Altmann A E, Halliday J L, Giles G G
Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Perinatal Data Collection Unit, Department of Human Services, Victoria, Australia.
Br J Cancer. 1998 Nov;78(9):1244-9. doi: 10.1038/bjc.1998.662.
This report describes a population-based case-control study that aimed to assess and quantify the risk of children with congenital malformations developing cancer. Three sources of data were used: the Victorian Cancer Register, the Victorian Perinatal Data Register (VPDR) and the Victorian Congenital Malformations/Birth Defects Register. Cases included all Victorian children born between 1984 and 1993 who developed cancer. Four controls per case, matched on birth date, were randomly selected from the VPDR. Record linkage between registers provided malformation data. A matched case-control analysis was undertaken. Of the 632 cancer cases, 570 (90.2%) were linked to the VPDR. The congenital malformation prevalence in children with cancer was 9.6% compared with 2.5% in the controls [odds ratio (OR) 4.5, 95% CI 3.1-6.7]. A strong association was found with chromosomal defects (OR=16.7, 95% CI 6.1-45.3), in particular Down's syndrome (OR=27.1, 95% CI 6.0-122). Most other birth defect groups were also associated with increased cancer risk. The increased risk of leukaemia in children with Down's syndrome was confirmed, and children with central nervous system (CNS) defects were found to be at increased risk of CNS tumours. The report confirms that children with congenital malformations have increased risks of various malignancies. These findings may provide clues to the underlying aetiology of childhood cancer, as congenital malformations are felt to be a marker of exposures or processes which may increase cancer risk. The usefulness of record linkage between accurate population-based registers in the epidemiological study of disease has also been reinforced.
本报告描述了一项基于人群的病例对照研究，旨在评估和量化先天性畸形儿童患癌症的风险。研究使用了三种数据来源：维多利亚癌症登记处、维多利亚围产期数据登记处（VPDR）和维多利亚先天性畸形/出生缺陷登记处。病例包括1984年至1993年间在维多利亚出生且患癌症的所有儿童。从VPDR中随机选取与每个病例出生日期匹配的四名对照。通过登记处之间的记录链接获取畸形数据。进行了匹配病例对照分析。在632例癌症病例中，570例（90.2%）与VPDR建立了链接。患癌症儿童的先天性畸形患病率为9.6%，而对照儿童为2.5%[优势比（OR）4.5，95%可信区间3.1 - 6.7]。发现与染色体缺陷有很强的关联（OR = 16.7，95%可信区间6.1 - 45.3），特别是唐氏综合征（OR = 27.1，95%可信区间6.0 - 122）。大多数其他出生缺陷组也与癌症风险增加有关。唐氏综合征儿童白血病风险增加得到证实，发现中枢神经系统（CNS）缺陷儿童患CNS肿瘤的风险增加。该报告证实，先天性畸形儿童患各种恶性肿瘤的风险增加。这些发现可能为儿童癌症的潜在病因提供线索，因为先天性畸形被认为是可能增加癌症风险的暴露或过程的标志。基于准确人群登记处的记录链接在疾病流行病学研究中的有用性也得到了加强。
