Childhood Cancer & Environment
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Childhood Cancer & Environment Feasibility study for establishing a registration system for studying the relationship between childhood cancer & environment Final Report – Décembre 2011 Epidemiologie Rue Juliette Wytsmanstraat 14 1050 Brussels Epidémiologie | Décembre 2011 | Bruxelles, Belgique N° de référence interne : N° de dépôt ou ISSN : D/2011/2505/62 P. Gosselin (a) , K. Simons (a) , L. Verschaeve (b), A. Van Nieuwenhuyse (a) (a). Unit Health & Environment OD Public Health & Surveillance WIV-ISP (b). Unit of Toxicology OD Public Health & Surveillance WIV-ISP La Science au service de la Santé Publique, de la Sécurité de la chaîne alimentaire et de l'Environnement. 2 This report has been written in the frame of the Belgian National Environment and Health Action Plan (NEHAP). The problematic of the relation between Childhood Cancers and Environment was prioritized high in the Operational Program of the Second Belgian NEHAP (2008-2013) in accordance with (i) the Action #6 from the EU Environment & Health Action Plan 2004-2010 and (ii) the Recommendation #2 of the first NEHAP (2003). This report has been prepared by the Health & Environment Unit of the Scientific Institute of Public Health (WIV-ISP). © Institut Scientifique de Santé Publique, Bruxelles 2008 Ce rapport ne peut être reproduit, publié ou distribué sans l’accord de l’ISP. 3 CONTENTS: 1. INTRODUCTION .................................................................................................... 8 2. LITERATURE REVIEW: ASSOCIATION BETWEEN CHILDHOOD CANCERS & ENVIRONMENTAL SOURCES.................................................................................. 8 2.1. Leukemia .......................................................................................................................................................11 2.1.1. Definitions ..............................................................................................................................................11 2.1.2. Epidemiological Patterns ......................................................................................................................12 2.1.2.1. Incidence..........................................................................................................................................12 2.1.2.2. Survival............................................................................................................................................14 2.1.2.3. Mortality..........................................................................................................................................15 2.1.2.4. Sex differences ................................................................................................................................15 2.1.2.5. Ethnic differences............................................................................................................................15 2.1.2.6. Parental & birth characteristics........................................................................................................16 2.1.2.7. Socioeconomics factors ...................................................................................................................16 2.1.3. Etiology ...................................................................................................................................................17 2.1.3.1. Genetic factors.................................................................................................................................17 a. Germ-line karyotypic abnormalities ....................................................................................................18 b. Somatic karyotypic abnormalities ........................................................................................................19 c. Translocations ......................................................................................................................................20 d. Deletions ..............................................................................................................................................20 2.1.3.2. Environmental factors......................................................................................................................20 a. Biological factors .................................................................................................................................20 b. Infectious etiology ................................................................................................................................21 Kinlen’s Model – populations mixing.................................................................................................21 Smith’s Model – prenatal specific infections......................................................................................22 Greaves’ Model – “Two Hits Model”.................................................................................................22 c. Vaccination ..........................................................................................................................................23 2.1.3.3. Physical factors................................................................................................................................23 a. Ionizing radiation ................................................................................................................................23 Nuclear sites........................................................................................................................................24 Background radiation & Radon ..........................................................................................................27 b. Non-ionizing radiation .........................................................................................................................28 2.1.3.4. Chemical factors..............................................................................................................................29 a. Solvents ................................................................................................................................................29 b. Pesticides .............................................................................................................................................30 c. Outdoor air pollution ...........................................................................................................................31 d. Tobacco smoke .....................................................................................................................................31 e. Diet .......................................................................................................................................................32 f. Pharmaceutical use ..............................................................................................................................32 2.2. Cancers of the brain and central nervous system.......................................................................................33 2.2.1. Definitions ..............................................................................................................................................33 2.2.2. Epidemiological Patterns ......................................................................................................................34 2.2.2.1. Incidence..........................................................................................................................................34 2.2.2.2. Survival............................................................................................................................................35 2.2.2.3. Mortality..........................................................................................................................................36 2.2.2.4. Sex differences ................................................................................................................................36 2.2.2.5. Ethnic differences............................................................................................................................37 2.2.2.6. Socioeconomic factors.....................................................................................................................37 2.2.2.7. Parental characteristics ....................................................................................................................37 2.2.3. Etiology ...................................................................................................................................................37 2.2.3.1. Genetic factors.................................................................................................................................38 2.2.3.2. Biological factors.............................................................................................................................39 2.2.3.3. Physical factors................................................................................................................................39 4 a. Ionizing radiation ................................................................................................................................39 b. Non-ionizing radiation .........................................................................................................................39 2.2.3.4. Chemical factors..............................................................................................................................41