佳目标。
