Season of birth and diagnosis for childhood cancer in Northern England, 1968–2005

Abstract

The aim of this study was to investigate seasonal variation in the incidence of cancer in children aged 0-14 years. Details of 2959 primary malignant cases (1659 males, 1300 females), diagnosed during the period 1968-2005, were extracted from a specialist registry (the Northern Region Young Persons' Malignant Disease Registry). Seasonal variation was analysed with respect to month of birth and diagnosis. The chi-squared heterogeneity test was used to test for non-uniform variation. Poisson regression analysis was used to fit sinusoidal (harmonic) models to the data, using month of birth and month of diagnosis, respectively, as covariates in separate models. There was significant sinusoidal variation based on month of birth for acute lymphoblastic leukaemia (ALL) aged 1-6 years (P = 0.04; peak in March). For 0- to 14-year-old boys, there was statistically significant sinusoidal variation in month of birth for acute non-lymphocytic leukaemia (P = 0.04; peak in September) and astrocytoma (P = 0.03; peak in October). Based on month of diagnosis, there was statistically significant sinusoidal variation in girls for all lymphomas (P = 0.048; peak in March) and Hodgkin lymphoma (HL) (P = 0.005; peak in January), and in boys for osteosarcoma (P = 0.049; peak in October). This study confirms previous findings of seasonal variation around the month of birth for childhood ALL (at the peak ages) and provides further evidence of seasonal variation around month of birth for astrocytoma and around month of diagnosis for HL. The results are consistent with a role for environmental factors in the aetiology of these diagnostic groups. Further studies are needed to examine putative candidate agents.

Perinatal risk factors for acute myeloid leukemia

“…An interaction between sex and season of birth in relation to AML risk has been reported previously (11). We evaluated for interaction between sex and season of birth by examining sex-stratified risk estimates and formally testing for interaction using a likelihood ratio test.…”

“…Infectious etiologies have been hypothesized for both ALL and AML (9) because of the high incidence of these cancers in early childhood, coinciding with common early infections and immune system immaturity (10). This hypothesis has been supported for ALL by some (11–15) but not all (16–18) studies reporting associations with season of birth, a proxy for perinatal infectious exposures. However, season of birth has rarely been studied in relation to AML risk, and has never been examined in large population-based cohort studies with the potential to provide more robust and generalizable risk estimates.…”

Population mixing for leukaemia, lymphoma and CNS tumours in teenagers and young adults in England, 1996–2005

“…This hypothesis is supported by several previous studies of childhood ALL [3, 6]. The evidence of a possible infectious aetiology for childhood tumours is most established for childhood leukaemia and lymphoma [2, 7–12], but is also emerging for central nervous system (CNS) tumours [13–17] although inconsistencies in the research exist for the latter group [18–20]. Despite increasing evidence of an infectious aetiology for childhood tumours, little aetiological research has been undertaken for major cancers occurring in teenagers and young adults (TYA).…”

Perinatal light imprinting of circadian clocks and systems (PLICCS): A signature of photoperiod around birth on circadian system stability and association with cancer

“…Interestingly, most of these findings are in higher latitude countries where seasonal differences in zeitgeber strength are more pronounced. In contrast, no season of birth association was observed for NHL, HD, brain neoplasms, leukaemia, or lymphoma in the UK, Denmark, Sweden, the Netherlands, USA, Belgium, and Canada (Basta et al, 2010;Choi et al, 1977;Crump et al, 2014;Feltbower et al, 2001;Higgins et al, 2001;Hoffman et al, 2007;Langagergaard et al, 2003;Manshande et al, 1985;Meltzer et al, 1996;Schmidt et al, 2009;Van Laar et al, 2013;Van Steensel-Moll et al, 1983).…”

“…Of seven studies carried out in Denmark, England, USA, and Hungary, all but one (Langagergaard et al, 2003) reported an acute lymphoblastic leukaemia (ALL) clustering for winter birth (with some autumn/spring overlap) (Basta et al, 2010;Feltbower et al, 2001;Halperin et al, 2004;Meltzer et al, 1989;Nyari et al, 2008;Sorensen et al, 2001). Winter birth clustering was also observed for acute myeloid leukaemia (AML) in Sweden (Crump et al, 2015), brain neoplasms combined in Finland and Norway (Heuch et al, 1998;Mainio et al, 2006), glioma in north-east USA (Brenner et al, 2004), and astrocytoma, ependymoma, medulloblastoma, glioblastoma, and germ cell tumours in England, Japan, Denmark, USA, and Germany (Hoffman et al, 2007;Koch et al, 2006;Makino et al, 2011;McNally et al, 2002;Schmidt et al, 2009).…”