Associations of demographic and perinatal factors with childhood neuroblastoma in Texas, 1995-2011.

Background: Neuroblastoma, the most common extracranial solid tumor in children, contributes disproportionately to childhood cancer mortality and few risk factors have been identified. Our objective was to evaluate associations between parental and infant characteristics and neuroblastoma incidence.
Methods: Children born in Texas between January 1995 and December 2011 were eligible for the present study. Cases (N = 637) were diagnosed with neuroblastoma in Texas during the same period; controls (N = 6370) matched on year of birth were randomly selected from birth certificates that did not link to a record in the Texas Cancer Registry. We obtained data on birth and parental demographic/reproductive characteristics from birth certificates, and estimated odds ratios (OR) and 95% confidence intervals (CIs) for neuroblastoma using logistic regression.
Results: Gestational age 34-36 weeks at birth was associated with neuroblastoma (OR 1.45, CI 1.09-1.90), whereas female sex was inversely associated (OR 0.68, CI 0.58-0.81). Relative to children of non-Hispanic White women, children of Hispanic (OR 0.53, CI 0.43-0.64) or non-Hispanic Black (OR 0.52, CI 0.38-0.71) women were at reduced odds of neuroblastoma. When maternal and paternal race/ethnicity were evaluated jointly, similar patterns were observed (two non-Hispanic Black parents: OR 0.55, 95%CI 0.36-0.79; two Hispanic parents: OR 0.53, 95%CI 0.41-0.67). Older maternal age was also positively associated with neuroblastoma (OR 1.41, CI 1.04-1.90 for 35-39 years; OR 1.62, CI 0.87-2.81 for ≥40 years, relative to 25-29 years).
Conclusions: Findings provide further evidence of racial/ethnic disparities in neuroblastoma incidence, determinants of which are unknown. In contrast to most published studies, we observed an association between maternal age and neuroblastoma. Further studies with more robust control for confounding are warranted.
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