Increased Prevalence of Malignant Diseases in the Close Neighborhood of Children with Cancer. (Features)

By Samuelsson, Ulf; Gustafsson, Britt et al. | Journal of Environmental Health, March 2002 | Go to article overview

Increased Prevalence of Malignant Diseases in the Close Neighborhood of Children with Cancer. (Features)


Samuelsson, Ulf, Gustafsson, Britt, Ludvigsson, Johnny, Journal of Environmental Health


Abstract

Clustering of cancer in families may be due to chance, inherited genetic mutations, common exposure to environmental agents, or a combination of these factors. The authors, to address a clinical impression that cancer occurs more often in the environment of a child with cancer, investigated whether the prevalence of cancer among children and adults in the neighborhood of children with cancer was higher than the prevalence in the neighborhood of healthy children. One hundred thirty-seven children diagnosed with a malignant disease between 1981 and 1992 at the Department of Pediatrics, University Hospital of Linkoping, Sweden, were investigated and compared with 232 healthy control children. The control children were traced from the official Swedish population registry. It was found that 13 percent of the children with cancer and six percent of the control children were close neighbors of other children diagnosed with cancer (p < .05). Cancer also was more common in the circles of acquaintances around the children with cancer than in circles of acquaintances around control children (p < .03). The frequency of cancer in the neighborhood or in the circle of acquaintances was significantly greater in older children than in younger children. These results support the hypothesis that environmental factors can initiate or precipitate cancer in children as well as in adults.

Introduction

At the level of the cell, cancer is nearly always a genetic disease with such features as the involvement of oncogenes and loss of the normal function of tumor suppressor genes (Pizzo & Poplack, 1999), DNA repair genes, and genes affecting cell survival (Hawn et al, 1995; Takano, Harmon, & Kerr, 1991). These genetic changes might be mediated both by exogenous and endogenous factors (Behrman, Kliegman, & Arvin, 1996; Chang, Syrjanen, & Tervahauta, 1993).

In adults, about 30 percent of all cancers are supposed to be caused by smoking and 30 percent by dietary factor (Berkel, 1996). Pediatric cancer, by contrast, has contributed much less to knowledge of the environmental aspects of carcinogenesis than to knowledge of genetic aspects. The Chernobyl reactor accident of April 1986 caused fear that the risk of cancer in children would increase as a result of increased exposure to radioactivity Investigations so far have not found such increase (Auvinen et al., 1994; Hjalmars, Gustafsson, & Kulldorf, 1994; Prisyazhiuk, Beral Buzanov Pjataj, & Reeves, 1991). Some studies have found a relation between magnetic fields and the risk for childhood brain tumors (Savitz, Barnes, John, Wachtel, & Tvrdik, 1988) and childhood leukemia (Feychting & Ahibom, 1993). Studies of smoking during pregnancy have shown conflicting results, some finding increased risk of leukemia in the child (Stjernfeldt, Berglund, Ludvigsson, & Lindsten, 1986) and others finding almost the opposite (P ershagen, Ericsson, Otterblad-Olausson, 1992). There is some evidence for a viral or infectious etiology in childhood leukemia (Alexander, 1993; Alexander et al., 1997; Greaves & Alexander, 1993; Kinlen, 1995; Sandler, 1995) as well as for Hodgkin's disease (Grufferman & Delzell, 1984). The virus hypothesis is based on the assumption of an abnormal response to some common infection (Greaves, 1999; Greaves & Alexander, 1993).

The associations between parental occupation or exposure of parents at the time of conception and cancer in their offspring are largely inconsistent. Some studies have found evidence for an association (Alexander, 1993; Brunetti, Cavallieri, Stanta, & Tamoro, 1997), and others have failed to do so (Gustafsson, Carstensen, & Ludvigsson, 1995; Kinlen, 1993; Olsen, Bautz, Boice, Fraumeni, & Seershoim, 1995; Olsen, Schulgen, de Nully Brown, & Jensen, 1991).

The aim of this study was to investigate whether the prevalence of cancer among children in the neighborhood of children with cancer was higher than the prevalence among children in the neighborhood of healthy control children. …

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