Abstract 2741: The risk of cancer among children with birth defects

Abstract

Abstract Background: Although a few genetic syndromes are known to increase cancer risk in children, the presence of a structural birth defect in the absence of these syndromes is increasingly being recognized as a risk factor for childhood cancer. To better understand associations of specific defects and cancer types, we conducted a population-based assessment to avoid biases often present in studies relying on single clinics, referral centers, or treatment networks. Methods: Records of those diagnosed with cancer <20 years of age between 1984 and 2013 in Washington State were linked to their birth certificates (N = 4,043). Birth records of children without cancer were selected at a ratio of 10:1 for a comparison group. Information on birth defects was obtained from birth records. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for: 1) having any reported defect and the risk of childhood cancer; 2) having any reported defect and the risk of specific cancer types; and 3) having a specific defect and the risk of specific cancer types. All models were adjusted for birth year. Results: Having any birth defect was associated with a 50% increased risk of childhood cancer overall (OR 1.5, 95% CI 1.2-1.8), and specifically for leukemia (OR = 1.7, 95% CI 1.2-2.4); neuroblastoma (OR = 1.9, 95% CI 1.0-3.5); soft tissue sarcoma (OR = 2.0, 95% CI 1.2-3.5); and germ cell tumors (OR = 3.0, 95% CI 1.6-5.5). Some specific defects were associated with specific cancer types: central nervous system (CNS) tumors with CNS defects (OR>4.0); leukemia, neuroblastoma, renal tumors, and soft tissue sarcoma with gastrointestinal anomalies (ORs>9.0); renal tumors and urogenital anomalies (OR>4.0); and soft tissue sarcoma with adactyly, polydactyly, or syndactyly (OR>8.0). Conclusions: Consistent with prior studies, structural birth defects were associated with increased cancer risk. Pooling similar data from many regions will increase power to identify specific associations in order to inform molecular studies examining possible common developmental pathways in the etiologies of birth defects and cancer, and will provide information that can be translated into screening strategies for children at high risk of developing cancer. Funding: Cancer Prevention Research Institute of Texas RP140258 and Alex's Lemonade Stand Foundation Citation Format: Philip J. Lupo, Michael E. Scheurer, Sharon E. Plon, Logan E. Spector, Beth A. Mueller. The risk of cancer among children with birth defects. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2741. doi:10.1158/1538-7445.AM2015-2741