Advertisement

Cancer Causes & Control

, Volume 20, Issue 6, pp 957–963 | Cite as

Maternal exposure to medical radiation and Wilms tumor in the offspring: a report from the Children’s Oncology Group

  • Ruchika Goel
  • Andrew F. Olshan
  • Julie A. Ross
  • Norman E. Breslow
  • Brad H. Pollock
Original Paper

Abstract

Objective

This study examined the association between pre-conception and in utero maternal medical radiation exposure and Wilms tumor, using data from a large population-based case–control study.

Methods

Cases were identified from the National Wilms Tumor Study Group. Controls were identified by random digit dialing and frequency matched to child’s age and geographic area of residence in the United States and Canada. Interview data from 512 cases and 509 controls were analyzed using multivariable logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) for Wilms tumor and exposure to: (1) maternal X-ray alone and; (2) all medical radiation types (X-ray, CT, RT, Nuclear scans, Fluoroscopy) combined, for the period from two years before conception until child birth were estimated after adjustment for age, geographic area, maternal education, and household income.

Results

We found no consistent association between the risk of Wilms tumor and either maternal X-ray exposure (OR 0.9, 95% CI 0.7–1.3) or all medical radiation types combined (OR 0.9, 95% CI 0.7–1.2). No meaningful associations were seen for analysis of gonadal or non-gonadal radiation exposure.

Conclusion

Our study did not find any consistent pattern of association between Wilms tumor and maternal radiation exposure during pre-pregnancy or pregnancy period. In view of the negative findings from the largest case control study of this question to date, the reduced doses of biological radiation during pregnancy, and the requirements for an improved study design, we believe that future studies of this exposure may not be a priority for research on Wilms tumor.

Keywords

Wilms Tumor Children’s Oncology Group Radiation Maternal 

Notes

Acknowledgments

This study was supported in part by a grant from the National Cancer Institute (R01CA75385) and National Institute of Environmental Health Sciences (P30ES10126). We wish to thank Joanna Smith for her data management support. We are deeply thankful for the families, investigators, and institutions across the country, who have participated in research to prevent and treat childhood cancer.

References

  1. 1.
    Ries LAG, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK (eds) (2004) SEER cancer statistics review 1975–2004. National Cancer Institute, BethesdaGoogle Scholar
  2. 2.
    Neville HL, Ritchey ML (2000) Wilms’ tumor. Overview of national Wilms’ tumor study group results. Urol Clin N Am 27(3):435–442. doi: 10.1016/S0094-0143(05)70091-4 CrossRefGoogle Scholar
  3. 3.
    Clericuzio CL (1993) Clinical phenotypes and Wilms tumor. Med Pediatr Oncol 21(3):182–187. doi: 10.1002/mpo.2950210306 PubMedCrossRefGoogle Scholar
  4. 4.
    Breslow N, Olshan A, Beckwith JB, Green DM (1993) Epidemiology of Wilms tumor. Med Pediatr Oncol 21(3):172–181. doi: 10.1002/mpo.2950210305 PubMedCrossRefGoogle Scholar
  5. 5.
    Wilkins JRIII, Sinks TH Jr (1984) Paternal occupation and Wilms’ tumour in offspring. J Epidemiol Community Health 38(1):7–11. doi: 10.1136/jech.38.1.7 PubMedCrossRefGoogle Scholar
  6. 6.
    Bunin GR, Nass CC, Kramer S, Meadows AT (1989) Parental occupation and Wilms’ tumor: results of a case–control study. Cancer Res 49(3):725–729PubMedGoogle Scholar
  7. 7.
    Olshan AF, Breslow NE, Falletta JM, Grufferman S, Pendergrass T, Robison LL et al (1993) Risk factors for Wilms tumor. Report from the National Wilms Tumor Study. Cancer 72(3):938–944 doi: 10.1002/1097-0142(19930801)72:3<938::AID-CNCR2820720345>3.0.CO;2-C PubMedCrossRefGoogle Scholar
  8. 8.
    Saddlemire S, Olshan AF, Daniels JL, Breslow NE, Bunin GR, Ross JA (2006) Breast-feeding and Wilms tumor: a report from the Children’s Oncology Group. Cancer Causes Control 17(5):687–693. doi: 10.1007/s10552-005-0508-y PubMedCrossRefGoogle Scholar
  9. 9.
    Cooney MA, Daniels JL, Ross JA, Breslow NE, Pollock BH, Olshan AF (2007) Household pesticides and the risk of Wilms tumor. Environ Health Perspect 115(1):134–137PubMedGoogle Scholar
  10. 10.
    Giles D, Hewitt D, Stewart A, Webb J (1956) Malignant disease in childhood and diagnostic irradiation in utero. Lancet 271(6940):447PubMedGoogle Scholar
  11. 11.
    Macmahon B (1962) Prenatal x-ray exposure and childhood cancer. J Natl Cancer Inst 28:1173–1191PubMedGoogle Scholar
  12. 12.
    Wakeford R (1995) The risk of childhood cancer from intrauterine and preconceptional exposure to ionizing radiation. Environ Health Perspect 103(11):1018–1025. doi: 10.2307/3432629 PubMedCrossRefGoogle Scholar
  13. 13.
    Hicks N, Zack M, Caldwell GG, Fernbach DJ, Falletta JM (1984) Childhood cancer and occupational radiation exposure in parents. Cancer 53(8):1637–1643 doi: 10.1002/1097-0142(19840415)53:8<1637::AID-CNCR2820530802>3.0.CO;2-Y PubMedCrossRefGoogle Scholar
  14. 14.
    Bross ID, Natarajan N (1974) Risk of leukemia in susceptible children exposed to preconception, in utero and postnatal radiation. Prev Med 3(3):361–369. doi: 10.1016/0091-7435(74)90048-6 PubMedCrossRefGoogle Scholar
  15. 15.
    Kneale GW, Stewart AM (1980) Pre-conception X-rays and childhood cancers. Br J Cancer 41(2):222–226PubMedGoogle Scholar
  16. 16.
    Mole RH (1974) Antenatal irradiation and childhood cancer: causation or coincidence? Br J Cancer 30(3):199–208PubMedGoogle Scholar
  17. 17.
    Mole RH (1990) Childhood cancer after prenatal exposure to diagnostic X-ray examinations in Britain. Br J Cancer 62(1):152–168PubMedGoogle Scholar
  18. 18.
    Shu XO, Jin F, Linet MS, Zheng W, Clemens J, Mills J et al (1994) Diagnostic X-ray and ultrasound exposure and risk of childhood cancer. Br J Cancer 70(3):531–536PubMedGoogle Scholar
  19. 19.
    Shu XO, Reaman GH, Lampkin B, Sather HN, Pendergrass TW, Robison LL (1994) Association of paternal diagnostic X-ray exposure with risk of infant leukemia. Investigators of the Children’s Cancer Group. Cancer Epidemiol Biomarkers Prev 3(8):645–653PubMedGoogle Scholar
  20. 20.
    Belson M, Kingsley B, Holmes A (2007) Risk factors for acute leukemia in children: a review. Environ Health Perspect 115(1):138–145PubMedCrossRefGoogle Scholar
  21. 21.
    Draper GJ, Little MP, Sorahan T, Kinlen LJ, Bunch KJ, Conquest AJ et al (1997) Cancer in the offspring of radiation workers: a record linkage study. BMJ Clinical Res (Clin Res Ed.) 315(7117):1181–1188Google Scholar
  22. 22.
    Doll R, Wakeford R (1997) Risk of childhood cancer from fetal irradiation. The British journal of radiology 70:130–139PubMedGoogle Scholar
  23. 23.
    Bithell JF, Stiller CA (1988) A new calculation of the carcinogenic risk of obstetric X-raying. Stat Med 7(8):857–864. doi: 10.1002/sim.4780070804 PubMedCrossRefGoogle Scholar
  24. 24.
    Stewart A, Kneale GW (1970) Radiation dose effects in relation to obstetric X-rays and childhood cancers. Lancet 1(7658):1185–1188. doi: 10.1016/S0140-6736(70)91782-4 PubMedCrossRefGoogle Scholar
  25. 25.
    Bithell JF, Stewart AM (1975) Pre-natal irradiation and childhood malignancy: a review of British data from the Oxford Survey. Br J Cancer 31(3):271–287PubMedGoogle Scholar
  26. 26.
    Ross JA, Severson RK, Pollock BH, Robison LL (1996) Childhood cancer in the United States. A geographical analysis of cases from the Pediatric Cooperative Clinical Trials groups. Cancer 77(1):201–207 doi: 10.1002/(SICI)1097-0142(19960101)77:1<201::AID-CNCR32>3.0.CO;2-7 PubMedCrossRefGoogle Scholar
  27. 27.
    The SAS System for Windows Version 9.1.3 (2006). SAS Institute Inc, Cary, NCGoogle Scholar
  28. 28.
    Gilman EA, Kneale GW, Knox EG, Stewart AM (1988) Pregnancy X-rays and childhood cancers: effects of exposure age and radiation dose. J Radiol Prot 8:3–8Google Scholar
  29. 29.
    Patton T, Olshan AF, Neglia JP, Castleberry RP, Smith J (2004) Parental exposure to medical radiation and neuroblastoma in offspring. Paediatr Perinat Epidemiol 18(3):178–185. doi: 10.1111/j.1365-3016.2004.00554.x PubMedCrossRefGoogle Scholar
  30. 30.
    Stalberg K, Haglund B, Axelsson O, Cnattingius S, Pfeifer S, Kieler H (2007) Prenatal X-ray exposure and childhood brain tumours: a population-based case–control study on tumour subtypes. Br J Cancer 97(11):1583–1587. doi: 10.1038/sj.bjc.6604046 PubMedCrossRefGoogle Scholar
  31. 31.
    Schuz J, Kaletsch U, Kaatsch P, Meinert R, Michaelis J (2001) Risk factors for pediatric tumors of the central nervous system: results from a German population-based case–control study. Med Pediatr Oncol 36(2):274–282 doi: 10.1002/1096-911X(20010201)36:2<274::AID-MPO1065>3.0.CO;2-D PubMedCrossRefGoogle Scholar
  32. 32.
    Hewitt D, Sanders B, Stewart A (1966) Oxford Survey of Childhood Cancers: progress report. IV. Reliability of data reported by case and control mothers. Mon bull Minist Health Public Health Lab Serv 25:80–85PubMedGoogle Scholar
  33. 33.
    Knox EG, Kneale GW, Gilman EA (1987) Prenatal irradiation and childhood cancer. J Soc Radiol Prot 7:177–189. doi: 10.1088/0260-2814/7/4/003 CrossRefGoogle Scholar
  34. 34.
    Infante-Rivard C, Mathonnet G, Sinnett D (2000) Risk of childhood leukemia associated with diagnostic irradiation and polymorphisms in DNA repair genes. Environ Health Perspect 108(6):495–498. doi: 10.2307/3454609 PubMedCrossRefGoogle Scholar
  35. 35.
    Badr I, Thomas SM, Cotterill AD, Pettett A, Oduko JM, Fitzgerald M et al (1997) X-ray pelvimetry—which is the best technique? Clin Radiol 52(2):136–141. doi: 10.1016/S0009-9260(97)80107-9 PubMedCrossRefGoogle Scholar
  36. 36.
    Osei EK, Faulkner K (1999) Fetal doses from radiological examinations. Br J radiol 72(860):773–780PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Ruchika Goel
    • 1
  • Andrew F. Olshan
    • 2
  • Julie A. Ross
    • 3
  • Norman E. Breslow
    • 4
  • Brad H. Pollock
    • 5
  1. 1.Department of PediatricsChildren’s Hospital of Pittsburgh of UPMCPittsburghUSA
  2. 2.Department of Epidemiology, School of Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of PediatricsUniversity of MinnesotaMinneapolisUSA
  4. 4.Department of BiostatisticsUniversity of WashingtonSeattleUSA
  5. 5.Department of Epidemiology and BiostatisticsUniversity of Texas Health Science Center at San AntonioSan AntonioUSA

Personalised recommendations