Perinatal, Familial, and Neighborhood Risk Factors for Childhood Cancer

描述(申请人提供)：在过去的60年里，儿童癌症的发病率稳步上升，是发达国家儿童死亡的第二大原因。大多数儿童癌症的病因不明，但由于围产期、家族性和环境风险因素尚未确定，推测起源于子宫。 我们建议进行迄今为止最大规模的基于人群的队列研究，利用瑞典整个人口的综合数据，确定特定儿童癌症的围产期、家族性和邻里关系风险因素。将从瑞典出生登记处和1973年至2008年在瑞典出生的所有个人(N=约350万儿童)的人口普查数据中确定围产期、家庭和邻里因素。这些数据将被链接到瑞典癌症登记处，以全面确定从出生到2009年确诊的最常见的儿童癌症(包括白血病、脑瘤、淋巴瘤、神经母细胞瘤、肾母细胞瘤、软组织肉瘤、视网膜母细胞瘤、骨肿瘤和肝母细胞瘤)。具体目的是：1)检查围产期、家族性和邻里关系特征与特定儿童癌症风险和组织学亚型之间的关系；2)探索围产期、家族性和邻里关系特征与特定儿童癌症风险之间的潜在交互作用；以及3)表征研究期间特定儿童癌症风险的时间趋势。这项具有成本效益的研究将促进对儿童癌症病因的了解，有助于识别高危婴儿，最终可能使早期预防和治疗干预措施能够降低儿童癌症的发病率和死亡率。

DESCRIPTION (provided by applicant): Childhood cancer has steadily increased in incidence over the past 60 years, and is the second leading cause of death among children in developed countries. Most childhood cancers have an unknown etiology but are hypothesized to originate in utero due to perinatal, familial, and environmental risk factors that have yet to be identified. We propose to conduct the largest population-based cohort studies to date to identify perinatal, familial, and neighborhood risk factors for specific childhood cancers using comprehensive data for the entire population of Sweden. Perinatal, familial, and neighborhood factors will be identified from the Swedish Birth Registry and census data for all individuals born in Sweden from 1973 through 2008 (N=~3.5 million children). These data will be linked to the Swedish Cancer Registry for complete ascertainment of the most common childhood cancers (including leukemias, brain tumors, lymphomas, neuroblastomas, Wilms tumors, soft tissue sarcomas, retinoblastomas, bone tumors, and hepatoblastomas), diagnosed from birth through 2009. The specific aims are to: 1) Examine the association between perinatal, familial, and neighborhood characteristics and the risk of specific childhood cancers and histologic subtypes; 2) Explore potential interactions among perinatal, familial, and neighborhood characteristics with respect to the risk of specific childhood cancers; and 3) Characterize time trends in the risk of specific childhood cancers during the study period. This cost-effective study will advance the understanding of childhood cancer etiologies, facilitate the identification of high-risk infants, ad ultimately may enable earlier preventive and therapeutic interventions to reduce childhood cancer incidence and mortality.