Mili F, Khoury M J, Flanders W D, Greenberg R S
National Center for Environmental Health, Centers for Disease Control, Atlanta, GA.
Am J Epidemiol. 1993 Mar 15;137(6):629-38. doi: 10.1093/oxfordjournals.aje.a116720.
To evaluate the risk of childhood cancer among infants with serious birth defects, the authors linked records of the population-based registry of the Georgia Center for Cancer Statistics for 1975 to 1988 with records of the population-based Metropolitan Atlanta Congenital Defects Program for 1968 to 1987. During the study period, birth defects were diagnosed in 19,373 infants younger than 1 year of age, and cancer was diagnosed in 400 children younger than 15 years of age. The observed number of children with a defect who developed cancer was compared with the number expected on the basis of the cancer registry rates. Of the 19,373 children with birth defects, 31 developed cancer (standardized incidence ratio (SIR) = 2.2, 95% confidence interval (CI) 1.5-3.2). Two associations were found: of 532 children with Down's syndrome (trisomy 21), three developed acute leukemia (SIR = 50.8, 95% CI 10.5-148.5) while of 746 children with pyloric stenosis, four developed cancer (SIR = 7.5, 95% CI 2.0-19.3). These data show that children with selected birth defects are at increased risk for specific childhood cancers. Such record-linkage can reveal new associations, which can in turn help researchers understand underlying mechanisms common to teratogenesis and carcinogenesis.
为评估患有严重出生缺陷的婴儿患儿童癌症的风险，作者将佐治亚癌症统计中心1975年至1988年基于人群的登记记录与1968年至1987年基于人群的大亚特兰大先天性缺陷项目记录相联系。在研究期间，19373名1岁以下婴儿被诊断出患有出生缺陷，400名15岁以下儿童被诊断出患有癌症。将观察到的患癌症的缺陷儿童数量与根据癌症登记率预期的数量进行比较。在19373名患有出生缺陷的儿童中，31人患了癌症（标准化发病率（SIR）=2.2，95%置信区间（CI）1.5 - 3.2）。发现了两种关联：在532名唐氏综合征（21三体综合征）儿童中，3人患急性白血病（SIR = 50.8，95%CI 10.5 - 148.5）；在746名患有幽门狭窄的儿童中，4人患癌症（SIR = 7.5，95%CI 2.0 - 19.3）。这些数据表明，患有特定出生缺陷的儿童患特定儿童癌症的风险增加。这种记录关联可以揭示新的关联，进而帮助研究人员了解致畸和致癌共同的潜在机制。
