Holly E A, Bracci P M, Mueller B A, Preston-Martin S
Department of Epidemiology and Biostatistics, School of Medicine, University of California at San Francisco, 94109, USA.
Cancer Epidemiol Biomarkers Prev. 1998 Sep;7(9):797-802.
Nineteen counties from San Francisco and Los Angeles, California and Seattle, Washington were the United States sites for a large population-based case-control study of childhood brain tumors (CBTs), sponsored by the National Cancer Institute. CBT patients who were < 20 years of age and were diagnosed between 1984 and 1991 were reported to each region's cancer registry. The 801 control subjects were obtained by random digit dial and were frequency-matched to the 540 CBT patients in San Francisco and Seattle (one patient to two controls) and in Los Angeles (one patient to one control). Data collected by in-person interview with subjects' mothers were analyzed to investigate an association between risk for CBTs and life on a farm, exposure to farm animals (dairy cattle, beef cattle, pigs, sheep/goats, poultry, and horses), and some cat and non-farm horse exposures. Elevated risks for CBTs were observed in association with mothers' exposure to pigs [odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.2-12] and horses (OR = 2.2, 95% CI = 1.0-4.8) on a farm during the index pregnancy. Children diagnosed with primitive neuroectodermal tumors showed elevated risks for CBTs with personal and maternal prenatal exposure to pigs (child, OR = 4.0, 95% CI = 1.2-13; mother, OR = 11.9, 95% CI = 2.8-51) and poultry (child, OR = 3.0, 95% CI = 1.1-8.0; mother, OR = 4.0, 95% CI = 1.2-14). No other animal exposures of children or mothers were found to be consistently related to CBTs. Children diagnosed with primitive neuroectodermal tumors who were on a farm for > 1 year and were first on a farm when they were < 6 months of age also had increased risk for CBTs (OR = 3.9, 95% CI = 1.2-13). A somewhat increased risk for CBTs was found for children of mothers who ever had worked on livestock farms compared with mothers who never had worked on a farm (OR = 7.4, 95% CI = 0.86-64, based on five case mothers and one control mother who worked on livestock farms during the 5 years preceding the birth of the index child). The associations are consistent with those of two previous studies in Norway (P. Kristensen et al., Int. J. Cancer, 65: 39-50, 1996) and the United States and Canada (G. R. Bunin et al., Cancer Epidemiol. Biomark. Prev., 3: 197-204, 1994) that investigated the role of farm-related exposures in the etiology of CBTs.
由美国国立癌症研究所资助,在加利福尼亚州旧金山和洛杉矶以及华盛顿州西雅图的19个县开展了一项基于大规模人群的儿童脑肿瘤(CBT)病例对照研究。年龄小于20岁且在1984年至1991年间被诊断为CBT的患者被报告至各地区的癌症登记处。801名对照对象通过随机数字拨号选取,并在旧金山和西雅图与540名CBT患者进行频率匹配(1名患者对应2名对照),在洛杉矶则是1名患者对应1名对照。通过对受试者母亲进行面对面访谈收集的数据进行分析,以调查CBT风险与农场生活、接触农场动物(奶牛、肉牛、猪、绵羊/山羊、家禽和马)以及一些猫和非农场马的接触之间的关联。在索引孕期,母亲接触农场猪[比值比(OR)= 3.8,95%置信区间(CI)= 1.2 - 12]和马(OR = 2.2,95% CI = 1.0 - 4.8)与CBT风险升高有关。被诊断为原始神经外胚层肿瘤的儿童,其个人和母亲产前接触猪(儿童,OR = 4.0,95% CI = 1.2 - 13;母亲,OR = 11.9,95% CI = 2.8 - 51)和家禽(儿童,OR = 3.0,95% CI = 1.1 - 8.0;母亲,OR = 4.0,95% CI = 1.2 - 14)时,CBT风险升高。未发现儿童或母亲的其他动物接触与CBT有一致关联。在农场生活超过1年且6个月龄前首次进入农场的被诊断为原始神经外胚层肿瘤的儿童,CBT风险也增加(OR = 3.9,95% CI = 1.2 - 13)。与从未在畜牧场工作过的母亲相比,曾在畜牧场工作过的母亲所生子女患CBT的风险有所增加(基于5名病例母亲和1名在索引儿童出生前5年内在畜牧场工作的对照母亲,OR = 7.4,95% CI = 0.86 - 64)。这些关联与挪威(P. Kristensen等人,《国际癌症杂志》,65: 39 - 50,1996年)以及美国和加拿大(G. R. Bunin等人,《癌症流行病学、生物标志物与预防》,3: 197 - 204,1994年)之前两项研究一致,这两项研究调查了与农场相关接触在CBT病因学中的作用。