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Perinatal risk factors for Wilms tumor in a Swedish national cohort.
- Source :
-
European journal of epidemiology [Eur J Epidemiol] 2014 Mar; Vol. 29 (3), pp. 191-7. Date of Electronic Publication: 2014 Feb 08. - Publication Year :
- 2014
-
Abstract
- Perinatal risk factors including high birth weight have been associated with Wilms tumor in case-control studies. However, these findings have seldom been examined in large cohort studies, and the specific contributions of gestational age at birth and fetal growth remain unknown. We conducted the largest population-based cohort study to date consisting of 3,571,574 persons born in Sweden in 1973-2008, followed up for Wilms tumor incidence through 2009 to examine perinatal risk factors. There were 443 Wilms tumor cases identified in 66.3 million person-years of follow-up. After adjusting for gestational age and other perinatal factors, high fetal growth was associated with increased risk of Wilms tumor among girls (hazard ratio per 1 standard deviation (SD), 1.36; 95% CI 1.20-1.54; P < 0.001), but not boys (1.10; 95% CI 0.97-1.25; P = 0.14) (P interaction = 0.02). Among girls, high fetal growth was associated with disease onset before age 5 years (odds ratio per 1 SD, 1.47; 95% CI 1.28-1.69; P < 0.001), but not beyond (1.00; 95% CI 0.76-1.31; P = 0.99). No clear associations were found for gestational age at birth or other perinatal factors. In this large cohort study, high fetal growth was associated with Wilms tumor before age 5 years among girls. These findings suggest that early-life growth factor pathways for Wilms tumor may be more common among girls than boys. Further elucidation of these mechanisms may reveal better targets for prevention or treatment of specific subtypes of Wilms tumor.
- Subjects :
- Age Factors
Birth Order
Birth Weight
Female
Follow-Up Studies
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Male
Maternal Age
Population Surveillance
Proportional Hazards Models
Registries
Regression Analysis
Risk Factors
Sex Factors
Socioeconomic Factors
Sweden epidemiology
Wilms Tumor diagnosis
Wilms Tumor etiology
Fetal Development
Wilms Tumor epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7284
- Volume :
- 29
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 24510487
- Full Text :
- https://doi.org/10.1007/s10654-014-9880-9