Childhood cancer and ethnic group in Britain: a United Kingdom children's Cancer Study Group (UKCCSG) study

Abstract

Summary We present here the results of the largest study of childhood cancer and ethnic group in Britain, based on 7,658 children treated at paediatric oncology centres throughout the country. Incidence rates could not be calculated and so relative frequencies were analysed by the log-linear modelling method of Kaldor et al. (1990) with allowance made for regional variations in the ages and diagnostic groups of the children included in the study. Children of Asian (Indian sub-continent) Childhood neoplasms are more appropriately classified by histology rather than primary site. A classification scheme was developed on the basis of histological type by Birch and Marsden (1987) and used for the recent monograph on international childhood cancer incidence (Parkin et al., 1988a). We have used a slightly modified version of this scheme for all of the analyses presented here. In this version, the principal changes are that megakaryocytic leukaemia has been. included with acute non-lymphocytic leukaemia (ANLL), rhabdoid renal tumour and bone-mestastasising renal tumour of childhood have both been included with Wilms' tumour, and peripheral neuroectodermal tumours have been classified with Ewing's sarcoma if in bone and with soft-tissue sarcoma other than rhabdomyosarcoma and fibrosarcoma if in other sites. Langerhans cell histiocytosis has been excluded since it is not now regarded as a neoplasm.The register is not population-based and population data are not available by ethnic group, hence incidence rates could not be calculated and the analyses are based on relative frequencies of different diagnostic groups.The distribution of ethnic groups in Britain varies geographically, and the age distribution of the child population may differ between ethnic groups. The proportion of children referred to paediatric oncology centres, and hence included in the register, varies between regions and diagnostic groups, and older children are generally less likely to be referred (Stiller, 1988). To allow for these confounding factors, the data were analysed by the log-linear modelling method of Kaldor et al. (1990) using the GLIM statistical package (Payne, 1987).As the data were not population-based and incidence rates could not be calculated, a case-control approach was adopted for analysing relative frequencies of each diagnostic group between the ethnic groups (Breslow & Day, 1987

High risk of lymphomas in children of Asian origin: ethnicity or confounding by socioeconomic status?

“…The distribution of the super profile categories in the two groups revealed that 73% of the Asian children were in the lowest three socioeconomic groups (VIII-X), compared with 26% of non-Asian children (P<0.0001, chi-square). Distribution of cancers by diagnostic groups (Birch and Marsden, 1987) in the Asian and non-Asian groups are given in Table II (Senior and Bhopal, 1994 (Stiller et al, 1991;Powell et al, 1994) The measure is also available for everyone with a recorded address. A disadvantage of this study is that, because Asian families are often concentrated in inner city areas, they will tend to be uniformly categorised as of low socioeconomic status.…”

“…The United Kingdom Children's Cancer Study Group (UKCCSG) has examined the pattern of paediatric cancers and estimated the risk in different ethnic groups. A significant excess of Hodgkin's disease (HD) was observed among Asian children compared with Caucasians (estimated relative risk 2.09) (Stiller et al, 1991). Comparison of the age-standardised incidence rates of paediatric cancer in ethnic groups in the West Midlands has shown a significantly higher annual incidence of all cancers in Asian children (Powell et al, 1994).…”

Effect of material deprivation on Epstein–Barr virus infection in Hodgkin’s disease in the West Midlands

“…Analysis of a much larger series of HD cases by Gulley et al (1994) also showed an association with Hispanic ethnicity (P < 0.001). Several UK studies have shown that Asian children have a higher rate of HD, with an estimated relative risk of 2.09 (Stiller et al, 1991;Muir et al, 1992;Varghese et al, 1996), but data on the frequency of EBV positivity in these tumours is not available. We were not able to determine ethnic or racial origin in our group of patients and the possibility that these factors may confound any association between EBV positivity in HD and material deprivation cannot be ruled out.…”

Different incidences of epigenetic but not genetic abnormalities between Wilms tumors in Japanese and Caucasian children

“…(2) Wilms tumor accounts for 8% of childhood cancers and occurs in 1 in 10 000 Caucasian children, though its incidence in East-Asian populations is half of that. (2) In Hawaii and Britain, the incidence of WT in people of Asian descent is about half to two-thirds of that in Caucasians, (3,4) suggesting that environmental factors play little part in the lower incidence.IGF2 is an imprinting gene expressed from the paternally inherited allele, and encodes a fetal polypeptide growth factor. Loss of imprinting (LOI) of IGF2 has been reported in various tumors, including pediatric tumors.…”