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Breast-feeding duration and the risk of malignant diseases in childhood in Sweden
Örebro University, Department of Clinical Medicine.
2001 (English)In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 55, no 3, p. 179-185Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To evaluate childhood cancer in relation to duration of breast-feeding.

SETTING:

Sweden. Records from Child Healthcare Centres were scrutinised regarding information on breast-feeding and other health-related items.

SUBJECTS:

All children aged 0-14 y with a malignant disease (benign brain tumours included) during the time period 1988-91 (n = 962) were identified from the Swedish Cancer Register. An equal number of controls matched for sex and age were selected from the Swedish Birth Register.

RESULTS:

Information was obtained for 835 cases and 860 controls. Overall, duration of breast-feeding did not influence the risk for a malignant disease in this age group. However, breast-feeding > or = 1 month increased the risk for non-Hodgkin's lymphoma (NHL) yielding an odds ratio (OR) 5.5 with 95% confidence interval (CI) 1.2-25. Breast-feeding 1 -< 6 months gave OR 5.1, CI 1.1-24 and > 6 months gave OR 7.0, CI 1.3-37 with a significant trend (P = 0.04). Adjustment for maternal and birth-related co-variates gave similar results. For other malignancies no significant changes of the risk were obtained.

CONCLUSIONS:

Overall, no association between duration of breast-feeding and childhood malignancies was found except for a significantly increased risk for NHL, but this was based on low numbers of cases and needs to be confirmed in other investigations

Place, publisher, year, edition, pages
2001. Vol. 55, no 3, p. 179-185
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-3100PubMedID: 11305266OAI: oai:DiVA.org:oru-3100DiVA, id: diva2:136977
Available from: 2006-09-01 Created: 2006-09-01 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Epidemiological aspects on malignant diseases in childhood
Open this publication in new window or tab >>Epidemiological aspects on malignant diseases in childhood
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The trends of malignant diseases in children aged 0 to 14 years, reported to the Swedish Cancer Registry 1960–1998 (n=9 298) were analyzed. The most common diagnoses were leukemia, 29.7%, tumors of the central nervous system (CNS), 27.6%, and lymphomas, 10.2%. The average annual incidence rate of childhood malignant diseases 1990–1998 was 16.19/100 000 person-years. Average annual change in incidence rate of all childhood cancer was +1.01% (95% confidence interval (CI)=0.80-1.22). Statistically significant increase was seen for leukemia +0.85% (95% CI=0.42–1.28), lymphomas +1.87% (95% CI=1.17–2.58), CNS tumors +1.45% (95% CI=1.02–1.88), sympathetic nervous system tumors +1.61% (95% CI=0.79–2.44), hepatic tumors +2.62% (95% CI=2.02–3.21), and germ cell and gonadal tumors +1.21% (95% CI=0.23–2.19).

Children are exposed to persistent organic pollutants (POPs) during fetal life and breast-feeding. In a case-control study including cases of childhood cancer reported to the Cancer Registry 1988–1991 (n=962) we used breastfeeding duration as a surrogate for exposure to POPs. One matched control per case was used. Information on breast-feeding, vaccinations and chronic illness was collected from copies of the children’s Child Health Center records.

Overall, breast-feeding did not affect the risk of childhood cancer, OR=1.0 (95% CI=0.7–1.3) using breast-feeding up to one month as reference. For non-Hodgkin lymphoma (NHL) OR for breast-feeding for >1 month yielded OR=5.0 (95% CI=1.1–23).

No association was seen between preschool vaccinations and childhood cancer except for lymphomas and measles/measles-mumps-rubella vaccination, OR=0.2 (95% CI=0.1–0.6). Increased risk of all cancer was found for congenital malformations, OR=1.7 (95% CI=0.97–2.9), especially of leukemia, OR=3.0 (95% CI=1.5–5.8). Children with disorders of brain function had an increased risk of all cancer, OR=6.0 (95% CI=1.3–27), especially of brain tumors, OR=10 (95% CI=1.3–78).

A childhood population expected to be more exposed to POPs is children of fishermen. In a register-based study, the cancer incidence rates in a cohort of fishermen children (at age 0-19 years) were compared to the rates of referent children. A modestly increased incidence rate ratio (IRR) of childhood cancer was found, IRR=1.38 (95% CI=0.96–2.00) and an increased IRR for acute lymphoid leukemia, IRR=2.65 (95% CI=1.005–6.97). In west coast fishermen children, an increased IRR was observed for NHL, IRR=3.19 (95% CI=0.98–10.4).

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2006. p. 91
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 7
Keywords
childhood cancer, incidence rates, persistent organic pollutants, breast-feeding
National Category
Medical and Health Sciences Cancer and Oncology
Research subject
Medicine; Oncology
Identifiers
urn:nbn:se:oru:diva-585 (URN)91-7668-494-6 (ISBN)
Public defence
2006-09-22, Wilandersalen, Universitetssjukhuset, Örebro, 13:15
Opponent
Supervisors
Available from: 2006-09-01 Created: 2006-08-28 Last updated: 2017-10-18Bibliographically approved

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