Higher risk for acute childhood lymphoblastic leukaemia in Swedish population centres 1973-94

Hjalmars, Ulf; Gustafsson, G

doi:10.1038/sj.bjc.6690007

Cited by 20 publications

(14 citation statements)

References 19 publications

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“…In contrast with previously published findings in Taiwan (Li et al, 1998), Australia (McWhirter and Bacon, 1980), Greece (Petridou et al, 1997), Sweden (Hjalmars and Gustafsson, 1999), and the United States (Muirhead, 1995), studies in the United Kingdom found higher incidence of childhood ALL in rural areas. The incidence of ALL among children aged 1 -7 years in 3270 electoral wards in England and Wales during 1984 -1988 increased over four levels of distance from built-up areas (RR ¼ 2.2; trend P ¼ 0.002) for wards 420 km from a built-up area (Alexander et al, 1990(Alexander et al, , 1996.…”

Section: Discussioncontrasting

confidence: 77%

“…Some researchers have assessed the effect of population density, as well as urbanisation per se, on incidence of ALL. Incidence of ALL among Swedish children under age 15 during 1973-1994(Hjalmars and Gustafsson, 1999 was significantly higher in 'population centres' than in the Swedish countryside (3.99 vs 2.38 cases per 100 000; OR ¼ 1.68; 95% CI ¼ 1.44 -1.95); no significant rural -urban gradient was observed for ANLL (0.67 vs 0.59 cases per 100 000; OR ¼ 1.13; 95% CI ¼ 0.98 -1.32). The childhood ALL incidence rates in Sweden increased monotonically with increasing degrees of urbanisation (3.32, 3.41, and 3.65 cases per 100 000 in 'rural', 'semiurban', and 'urban' areas, respectively), and also with increasing population density (3.55, 3.63, and 4.09 cases per 100 000 in areas with o400, 400 -800, and 4800 persons per square kilometer, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Studies in the UK (Alexander et al, 1990(Alexander et al, , 1996Gilman and Knox, 1998;Dickinson and Parker, 1999) have generally shown higher rates of ALL or non-Hodgkin's lymphoma (NHL) in rural areas. However, studies in Taiwan (Li et al, 1998), Australia (McWhirter and Bacon, 1980), Greece (Petridou et al, 1997), Sweden (Hjalmars and Gustafsson, 1999), and the United States (Muirhead, 1995) have shown higher incidence of ALL in urban or high-density regions.…”

mentioning

confidence: 99%

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Urbanisation and incidence of acute lymphocytic leukaemia among United States children aged 0–4

McLaughlin²,

et al. 2005

Br J Cancer

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Acute lymphocytic leukaemia (ALL) incidence among children under 5 years of age was examined, utilising data from 24 United States cancer registries. County-based incidence rates among white children were compared across four levels of urbanisation: large and small metropolitan counties, and adjacent and nonadjacent rural counties. In metropolitan areas, the incidence of ALL was lower among blacks (rate ratio (RR) ¼ 0.38, confidence interval (CI) ¼ 0.33 -0.44) and among Asians/Pacific Islanders (RR ¼ 0.78, CI ¼ 0.63 -0.97) than among whites. Among white children, the incidence of ALL decreased across the four strata of urbanisation, from 67 to 62 to 65 to 54 cases per million person-years at-risk (two-sided trend P ¼ 0.009), such that rates were significantly lower in the most remote rural counties than in the most populous metropolitan counties (RR ¼ 0.80, 95% CI ¼ 0.70 -0.91).

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Urbanisation and incidence of acute lymphocytic leukaemia among United States children aged 0–4

McLaughlin²,

et al. 2005

Br J Cancer

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“…Previous studies in Britain have also found a higher incidence of ALL in rural or isolated areas (Alexander et al, 1990b;Dickinson and Parker, 1999). This contrasts with findings of higher incidence in urban areas in several other countries, including Greece (Petridou et al, 1997), Taiwan (Li et al, 1998), Sweden (Hjalmars et al, 1999) and the United States (Adelman et al, 2005). None of these studies controlled for socioeconomic status, however, and patterns of socioeconomic status in relation to urbanisation may differ between countries.…”

Section: Discussionmentioning

confidence: 83%

Population mixing, socioeconomic status and incidence of childhood acute lymphoblastic leukaemia in England and Wales: analysis by census ward

et al. 2008

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In this population-based study of acute lymphoblastic leukaemia (ALL) diagnosed among children aged under 15 years in England and Wales during 1986 -1995, we analysed incidence at census ward level in relation to a range of variables from the 1991 census, which could be relevant to theories of infectious aetiology. 'Population-mixing' measures, used as surrogates for quantity and diversity of infections entering the community, were calculated from census data on the origins and destinations of migrants in the year before the census. Incidence at ages 1 -4 years tended independently to be higher in rural wards, to increase with the diversity of origin wards from which in-migrants had moved during the year before the census, and to be lower in the most deprived areas as categorised by the Carstairs index. This last association was much weaker when urban/rural status and in-migrants' diversity were allowed for. There was no evidence of association with population mixing or deprivation for ALL diagnosed at ages 0 or 5 -14 years. The apparent specificity to the young childhood age group suggests that these associations are particularly marked for precursor B-cell ALL, with the disease more likely to occur when delayed exposure to infection leads to increased immunological stress, as predicted by Greaves. The association with diversity of incomers, especially in rural areas, is also consistent with the higher incidence of leukaemia predicted by Kinlen, where population mixing results in below average herd immunity to an infectious agent.

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“…In a previous Swedish study, an enhanced risk of childhood ALL was found in population centres, but there was no indication that specific geographically localized areas were involved [23]. Another Swedish study on parental occupation and childhood cancer using information from the 1960 national census for occupation, showed an increased risk for lymphoma in children to seamen but no increased risk of cancer for fishermen children.…”

Section: Discussionmentioning

confidence: 98%

Incidence Rates of Malignant Diseases in Childhood and Adolescence in Children to Swedish Fishermen

Dreifaldt¹

2014

J Carcinog Mutagen

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In this register-based study the risks of childhood malignant diseases in the offspring of Swedish fishermen were analysed. Having a fisherman as a parent was used as surrogate for exposure, both pre-and postnatal, to Persistent Organic Pollutants (POPs) due to high fish consumption. A cohort of fishermen was identified by Statistics Sweden by using the national census registration carried out from 1960 to 1990. For each fisherman, 4 matched -population-based referents were drawn. The children of fishermen and referents were identified and matched against the Swedish cancer registry 1960-1998, the causes of death registry 1960-1997 and notifications of deaths 1998-1999. Children diagnosed with cancer before the parent appeared in the census were excluded. MantelHaenszel analysis, adjusted for age and gender, was performed. Incidence rate ratios (IRR) and 95% Confidence Intervals (CI) for the different malignant diagnoses in children 0 to 19 years old were calculated. Fishermen children had an overall increased incidence rate ratio of cancer, IRR=1.38, 95% CI=0.96-2.00. An increased incidence rate ratio was observed for acute lymphatic leukaemia (ALL), IRR=2.65, 95% CI=1.005-6.97, and in west coast children for non-Hodgkin's lymphoma, IRR=3.19, 95% CI=0.98-10.4. The importance of exposure to POPs to these findings needs further investigation.

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Higher risk for acute childhood lymphoblastic leukaemia in Swedish population centres 1973-94

Cited by 20 publications

References 19 publications

Urbanisation and incidence of acute lymphocytic leukaemia among United States children aged 0–4

Urbanisation and incidence of acute lymphocytic leukaemia among United States children aged 0–4

Population mixing, socioeconomic status and incidence of childhood acute lymphoblastic leukaemia in England and Wales: analysis by census ward

Incidence Rates of Malignant Diseases in Childhood and Adolescence in Children to Swedish Fishermen

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