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Is the risk of childhood leukaemia associated with socioeconomic measures in Denmark? A nationwide register-based case-control study

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DOI

  • Friederike Erdmann, Johannes Gutenberg University Mainz
  • ,
  • Ulla Arthur Hvidtfeldt, Kræftens Bekæmpelse
  • ,
  • Maria Feychting, Karolinska Institutet
  • ,
  • Mette Sørensen, Kræftens Bekæmpelse, Roskilde University
  • ,
  • Ole Raaschou-Nielsen

The aetiology of childhood leukaemia is poorly understood. Knowledge about differences in risk by socioeconomic status (SES) may enhance etiologic insights. We conducted a nationwide register-based case-control study to evaluate socioeconomic differences in the risk of childhood leukaemia in Denmark and to access whether associations varied by different measures of SES, time point of assessment, leukaemia type and age at diagnosis. We identified all cases of leukaemia in children aged 0 to 19 years, born and diagnosed between 1980 and 2013 from the Danish Cancer Registry (N = 1336) and sampled four individually matched controls per case (N = 5330). We used conditional logistic regression models for analysis. Medium and high level of parental education was associated with a higher risk of acute myeloid leukaemia (AML) in the offspring, mainly driven by children diagnosed at ages 0 to 4 years [odds ratio (OR) for high maternal education = 3.07; 95% confidence interval (CI): 1.44-6.55]. We also observed a modestly increased risk for lymphoid leukaemia (LL) in association with higher level of parental education, but only in children diagnosed at ages 5 to 19 years. Higher parental income was associated with an increased risk of LL but not AML among children aged 5 to 19 years at diagnosis (OR for high maternal income = 2.78; 95% CI: 1.32-5.89). Results for neighbourhood SES measures indicated null associations. Bias or under-ascertainment of cases among families with low income or basic education are unlikely to explain the observed socioeconomic differences. Future research addressing explicitly the underlying mechanisms of our results may help to enhance etiologic insights of the disease.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cancer
Vol/bind148
Nummer9
Sider (fra-til)2227-2240
Antal sider14
ISSN0020-7136
DOI
StatusUdgivet - 1 maj 2021

Bibliografisk note

Funding Information:
The authors are grateful to Andrea Bautz (Danish Cancer Society Research Center, Childhood Cancer Research Group) for her technical support with data preparation. This work was supported by a grant from the Danish Childhood Cancer Foundation (Grant number 2017‐2018). The funding sources had no involvement in the content or preparation of the manuscript.

Publisher Copyright:
© 2020 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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