Childhood cancer incidence in a cohort of twin babies

Murphy, Michael; Whiteman, David C.; Hey, Kate; Griffith, Myfanwy; Gill, Leicester; Goldacre, Michael J; Vincent, Tim; Bunch, Kathryn

doi:10.1054/bjoc.2001.1799

Cited by 16 publications

(13 citation statements)

References 17 publications

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“…However, previous studies have suggested that twins had lower risk for cancers of the lung (20, 48, 49), skin (20), colon, and rectum (18, 20, 48). Thus, it does not seem likely that the average lower birth weight and gestational age for twins (50, 51) compared with singletons influence cancer risk, which has also been supported in previous studies (52–54). …”

Section: Discussionsupporting

confidence: 72%

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Ahrenfeldt

Skytthe

Möller

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Increasing evidence shows that some cancers originate in utero. It is hypothesized that elevated exposure to some steroid hormones might increase cancer risk and that hormone transfer between twin fetuses could result in different prenatal exposure to testosterone. Methods This large-scale prospective twin study compared opposite-sex (OS) and same-sex (SS) twins to test the impact of intrauterine exposures on cancer risk. On the basis of the Danish and Swedish twin and cancer registries, we calculated incidence rate ratios for OS and SS twins, whereas standardized incidence ratios (SIR) with 95% confidence intervals (CI) were calculated for OS/SS twins compared with the general population. Results Atotal of 18,001 cancers were identified during 1943–2009. No significant differences were observed between OS and SS twins, neither for the sex-specific cancers nor for cancer at all sites. All-cause cancer was slightly reduced for OS and SS twins compared with the general population, significant for OS males (SIR, 0.95; 95% CI, 0.92–0.98) and for SS males and females (SIR, 0.97; 95% CI, 0.94–0.99). Conclusions Our data suggest that having a male co-twin—which may entail higher exposure to prenatal testosterone—does not increase the risk of sex-specific cancers in OS females. Furthermore, the study supports that twinning per se is not a risk factor of cancer. Impact Findings are reassuring, as they fail to provide evidence for the hypothesis that endocrine or other difference in the in utero milieu affects the risk of sex-specific cancers.

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Section: Discussionsupporting

confidence: 72%

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Ahrenfeldt

Skytthe

Möller

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…One study assessed whether cancer occurred more often in the heavier twin, which was the case for leukemia but not all other cancer types combined (5, 9). Another found that there was a reduced incidence of childhood cancer overall in twins weighing below 3000g at birth and an excess in twins weighing 3000g or more (7). Among the few studies that have examined specific cancer diagnoses besides leukemia, one reported fewer cases of renal cancer than expected (4).…”

Section: Discussionmentioning

confidence: 99%

Childhood Cancer among Twins and Higher Order Multiples

Puumala¹,

Carozza

Chow

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Although several studies have found no change or a decreased risk of childhood cancer in twins, few have controlled for potential confounders such as birth weight. We examined the association of birth plurality and childhood cancer in pooled data from five U.S. states (California, Minnesota, New York, Texas, and Washington) using linked birth-cancer registry data. The data, excluding children with Down syndrome or who died before 28 days of life, included 17,672 cases diagnosed from 1980 to 2004 at ages 28 days to 14 years and 57,966 controls with all cases and controls born from 1970 to 2004. Analyses were restricted to children weighing V4,000 g at birth. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regression adjusting for sex, gestational age, birth weight, birth order, maternal age, maternal race, state of birth, and birth year. Children who were multiples had no difference in risk of cancer overall (OR, 0.93; 95% CI, 0.82-1.07), but a borderline reduced risk of Wilms' tumor (OR, 0.65; 95% CI, 0.39-1.09). For children diagnosed <2 y of age there was a reduced risk of Wilms' tumor (OR, 0.27; 95% CI, 0.09-0.86) and neuroblastoma (OR, 0.46; 95% CI,) and an increased risk of fibrosarcoma (OR, 5.81; 95% CI,). Higher-order multiple birth (triplets or higher) was not associated with childhood cancer. Our analysis suggests that mechanisms other than birth weight and gestational age may influence the lower risk of Wilms' tumor and neuroblastoma in multiple births. (Cancer Epidemiol Biomarkers Prev 2009;18(1):162-8)

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“…There is emerging evidence that being a twin is protective for childhood cancer, possibly due to the lower birth weight of twins, earlier limitation of their growth velocity, or the selection effects of higher intrauterine death rates (Murphy et al, 2001;Neale et al, 2005;Milne et al, 2007). It is not yet known how far this extends into young adulthood, although it seems likely that there is no long-term difference in the overall risk of cancer in twins compared with singletons (Hemminki and Chen, 2005).…”

Section: Discussionmentioning

confidence: 99%

Testicular cancer in twins: a meta-analysis

Neale

Carrière

Murphy³

et al. 2007

Br J Cancer

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In a meta-analysis of testicular cancer in twins, twins had a 30% increased risk (estimate 1.31, 95% CI 1.1 -1.6), providing indirect support for the hypothesis that in utero hormone variations influence risk of testicular cancer. The summary-estimate for dizygotic twins was 1.3 (1.0 -1.7) and for monozygotic or same sex twins 1.4 (1.2 -1.8). Testicular germ-cell cancer is either the most common or second most common cancer in men aged 15 -45, depending on country, and rates have been increasing substantially in developed countries over the past few decades (Huyghe et al, 2007). Despite attempts to identify risk factors, the aetiology remains unclear. Cryptorchidism, age (Garner et al, 2005), contra-lateral disease, and family history (Hemminki and Chen, 2006) are the only established risk factors. Both low and high birth weight may also be associated (Michos et al, 2007). Evidence from animal models (Newbold et al, 1987), and indirectly from human studies (reviewed in Grotmol et al, 2006), indicates that the susceptibility for testicular cancer is probably established in utero. The relative importance of environmental factors and genetic factors are not clear, but it is likely that both play an aetiological role (Oosterhuis and Looijenga, 2003). Although the mechanism is uncertain, it is thought that foetal exposure to unusually high oestrogen levels, or an imbalance of oestrogen and androgen levels, might contribute to an increased risk. Examining features of pregnancy, which can affect the levels of these hormones, may help to elucidate the aetiology of this cancer. Twinning is of interest, as twin pregnancies, perhaps particularly with dizygotic twins, result in higher maternal levels of serum oestrogens than with singleton pregnancies.Several studies have suggested an association between being a twin and testicular cancer, but as both testicular cancer and twinning are rare events, inferences have been limited by a lack of precision in most studies. We therefore aimed to improve the precision of the estimate of testicular cancer risk among twins by carrying out a meta-analysis of previously published studies. MATERIALS AND METHODSStudies published in English between 1961 and 2006 were identified through systematic searches of computerised bibliographic databases (Medline and Embase) using combinations of individual search terms and subject headings. We inspected the reference lists of studies retrieved from these initial searches for previously unidentified studies, which were then located on Medline to identify their subject headings. Further searches were then undertaken using these derived subject headings.We included all studies that had reported the risk of testicular cancer in twins compared with the general population or a specific single birth control group. Some studies did not provide a risk estimate for all male twins, instead reporting monozygotic and dizygotic twin risks separately (Braun et al, 1995;Swerdlow et al, 1997;Verkasalo et al, 1999), but if a total estimate could be calculated from t...

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Childhood cancer incidence in a cohort of twin babies

Cited by 16 publications

References 17 publications

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Childhood Cancer among Twins and Higher Order Multiples

Testicular cancer in twins: a meta-analysis

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