Pre/peri- or postnatal medical history on the risk of brain tumors in children and adolescents: reports from CEFALO multicenter case-control study

摘要

Background: The effect on childhood brain tumor risk from medical history during a sensitive period of neural development remains unknown. Aims: Our aim was to investigate whether pre/peri- or postnatal medical history affects the risk of pediatric brain tumors. Methods: Data were derived from CEFALO, a multicenter case-control study conducted in Denmark, Norway, Sweden, and Switzerland including all persons aged 7 to 19 years diagnosed with a primary brain tumor from 2004 to 2008. For each case two population controls matched on sex, birth year, and region were randomly selected. Medical history and treatments were identified through personal interviews with 352 (83%) cases and 646 (71%) controls, and their parents. Results: X-rays, scans or ultrasound during pregnancy, perinatal hypoglycemia or jaundice, fever during the first 12 weeks, postnatal general anesthesia, or febrile seizures were not associated with the risk of pediatric brain tumors. Postnatal exposure to any type of X-ray or scan was associated with a slightly reduced risk estimate, while head CT/PET scans was associated with a twofold risk increase, none of them statistically significant although borderline. No association was observed with MRI scans to the head. Some indications of increased risk of pediatric brain tumors after head injury were observed. Conclusions: The pattern of the results indicate a possibility of recall bias when reporting post-natal medical radiation for diagnostic purposes as well as head injury, although the difference between risk estimates for head CT/PET compared to head MRI are noteworthy. Also, the possibility of chance findings due to limited numbers of exposed cases cannot be ruled out.