TY - JOUR
T1 - Sex differences in associations between birth characteristics and childhood cancers
T2 - a five-state registry-linkage study
AU - Williams, Lindsay A.
AU - Sample, Jeannette
AU - McLaughlin, Colleen C.
AU - Mueller, Beth A.
AU - Chow, Eric J.
AU - Carozza, Susan E.
AU - Reynolds, Peggy
AU - Spector, Logan G.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2021/11
Y1 - 2021/11
N2 - Background: There is a well-recognized male excess in childhood cancer incidence; however, it is unclear whether there is etiologic heterogeneity by sex when defined by epidemiologic risk factors. Methods: Using a 5-state registry-linkage study (cases n = 16,411; controls n = 69,816), we estimated sex-stratified odds ratios (OR) and 95% confidence intervals (95% CI) between birth and demographic characteristics for 16 pediatric cancers. Evidence of statistical interaction (p-interaction < 0.01) by sex was evaluated for each characteristic in each cancer. Results: Males comprised > 50% of cases for all cancers, except Wilms tumor (49.6%). Sex interacted with a number of risk factors (all p-interaction < 0.01) including gestational age for ALL (female, 40 vs. 37–39 weeks OR: 0.84, 95% CI 0.73–0.97) and ependymoma (female, 40 vs. 37–39 OR: 1.78, 95% CI 1.14–2.79; female, ≥ 41 OR: 2.01. 95% CI 1.29–3.14), birth order for AML (female, ≥ 3rd vs. 1st OR: 1.39, 95% CI 1.01–1.92), maternal education for Hodgkin lymphoma (male, any college vs. < high school[HS] OR: 1.47, 95% CI 1.03–2.09) and Wilms tumor (female, any college vs. HS OR: 0.74, 95% CI 0.59–0.93), maternal race/ethnicity for neuroblastoma (male, black vs. white OR: 2.21, 95% CI 1.21–4.03; male, Hispanic vs. white OR: 1.86, 95% CI 1.26–2.75; female, Asian/Pacific Islander vs. white OR: 0.28, 95% CI 0.12–0.69), and paternal age (years) for hepatoblastoma in males (< 24 vs. 25–29 OR: 2.17, 95% CI 1.13–4.19; ≥ 35 vs. 25–29 OR: 2.44, 95% CI 1.28–4.64). Conclusions: These findings suggest etiologic heterogeneity by sex for childhood cancers for gestational age, maternal education, and race/ethnicity and paternal age.
AB - Background: There is a well-recognized male excess in childhood cancer incidence; however, it is unclear whether there is etiologic heterogeneity by sex when defined by epidemiologic risk factors. Methods: Using a 5-state registry-linkage study (cases n = 16,411; controls n = 69,816), we estimated sex-stratified odds ratios (OR) and 95% confidence intervals (95% CI) between birth and demographic characteristics for 16 pediatric cancers. Evidence of statistical interaction (p-interaction < 0.01) by sex was evaluated for each characteristic in each cancer. Results: Males comprised > 50% of cases for all cancers, except Wilms tumor (49.6%). Sex interacted with a number of risk factors (all p-interaction < 0.01) including gestational age for ALL (female, 40 vs. 37–39 weeks OR: 0.84, 95% CI 0.73–0.97) and ependymoma (female, 40 vs. 37–39 OR: 1.78, 95% CI 1.14–2.79; female, ≥ 41 OR: 2.01. 95% CI 1.29–3.14), birth order for AML (female, ≥ 3rd vs. 1st OR: 1.39, 95% CI 1.01–1.92), maternal education for Hodgkin lymphoma (male, any college vs. < high school[HS] OR: 1.47, 95% CI 1.03–2.09) and Wilms tumor (female, any college vs. HS OR: 0.74, 95% CI 0.59–0.93), maternal race/ethnicity for neuroblastoma (male, black vs. white OR: 2.21, 95% CI 1.21–4.03; male, Hispanic vs. white OR: 1.86, 95% CI 1.26–2.75; female, Asian/Pacific Islander vs. white OR: 0.28, 95% CI 0.12–0.69), and paternal age (years) for hepatoblastoma in males (< 24 vs. 25–29 OR: 2.17, 95% CI 1.13–4.19; ≥ 35 vs. 25–29 OR: 2.44, 95% CI 1.28–4.64). Conclusions: These findings suggest etiologic heterogeneity by sex for childhood cancers for gestational age, maternal education, and race/ethnicity and paternal age.
KW - Etiologic heterogeneity
KW - Pediatric cancer
KW - Registry-based study
KW - Sex differences
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U2 - 10.1007/s10552-021-01479-1
DO - 10.1007/s10552-021-01479-1
M3 - Article
C2 - 34297242
AN - SCOPUS:85111150161
SN - 0957-5243
VL - 32
SP - 1289
EP - 1298
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 11
ER -