Abstract 5778: Hernia and Ewing sarcoma

Abstract

Abstract Introduction: Ewing sarcoma (ES) is a rare cancer with an incidence that peaks in adolescence and young adulthood. The tumor occurs in bone and soft tissue and the etiology is unclear. Several studies have observed increased ES risk in children and young adults with hernia, including umbilical and inguinal hernia, suggesting a mechanism for a common causal pathway. A meta-analysis of 3 case-control studies reported a threefold increased risk of ES among hernia patients. The purpose of this study is to examine the association between hernia and ES in a population-based study. Methods: We ascertained Ewing sarcoma cases (age <20 years) from the Danish Cancer Registry (diagnoses 1977-2016; births 1977-2013), then randomly selected controls free of cancer at the date of corresponding cases diagnosis and matched (25:1) by sex and year of birth from the Central Population Register (N=4,160). Ewing sarcoma cases (N=122) were identified with the International Classification of Diseases for Oncology (ICD-O-1 and ICD-O-3 code 9260). Information on birth outcomes and gestational factors were taken from the Medical Birth Registry (1973+) and information on mother's and child's health was taken from the National Patient Register (1977+). We also searched this Register for diagnoses of hernia in the child based on procedure codes (a Nordic coding system from 1977-1995, and an extended version of ICD-10 thereafter). We used conditional logistic regression to determine associations for hernia and ES. Results: 122 ES cases were identified, among whom 6 cases had a diagnosis of hernia (1 of them had hernia diagnosed within the first 3 years of life). Among controls, 203 (6.7%) had a diagnosis of hernia. Of all children diagnosed with hernia, 27 (12.9%) presented hernia during the first year of life and 74 (35.4%) presented during the first 3 years of life. In ES cases there was no increase in risk of hernia (OR= 0.53, 0.17-1.72). Adjustment for presence of other congenital malformations did not change the results for hernia (OR=0.65). Restriction to younger cases (diagnosed ≤15 years) showed similar results for hernia. Conclusions: Previous studies have raised the possibility that inherited genes causing both developmental anomalies and cancer might be involved with the etiology of ES. However, based on registry and hospitalization data, we were not able to confirm previous associations with hernia. Either this study or earlier studies may have been influenced by small sample size. There is also a possibility that previous reports of positive associations are due to recall or publication biases. Citation Format: Di He, Johnni Hansen, Noah Federman, Jorn Olsen, Beate Ritz, Julia E. Heck. Hernia and Ewing sarcoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5778.