Cross‐space‐time clustering of childhood cancer in Great Britain: Evidence for a common aetiology

• Published in: International journal of cancer Vol. 134; no. 1; pp. 136 - 143
• Main Authors: McNally, Richard J.Q., Stiller, Charles, Vincent, Tim J., Murphy, Michael F.G.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley-Blackwell 01-01-2014; Wiley Subscription Services, Inc; BlackWell Publishing Ltd
• Subjects: Adolescent; aetiology; Biological and medical sciences; Cancer; Child; Child, Preschool; childhood; Children & youth; Epidemiology; Female; Great Britain; Humans; Infant; Infant, Newborn; Leukemia; Lymphoma; Male; Medical research; Medical sciences; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - epidemiology; Neoplasms - etiology; Space-Time Clustering; Tumors; United Kingdom - epidemiology; United Kingdom; Great Britain; Europe; Human; Great Britain; Cancerology; childhood; Etiology; space-time clustering; aetiology; Malignant tumor; Child; Epidemiology; Cancer; epidemiology; cancer
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.28332

Previously, we identified space‐time clustering in certain childhood cancers. This study aimed to determine whether there was cross‐space‐time clustering between different diagnostic groups. A total of 32,295 cases were diagnosed during 1969–1993. Cross‐space‐time clustering was analyzed by a second‐order procedure based on Diggle's method. Locations were birth and diagnosis addresses. The following space‐time combinations were examined: address and date of birth; address at birth and date of diagnosis; address and date of diagnosis. Cross‐space‐time clustering analyses considered clustering pairs of cases from two different diagnostic groups. Formal statistical significance was taken as p < 0.00067 and marginal significance 0.01 > p ≥ 0.00067. Based on address at birth and date of diagnosis, there was statistically significant cross‐clustering between cases of HL and intracranial and intraspinal embryonal tumors (IIET), both aged 0–14 years (p < 0.0001). Based on address and date of birth, there was marginally significant cross‐clustering between cases of lymphoid leukemia (LL) aged 5‐14 years and Hodgkin lymphoma (HL) aged 0–14 years (p = 0.0019). Based on address and date of diagnosis there was marginally significant cross‐clustering between cases of LL aged 1–4 years and soft tissue sarcoma (STS) aged 0–14 years (p = 0.0041). Findings from this study are consistent with possible common aetiological factors between different diagnostic groups. They suggest a common aetiology for the following pairs of diagnostic groups: HL and IIET; older cases of LL and HL; younger cases of LL and STS. The possibility of common infectious mechanisms should be explored.
What's new?
The clustering of childhood cancers within specific geographical areas of Great Britain between 1969 and 1993 has raised questions about the possible etiological involvement of environmental exposures. Here, cross‐space‐time clustering analysis was used to explore associations between different childhood cancers diagnosed in the region during the 1ST January 1969 to 31ST December 1993 is a 25‐year period. Significant clustering was identified between cases of Hodgkin lymphoma and intracranial and intraspinal embryonal tumors, while marginal clustering was observed between lymphoid leukemia and Hodgkin lymphoma and between lymphoid leukemia and soft tissue sarcoma. The findings support the idea that common etiological factors could explain the clustering of these different cancers.