Abstract
BackgroundWe specifically tested the aetiological hypothesis that a factor influencing geographical or temporal heterogeneity of childhood central nervous system (CNS) tumour incidence was related to exposure to a transient environmental agent.MethodsInformation was extracted on individuals aged 0-14 years, diagnosed with a CNS tumour between the 1st January 1974 and 31st December 2006 from the Yorkshire Specialist Register of Cancer in Children and Young People. Ordnance Survey eight-digit grid references were allocated to each case with respect to addresses at the time of birth and the time of diagnosis, locating each address to within 0.1 km. The following diagnostic groups were specified a priori for analysis: ependymoma; astrocytoma; primitive neuroectodermal tumours (PNETs); other gliomas; total CNS tumours. We applied the K-function method for testing global space-time clustering using fixed geographical distance thresholds. Tests were repeated using variable nearest neighbour (NN) thresholds.ResultsThere was statistically significant global space-time clustering for PNETs only, based on time and place of diagnosis (P = 0.03 and 0.01 using the fixed geographical distance and the variable NN threshold versions of the K-function method respectively).ConclusionsThere was some evidence for a transient environmental component to the aetiology of PNETs. However, a possible role for chance cannot be excluded.
Highlights
We tested the aetiological hypothesis that a factor influencing geographical or temporal heterogeneity of childhood central nervous system (CNS) tumour incidence was related to exposure to a transient environmental agent
One study from Japan identified a peak for all central nervous system tumours who were born in the winter [9], a study from northern England found an excess of astrocytoma cases born in October [10], and a study from the USA showed an excess of primitive neuroectodermal tumours (PNETs) cases born in October [11]
This study has found evidence of overall space-time clustering amongst cases of the PNET sub-type (partly supporting prior hypothesis (i) that a transient environmental agent may be involved in aetiology)
Summary
We tested the aetiological hypothesis that a factor influencing geographical or temporal heterogeneity of childhood central nervous system (CNS) tumour incidence was related to exposure to a transient environmental agent. If infections that are non-ubiquitous and non-endemic are involved in disease aetiology, among cases the distribution of births (for an early exposure) or diagnoses (for a later exposure) may exhibit seasonal variation. There have been several recent studies of space-time clustering of national (GB) childhood cancer data [12,13], which found statistically significant evidence of clustering overall and marginally significant evidence for cases of astrocytoma diagnosed during the period 1969-1993. A study from North West England found evidence of space-time clustering and seasonal variation amongst cases of childhood CNS tumours, astrocytoma and ependymoma [14]. Another study from the Netherlands of adult gliomas, diagnosed in cases aged more than 15 years, found evidence of overall spacetime clustering which could not be attributed to a specific sub-type [15,16]
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