Socioeconomic differences in the risk of childhood central nervous system tumors in Denmark: a nationwide register-based case–control study

Abstract

Purpose Differences in the risk of childhood central nervous system (CNS) tumors by socioeconomic status (SES) may enhance etiologic insights. We conducted a nationwide register-based case-control study to evaluate socioeconomic differences in the risk of childhood CNS tumors in Denmark and examined whether associations varied by different SES measures, time points of assessment, specific tumor types, and age at diagnosis. Methods We identified all children born between 1981 and 2013 and diagnosed with a CNS tumor at ages 0-19 years (n = 1,273) from the Danish Cancer Registry and sampled four individually matched controls per case (n = 5,086). We used conditional logistic regression models to estimate associations with individual-level and neighborhood-level socioeconomic measures. Results We observed elevated risks of ependymoma and embryonal CNS tumors in association with higher parental education (odds ratios (ORs) of 1.6-2.1 for maternal or paternal high education and ependymoma) and higher risk of all tumor types in association with higher maternal income, e.g., OR 1.93; 95% CI 1.05-3.52 for high versus low income for astrocytoma and other gliomas. Associations were often stronger in children diagnosed at ages 5-19 years. We found little evidence for an association with neighborhood SES. Conclusion This large nationwide register study with minimal risk of bias showed that having parents with higher educational level and a mother with higher income was associated with a higher risk of childhood CNS tumors. Bias or underascertainment of cases among families with low income or basic education is unlikely to explain our findings.

Pediatric Brain Tumors: Descriptive Epidemiology, Risk Factors, and Future Directions

“…However, the results from the studies of parental occupational/residential exposure to pesticides are more consistent and the meta-analysis studies indicate a positive association between risk of PBTs and exposure to pesticides (6,12,45,46). In addition, positive associations between parental high socioeconomic status (47,48) as well as maternal intake of dietary N-nitroso compounds (NOC) and risk of PBTs in offspring have been reported by meta-analysis (6,12,49).…”

Air pollution exposure at the residence and risk of childhood cancers in Denmark: A nationwide register-based case-control study

“…In a Danish context, an area-level effect with a higher incidence of leukemia observed in deprived municipalities, have been reported [32] . A Danish study on socioeconomic status (SES) and childhood central nervous system (CNS) tumors found a higher risk in relation to higher parental education and maternal income, but no association for neighborhood-level SES indicators [33] .…”

Is the risk of childhood leukaemia associated with socioeconomic measures in Denmark? A nationwide register‐based case‐control study

“…We operationalised three neighbourhood SES measures based on the distribution of educational achievements, disposable income and profession among inhabitants of a given parish as described previously 44 . Parish is the smallest geographical unit at which socioeconomic information is available in Denmark.…”

“…We obtained annual information on maternal and paternal highest education and disposable income from the Danish education 42 and income registers 43 We operationalised three neighbourhood SES measures based on the distribution of educational achievements, disposable income and profession among inhabitants of a given parish as described previously. 44 Parish is the smallest geographical unit at which socioeconomic information is available in Denmark. In 2013, parishes (N = 2160) differed in size from 0.12 to 126.2 km 2 (mean area = 19.9 km 2 ) and in population from 26 to 42 251 inhabitants (median = 1037 inhabitants).…”