Association between medically diagnosed postnatal infection and childhood cancers: A matched case-control study in Denmark, 1978 to 2016

Article describes how, although the association between infection and childhood cancer has been long investigated, there is limited information on rarer cancers. This article aimed to explore the association between postnatal infection and childhood cancers in the Danish population

Association Between Pharmacological and Infection Exposures in Maternal and Child and Risk of Childhood Cancers

Childhood cancer is a complex group of diseases affecting children, causing significant physical, emotional, and financial burdens globally. Genetic predisposition, infections during pregnancy, and pharmaceutical exposures are potential risk factors for childhood cancer. Understanding childhood cancer is crucial for effective prevention and treatment strategies. This dissertation investigates the impact of maternal and child infections and pharmaceutical exposure during pregnancy on childhood cancer risk through population-based studies in Denmark and Taiwan.The first study examined the effect of postnatal infection on childhood cancer risk using Danish nationwide registries from 1978 to 2016. The findings from this matched case-control study revealed a positive association between postnatal infections and various childhood cancers, including acute lymphoblastic leukemia (ALL), acute myeloid leukemia, non-Hodgkin's lymphoma, and central nervous system tumors (CNS). The second study explored infection and antibiotic exposure during pregnancy using Taiwan's Maternal and Child Health Database and national health and cancer registries from 2004 to 2015. This cohort study unveiled moderate associations between infections during pregnancy and the risk of hepatoblastoma, accompanied by a discernible elevation in the risk of ALL. Antibiotic prescriptions during pregnancy, especially tetracyclines, increased the risk of childhood ALL, and certain antibiotics raised hepatoblastoma risk.The third investigation focused on nitrosatable drug exposure during pregnancy employing a meticulous matched case-control study and analyzing data sourced from Danish nationwide registries spanning the years 1995 to 2016. The study found that nitrosatable drug prescription during pregnancy was potentially associated with the risk of offspring’s CNS and neuroblastoma. The final study assessed acetaminophen exposure during pregnancy using the Taiwan population-based cohort from 2004 to 2017. Prolonged acetaminophen use throughout all trimesters was potentially associated with elevating the risk of medulloblastoma, hepatoblastoma, and bone tumors.In summary, this dissertation sheds light on the impact of maternal and child infections and pharmaceutical exposure during pregnancy on childhood cancer risk. Utilizing rigorous population-based case-control and cohort studies in Denmark and Taiwan, this research enhances our understanding of etiological factors of childhood cancer. The findings highlight the need to investigate potential risk factors such as infections, antibiotics, nitrosatable drugs, and acetaminophen use during pregnancy to advance prevention strategies for childhood cancers

Data Reliability and Coding Completeness of Cancer Registry Information Using Reabstracting Method in the National Cancer Institute: Thailand, 2012 to 2014

Purpose: Data quality is a core value of cancer registries, which bring about greater understanding of cancer distribution and determinants. Thailand established its cancer registry in 1986; however, studies focusing on data reliability have been limited. This study aimed to assess the coding completeness and reliability of the National Cancer Institute (NCI) hospital-based cancer registry, Thailand. Methods: This study was conducted using the reabstracting method. We focused on seven cancer sites—the colon, rectum, liver, lung, breast, cervix, and prostate—registered between 2012 and 2014 in the NCI hospital-based cancer registry. Missing data were identified for coding completeness calculation among important variables. The agreement rate and κ coefficient were computed to represent data reliability. Results: For reabstracting, we retrieved 957 medical records from a total of 5,462. These were selected using the probability proportional to size method, stratified by topology, sex, and registered year. The overall coding completeness of the registered and reabstracted data was 89.9% and 93.6%, respectively. In addition, the overall agreement rate among variables ranged from 84.7% to 99.6%, and κ coefficient ranged from 0.619 to 0.995. The misclassification among unilateral organs caused lower coding completeness and agreement rate of laterality coding. The completeness of current residency could be improved using the reabstracting method. The lowest agreement rate was found among various categories of diagnosis basis. Sex misclassification for male breast cancer was identified. Conclusion: The coding completeness and data reliability of the NCI hospital-based cancer registry met the standard in most critical variables. However, some challenges remain to improve the data quality. The reabstracting method could identify the critical points affecting the quality of cancer registry data

Association between medically diagnosed postnatal infection and childhood cancers: A matched case-control study in Denmark, 1978 to 2016.

Although the association between infection and childhood cancer has been long investigated, there is limited information on rarer cancers. This article aimed to explore the association between postnatal infection and childhood cancers in the Danish population. A matched case-control study was conducted using Danish nationwide registries from 1978 to 2016. Each childhood cancer case was matched 1:25 with controls by birth date within a week and sex. Postnatal infections were identified from the Danish National Patient Registry, which lists diagnoses seen in hospital, specialist or emergency care services. Multivariable conditional logistic regression was used to estimate adjusted odds ratios (adj.OR) and 95% confidence intervals (CI). Specific types of infections and the number of infection episodes were also considered. The study included 4125 childhood cancer cases and 103 526 matched controls with ages ranging from 0 to 19 years. Medically diagnosed postnatal infections were positively associated with many types of childhood cancer including acute lymphoblastic leukemia (adj.OR = 1.42; 95% CI: 1.23-1.63), acute myeloid leukemia (adj.OR = 1.80; 95% CI: 1.28-2.52), non-Hodgkin lymphoma (adj.OR = 1.53; 95% CI: 1.19-1.97) and central nervous system tumors (adj.OR = 1.57; 95% CI: 1.39-1.77). A higher number of infection episodes were also associated with an increased risk of these cancers. Specific infections such as viral, enteric and urinary tract infections were also strongly associated with specific types of cancer. In conclusion, children who later develop cancer appear to have adverse reactions to infections necessitating referral to specialized health care services, perhaps indicating dysregulated immune function

Maternal medically diagnosed infection and antibiotic prescription during pregnancy and risk of childhood cancer: A population-based cohort study in Taiwan, 2004 to 2015.

While associations between maternal infections during pregnancy and childhood leukemia in offspring have been extensively studied, the evidence for other types of childhood cancers is limited. Additionally, antibiotic exposure during pregnancy could potentially increase the risk of childhood cancers. Our study investigates associations between maternal infections and antibiotic prescriptions during pregnancy and the risk of childhood cancer in Taiwan. We conducted a population-based cohort study using the Taiwan Maternal and Child Health Database (TMCHD), linked with national health and cancer registries. The study included 2 267 186 mother-child pairs, and the median follow-up time was 7.96 years. Cox proportional hazard models were utilized to estimate effects. Maternal infections during pregnancy were associated with a moderate increase in the risk of childhood hepatoblastoma (adjusted hazard ratio [HR] = 1.34; 95% confidence interval [CI]: 0.90-1.98) and a weaker increase in the risk of childhood acute lymphoblastic leukemia (ALL) (adjusted HR = 1.15; 95% CI: 0.99-1.35). Antibiotic prescriptions during pregnancy were also associated with an elevated risk of childhood ALL (adjusted HR = 1.30; 95% CI: 1.04-1.63), particularly with tetracyclines (adjusted HR = 2.15; 95% CI: 1.34-3.45). Several specific antibiotics were also associated with an increased risk of hepatoblastoma and medulloblastoma. Children exposed in utero to antibiotic prescription or both infections and antibiotics during pregnancy were at higher risk of developing ALL. Our findings suggest that there are associations between maternal infections, antibiotic use during pregnancy and the risk of several childhood cancers in addition to ALL and highlight the importance of further research in this area