Background: While a parental history of asthma has been widely reported as a risk factor for childhood asthma, less is known about the impact of multigenerational family history of asthma on the occurrence of asthma in children. Methods: From 2012 to 2013, a cross-sectional study was carried out in seven Chinese cities. Participants were randomly selected from 94 middle schools, elementary schools and kindergartens. Questionnaires, from which information on asthma, environmental exposure and family members (parents, paternal grandparents and maternal grandparents) affected by asthma were obtained, were completed by the children's parents or guardians. Two-level logistic regressions were used to assess hereditary patterns of asthma, adjusted for potential confounding factors. Mediation analysis was performed to estimate the potential mediation effect of parents on the association between grandparental asthma and offspring asthma. Results: A paternal grandfather (OR: 2.59, 95%CI: 2.14-3.13), paternal grandmother (OR: 2.40, 95%CI: 1.93-2.99), maternal grandfather (OR: 2.08, 95%CI: 1.71-2.53) and maternal grandmother (OR: 2.08, 95%CI: 1.67-2.59) with asthma were associated with childhood asthma, independent of parental asthma. Of the children who had two family members with asthma, the risk of childhood asthma was highest when both parents had asthma (OR: 15.92, 95%CI: 4.66-54.45) or when both father and paternal grandfather had asthma (OR: 11.11, 95%CI: 5.77-21.38). Parents had a small proportion of mediation effect on the association between grandparental asthma and childhood asthma. Conclusions: A family history of grandparental asthma was associated with childhood asthma and parents only partially mediate the association.

Increase in years of life after eliminating causes of death: Significance for health priorities. Hemminki, E., Hemminki, K., Hakulinen, T. and Hakama, M. (Dept. of Public Health Sciences, University of Tampere, Dept. of Medical Chemistry, University of Helsinki and the Finnish Cancer Registry, Finland). The theory of competing risks of death has been applied in this study for the construction of two indices: (1) increase in the expectation of life as a function of age, and (2) increase in the average number of years to be lived by a newborn up to various ages, when selected causes of death are eliminated. The indices have been applied to the 1970 mortality in Finland. Vascular diseases comprise the most important cause of death in both sexes, when the first index is applied. According to the second index, considering ages up to 65 years, violent deaths emerge as the most important cause of death among men and neoplasms appear equally important as vascular diseases among women. The magnitude of a health problem was found to be dependent on the index selected, which should be considered in health planning.

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This issue includes a special section on the genetic causes and treatment-related implications of multiple cancers and on the interpretation of key epidemiologic measures, with a part on multiple cancers. The paper by Cezary Cybulski, Safia Nazarali and Steven A Narod "Multiple Primary Cancers as a Guide to Heritability" reviews hereditary cancers which are now known to be caused by any of some 100 predisposition genes. Features indicative of syndromatic cancer include a

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