A case-control study of risk factors for Wilms' tumor.

摘要

A case-control study was conducted to examine the relationship between Wilms' tumor and parental and childhood exposures. The factors studied included parental occupational exposures, maternal infections and medications during pregnancy, pregnancy complications, pregnancy history, childhood medical history, and general family environmental exposures. The case group consisted of 162 children diagnosed as having Wilms' tumor who were registered at selected National Wilms' Tumor Study institutions during the period June 1, 1984-June 1, 1986. One or more controls of the same age and geographic area were matched to each case using a modified random digit dialing procedure. The parents of cases and controls completed a self-administered questionnaire.;There was no consistent pattern of increased risk for paternal occupational exposure to hydrocarbons or lead found in this study. However, certain paternal occupations were found to be associated with Wilms' tumor, including vehicle mechanics, electrical equipment mechanics, and cutters and welders. Neither maternal consumption of cigarettes, coffee or tea; history of infections during pregnancy; nor use of hair dyes during pregnancy was associated with an increased risk of Wilms' tumor in her offspring. A possible association with maternal use of birth control pills during the first three months of pregnancy was found in this study, but this result may have been due to chance. Household insect extermination in the three years prior to diagnosis was found to be associated with a two-fold increased risk of Wilms' tumor, and showed a dose-response relationship when analyzed by number of exterminations per year. No association was found for complications and treatments that occur during pregnancy, labor, or during the neonatal period. Pregnancy history, birthweight, and a family history of disease, birth defects and cancer were not found to be related in an increased risk of Wilms' tumor.;Thus, several previously hypothesized exposures for Wilms' tumor were not documented in this study. However, some positive associations were found that require further evaluation.