AN EXPLORATORY-STUDY OF ENVIRONMENTAL AND MEDICAL FACTORS POTENTIALLY RELATED TO CHILDHOOD-CANCER
AN EXPLORATORY-STUDY OF ENVIRONMENTAL AND MEDICAL FACTORS POTENTIALLY RELATED TO CHILDHOOD-CANCER
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DOI：
10.1002/mpo.2950190209
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发表时间：
1991-01-01
期刊：
影响因子：
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通讯作者：
DAVIS, B
中科院分区：
文献类型：
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作者：
SCHWARTZBAUM, JA;GEORGE, SL;DAVIS, B
为了确定儿童癌症医院是否可以使用通用流行病学调查问卷来确定环境因素与主要儿童癌症类型之间的关联，我们报告了从此类调查问卷中获得的数据的分析结果。 1979 年至 1986 年间，田纳西州孟菲斯市圣裘德儿童研究医院入院时，对 1,270 名被诊断患有儿童癌症的患者的母亲进行了调查问卷。大约一半的儿童患有急性白血病（n = 629）；其余的患有淋巴瘤（n = 237）或实体瘤（n = 404）。对有关患者和父母的环境和医疗史的问题的回答在九个诊断类别中进行了比较。在调整患者或产妇年龄、出生或诊断年份、患者种族和社会阶层的混杂因素后，232 个变量中只有 5 个保持名义上的统计学显着性 (P < 0.05)。确定的变量是患者母乳喂养的时间长度（chi-2 = 16.1，P = 0.04）；拥有一个装有肥料、除草剂和杀虫剂的花园（chi-2 = 17.2，P = 0.03）；患者出生前一年内母亲使用性激素的情况（chi-2 = 18.2，P = 0.02）；母亲吸烟量（chi-2 = 18.0，P = 0.02）；以及患者与癌症患者的接触（chi-2 = 20.7，P = 0.01）。尽管研究了大量患者，但我们发现的显着变量比原假设下平均预期的要少。我们的结论是，从通用流行病学调查问卷中获得的数据并不能提供有关环境因素暴露与几种儿童癌症之间关系的有用概述。
To determine whether a general-purpose epidemiologic questionnaire can be used in childhood cancer hospitals to identify associations between environmental factors and the major types of childhood cancer, we report the results of the analysis of the data obtained from such a questionnaire. On admission to St. Jude Children's Research Hospital in Memphis, Tennessee, between 1979 and 1986 a questionnaire was administered to 1,270 mothers of patients diagnosed with childhood cancer. Approximately one-half of the children had acute leukemias (n = 629); the remainder had lymphomas (n = 237) or solid tumors (n = 404). Responses to questions regarding the patients' and parents' environmental and medical histories were compared across nine diagnostic categories. Only 5 of 232 variables remained nominally statistically significant (P < 0.05) after adjusting for confounding by patient or maternal age, year of birth or diagnosis, patient's race, and social class. The variables identified were length of time the patient was breast-fed (chi-2 = 16.1, P = 0.04); having a garden with fertilizers, herbicides, and pesticides (chi-2 = 17.2, P = 0.03); maternal use of sex hormones during the year before the patient's birth (chi-2 = 18.2, P = 0.02); maternal cigarette consumption (chi-2 = 18.0, P = 0.02); and patient contact with persons with cancer (chi-2 = 20.7, P = 0.01). Despite the large number of patients studied, we identified fewer signficant variables than would be expected, on the average, under the null hypothesis. We conclude that the data obtained from a general-purpose epidemiologic questionnaire do not provide a useful overview of the association between exposure to environmental factors and several types of childhood cancer.