Análisis en áreas pequeñas del cáncer pediátrico en el municipio de Murcia

Ortega-García, Juan Antonio; Hernández, Fernando A. López; Cárceles-Álvarez, Alberto; Santiago-Rodríguez, Elvis; Sánchez, Antonio; Bermúdez-Cortés, Mar; Ruiz, Antonio José Ortiz

doi:10.1016/j.anpedi.2015.04.021

Cited by 9 publications

(18 citation statements)

References 23 publications

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“…A separate analysis is critical in the case of childhood cancer because its dynamics is absolutely different from that of adults. 3,7 The lack of studies on childhood cancer c o n d u c t e d i n A r g e n t i n a u s i n g t h e s a m e methodology or tools as in this study may be considered a disadvantage because it is not possible to compare results that would certainly improve the approach to this problem. In turn, it is critical to create interdisciplinary research and working groups to establish monitoring, research and prevention systems targeted at childhood cancer and its risk factors in Argentina.…”

Section: Discussionmentioning

confidence: 96%

“…Although they cannot be directly compared, those studies found, as in our study, clusters within the large groups of total tumors, leukemias, tumors of the central nervous system, and lymphomas. 7,[24][25][26][27][28][29][30][31] However, those studies failed to establish a conclusive relationship between results and a socioenvironmental factor, even though the presence of clusters is probably an evidence of the fact that environmental factors are related to the presence and development of cancer. [32][33][34] Apart from ionizing radiation and some congenital genetic syndromes, there is little evidence -and lots of suspicion-regarding other factors that may influence the clustering of childhood cancer.…”

Section: Discussionmentioning

confidence: 99%

“…One of the disadvantages of working with registries of childhood cancer is its low incidence, which results in methodological challenges in terms of data consistency. 7 Although we were able to work with data corresponding to a ten-year period provided by the Registry of Tumors of the Province of Córdoba, it is important to continue corroborating results in the following years considering that the registry is rather recent and is under constant review. 13 In the future, the plan involves working with data from children and youth aged 0-19 years old to widen case reporting and include an age group whose characteristics is more related to child and adolescent development than to the adult stage.…”

Section: Discussionmentioning

confidence: 99%

“…11 Geographic information systems (GIS), together with cluster analysis tools, establish the first approach to delimiting research on specific population groups and/ or areas and make it effective, helping to the future knowledge of childhood cancer etiology. 7,11 The objective of this research project is to perform exploratory spatial-temporal analyses based on the database of the Registry of Tumors of the Province of Córdoba (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) to determine the clustering of childhood cancer incidence in Córdoba (Argentina).…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Childhood cancer refers to a group of diseases of multifactorial origin, for which more advances have been made in terms of treatment than in the study of their etiology or determining factors. [3][4][5][6][7] Although the origin or influence factors of these diseases consider both genetic and environmental factors (and their interaction), many investigations suggest that the environment carries far more weight. 4,5,[8][9][10] Environmental factors refer to anything in interaction with the child, that is not related to a hereditary trait, and that may influence the development of cancer in the pediatric or adult stage.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of spatial-temporal clusters of childhood cancer incidence in the province of Córdoba, Argentina (2004-2013)

Agost

2016

Arch Argent Pediat

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Introduction. In spite of its low incidence, childhood cancer is becoming increasingly more relevant in Argentina. More advances have been made in cancer treatment than in the study of its etiology or determining factors. There are no investigations that analyze its spatial and temporal distribution or potential clustering. Objective. To perform exploratory spatial and temporal analyses based on the database of the Registry of Tumors of the Province of Córdoba (2004Córdoba ( -2013 to determine the clustering of childhood cancer incidence in Córdoba (Argentina). Populations and methods. Epidemiological, retrospective, ecological study. Data from 1098 patients with malignancies aged 0-14 years old from the Registry of Tumors of the Province of Córdoba (2004Córdoba ( -2013 were used. A geographic information system model was developed. The presence of spatial, temporal, and spatialtemporal clusters was analyzed in the districts of Córdoba using the SaTScan software. Results. Spatial clusters were detected, with a high number of cases, for total tumors (p= 0.01), leukemias (p= 0.02), malignant neoplasms of lymphoid, hematopoietic and related tissue (p= 0.03), central nervous system tumors (p= 0.03), and a high level of indicators of risk for renal tumors (p= 0.01). In addition, a temporal cluster (p= 0.01) and a spatial-temporal cluster (p= 0.02) for neuroblastoma and other peripheral nervous cell tumors were also observed. Conclusions. Significant clusters were determined, with important associated indicators observed in several districts of Córdoba. This is the first methodological step towards the development of new investigations on the risk factors for childhood cancer and its etiology.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of spatial-temporal clusters of childhood cancer incidence in the province of Córdoba, Argentina (2004-2013)

Agost

2016

Arch Argent Pediat

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Space–time clustering of childhood cancers: a systematic review and pooled analysis

et al. 2018

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The aetiology of childhood cancers remains largely unknown. Space–time clustering of cases might imply an aetiological role of infections. We aimed to review the evidence of space–time clustering of specific childhood cancers. We searched Medline and Embase for population-based studies that covered a pre-defined study area, included cases under 20 years of age and were published before July 2016. We extracted all space–time clustering tests and calculated the proportion of positive tests per diagnostic group. In a pooled analysis, we performed a Knox test of the number of pairs of cases close to each other in time and space pooled across studies. 70 studies met our eligibility criteria, 32 of which reported Knox tests. For leukaemia, the proportion of positive tests was higher than expected by chance at both time of diagnosis (26%) and birth (11%). The pooled analysis showed strong evidence of clustering at diagnosis for children aged 0–5 years for a spatial and temporal lag of 5 km and 6 months, respectively (p < 0.001). The evidence was mixed for lymphoma and tumours of the central nervous system. The current study suggests that leukaemia cases cluster in space–time due to an aetiological factor affecting children under 5 years of age. The observed pattern of clustering of young children close to time of diagnosis is compatible with Greaves’ delayed-infections-hypothesis.Electronic supplementary materialThe online version of this article (10.1007/s10654-018-0456-y) contains supplementary material, which is available to authorized users.

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Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History

Cárceles-Álvarez

Ortega-García

Hernández

et al. 2017

Environmental Research

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Background Leukaemia remains the most common type of paediatric cancer and its aetiology remains unknown, but considered to be multifactorial. It is suggested that the initiation in utero by relevant exposures and/or inherited genetic variants and, other promotional postnatal exposures are probably required to develop leukaemia. This study aimed to map the incidence and analyse possible clusters in the geographical distribution of childhood acute leukaemia during the critical periods and to evaluate the factors that may be involved in the aetiology by conducting community and individual risk assessments. Materials and methods We analysed all incident cases of acute childhood leukaemia (<15 years) diagnosed in a Spanish region during the period 1998-2013. At diagnosis, the addresses during pregnancy, early childhood and diagnosis were collected and codified to analyse the spatial distribution of acute leukaemia. Scan statistical test methodology was used for the identification of high-incidence spatial clusters. Once identified, individual and community risk assessments were conducted using the Paediatric Environmental History. Results A total of 158 cases of acute leukaemia were analysed. The crude rate for the period was 42.7 cases per million children. Among subtypes, acute lymphoblastic leukaemia had the highest incidence (31.9 per million children). A spatial cluster of acute lymphoblastic leukaemia was detected using the pregnancy address (p <0.05). The most common environmental risk factors related with the aetiology of acute lymphoblastic leukaemia, identified by the Paediatric Environmental History were: prenatal exposure to tobacco (75%) and alcohol (50%); residential and community exposure to pesticides (62.5%); prenatal or neonatal ionizing radiation (42.8%); and parental workplace exposure (37.5%) Conclusions Our study suggests that environmental exposures in utero may be important in the development of childhood leukaemia. Due to the presence of high-incidence clusters using pregnancy address, it is necessary to introduce this address into the childhood cancer registers. The Paediatric Environmental History which includes pregnancy address and a careful and comprehensive evaluation of the environmental exposures will allow us to build the knowledge of the causes of childhood leukaemia.

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Análisis en áreas pequeñas del cáncer pediátrico en el municipio de Murcia

Cited by 9 publications

References 23 publications

Analysis of spatial-temporal clusters of childhood cancer incidence in the province of Córdoba, Argentina (2004-2013)

Analysis of spatial-temporal clusters of childhood cancer incidence in the province of Córdoba, Argentina (2004-2013)

Space–time clustering of childhood cancers: a systematic review and pooled analysis

Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History

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