Risk of malignant childhood germ cell tumors in relation to demographic,gestational, and perinatal characteristics |
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| Affiliation: | 1. Department of Epidemiology, Fielding School of Public Health, University of California, CA, USA;2. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;3. Division of Pediatric Hematology/Oncology, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA;1. Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, 135, Nan-Hsiao Street, Changhua 500, Taiwan;2. Department of Internal Medicine, Changhua Christian Hospital, 135, Nan-Hsiao Street, Changhua 500, Taiwan;3. Green Energy and Environment Research Laboratories, Industrial Technology Research Institute, No. 195, Section 4, Chung Hsing Road, Chutung, Hsinchu 310, Taiwan;4. Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua 500, Taiwan;1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden;2. Department of Health Sciences, University of Leicester, UK;1. Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA;2. Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA;3. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA;4. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA;5. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;6. Tel Aviv University, Tel Aviv, Israel;1. Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, 07005 Palma, España, Instituto de Investigación Sanitaria de Palma, 07010 Palma, Spain;2. Evaluation and Clinical Epidemiology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain;3. Clinical Epidemiology and Biostatistics Unit, A Coruña University, Complexo Hospitalario Universitario A Coruña, Xubias de Arriba, 84, Hotel de los pacientes 7ª planta, 15006, A Coruña, Spain;4. Serreria II Primary Care Centre, Valencia Institute of Health, C/Pedro de Valencia 28, 46022, Valencia, Spain;5. Canal Imperial Primary Care Centre, Paseo Colon 4, Zaragoza, 50006, Spain;6. Department of Public Health, Balearic Department of Health, C/Jesus n 33, 07001, Instituto de Investigación Sanitaria de Palma, 07010 Palma, Spain, Spain;1. Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;2. School of Pharmacy, Queen’s University Belfast, Northern Ireland, United Kingdom;3. Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;1. Registre général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe;2. Service d’anatomopathologie, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe;3. Service d’Oncologie-Radiothérapie, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe;4. Service de Gynécologie-Obstétrique, Centre Hospitalier de la Basse-Terre, Guadeloupe;5. Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe;6. Institut National de la Santé et de la Recherche Médicale Inserm U1085 - IRSET, Campus Universitaire de Fouillole, Guadeloupe |
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| Abstract: | BackgroundChildhood germ cell tumors (GCTs) are a rare assortment of neoplasms, with mostly unknown etiology, that are believed to originate very early in life. Few studies have examined risk factors by histologic subtype, despite evidence of different risk profiles.Materials and methodsIn this population-based case-control study, 451 childhood malignant GCT cases ages 0–5 years were identified from the California Cancer Registry. Differentiating between common histologic subtypes, we identified 181 yolk sac tumors, 216 teratomas, and 54 rarer subtypes. Cases were linked to their birth certificates and 271,381 controls, frequency matched by birth year, were randomly selected from California birthrolls to investigate the contributions of demographic, gestational, and pregnancy factors using unconditional logistic regression analysis.ResultsCompared to non-Hispanic whites, Asian/Pacific Islander children were at an increased risk for developing GCTs (odds ratio [OR] = 1.94; 95% confidence interval [CI] = 1.47, 2.56). Among pregnancy complications and procedures, yolk sac tumors were positively associated with the presence of fetopelvic disproportion (OR = 2.97; 95% CI = 1.55, 5.68), while teratomas were strongly associated with polyhydramnios or oligohydramnios (OR = 14.76; 95% CI = 7.21, 30.19) and the presence of an ear, face, or neck anomaly at birth (OR = 93.70; 95% CI = 42.14, 208.82).ConclusionsMalignant yolk sac tumors and malignant teratomas exhibited distinct demographic and gestational characteristics; additionally, complications in pregnancy and labor may be brought on by specific histologic subtypes. |
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| Keywords: | Germ cell tumor Yolk sac tumor Teratoma Childhood Cancer Congenital malformation Race Perinatal Risk factor Epidemiology |
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