Julia Ventelä, Mia Korja, Anssi Auvinen, Olli Lohi, Atte Nikkilä
{"title":"芬兰儿童急性白血病的聚类:一项全国性的基于登记的研究。","authors":"Julia Ventelä, Mia Korja, Anssi Auvinen, Olli Lohi, Atte Nikkilä","doi":"10.1007/s10552-025-01998-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Acute leukemia is the most common childhood malignancy, with suspected contributions from environmental factors and immune responses to common pathogens. A recent meta-analysis indicated possible spatiotemporal clustering, though the findings were hindered by data quality limitations. We investigated spatial and spatiotemporal clustering of childhood leukemia using advanced methods and complete residential histories.</p><p><strong>Methods: </strong>We included patients aged 0-17 years diagnosed in 1990-2019, using data from the Finnish Cancer Registry. A 1:3 age- and sex-matched case-control design was employed and residential history data with exact coordinates was collected. Clustering was evaluated using the Cuzick-Edwards test, Knox test, Kulldorff's scan statistic, and Jacquez's Q statistic.</p><p><strong>Results: </strong>The dataset included 1,626 childhood leukemia cases (median age 5.0 years, 54% male). The Knox test revealed no evidence of spatiotemporal clustering. However, the Cuzick-Edwards test revealed spatial clustering at diagnosis addresses for children under 1 year (OR 1.35, 95% CI 1.14-1.57). Further analysis with Jacquez's Q test using complete residential histories identified significant spatiotemporal clustering in young children (ages 1.5-5.99 years) with acute lymphoblastic leukemia (ALL, p = 0.037). We also tested for co-incidence between leukemia and type 1 diabetes but found no clustering.</p><p><strong>Conclusion: </strong>Overall, we found limited evidence for clustering. In the subgroup analyses, significant spatiotemporal clustering in acute lymphoblastic leukemia cases among children aged 1.5-5.99 years was observed, coinciding with the peak incidence in early childhood. Previous research has shown that this age group has distinct genetic characteristics and may possess a unique etiology.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clustering of childhood acute leukemia in Finland: a nationwide register-based study.\",\"authors\":\"Julia Ventelä, Mia Korja, Anssi Auvinen, Olli Lohi, Atte Nikkilä\",\"doi\":\"10.1007/s10552-025-01998-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Acute leukemia is the most common childhood malignancy, with suspected contributions from environmental factors and immune responses to common pathogens. A recent meta-analysis indicated possible spatiotemporal clustering, though the findings were hindered by data quality limitations. We investigated spatial and spatiotemporal clustering of childhood leukemia using advanced methods and complete residential histories.</p><p><strong>Methods: </strong>We included patients aged 0-17 years diagnosed in 1990-2019, using data from the Finnish Cancer Registry. A 1:3 age- and sex-matched case-control design was employed and residential history data with exact coordinates was collected. Clustering was evaluated using the Cuzick-Edwards test, Knox test, Kulldorff's scan statistic, and Jacquez's Q statistic.</p><p><strong>Results: </strong>The dataset included 1,626 childhood leukemia cases (median age 5.0 years, 54% male). The Knox test revealed no evidence of spatiotemporal clustering. However, the Cuzick-Edwards test revealed spatial clustering at diagnosis addresses for children under 1 year (OR 1.35, 95% CI 1.14-1.57). Further analysis with Jacquez's Q test using complete residential histories identified significant spatiotemporal clustering in young children (ages 1.5-5.99 years) with acute lymphoblastic leukemia (ALL, p = 0.037). We also tested for co-incidence between leukemia and type 1 diabetes but found no clustering.</p><p><strong>Conclusion: </strong>Overall, we found limited evidence for clustering. In the subgroup analyses, significant spatiotemporal clustering in acute lymphoblastic leukemia cases among children aged 1.5-5.99 years was observed, coinciding with the peak incidence in early childhood. Previous research has shown that this age group has distinct genetic characteristics and may possess a unique etiology.</p>\",\"PeriodicalId\":9432,\"journal\":{\"name\":\"Cancer Causes & Control\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Causes & Control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10552-025-01998-1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Causes & Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10552-025-01998-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:急性白血病是儿童最常见的恶性肿瘤,可能与环境因素和对常见病原体的免疫反应有关。最近的一项荟萃分析表明了可能的时空聚类,尽管研究结果受到数据质量限制的阻碍。我们使用先进的方法和完整的居住史来调查儿童白血病的时空聚类。方法:我们纳入了1990-2019年诊断的0-17岁患者,使用芬兰癌症登记处的数据。采用1:3年龄和性别匹配的病例对照设计,收集精确坐标的居住史数据。采用Cuzick-Edwards检验、Knox检验、Kulldorff’s scan统计量和Jacquez’s Q统计量评价聚类。结果:该数据集包括1,626例儿童白血病病例(中位年龄5.0岁,男性占54%)。诺克斯测试没有发现时空聚类的证据。然而,Cuzick-Edwards检验显示1岁以下儿童的诊断地址存在空间聚类(OR 1.35, 95% CI 1.14-1.57)。使用完整居住史的Jacquez’s Q检验进一步分析发现,急性淋巴细胞白血病的幼儿(1.5-5.99岁)存在显著的时空聚类(ALL, p = 0.037)。我们还测试了白血病和1型糖尿病的合并症,但没有发现聚类。结论:总的来说,我们发现聚类的证据有限。在亚组分析中,急性淋巴细胞白血病病例在1.5-5.99岁的儿童中观察到显著的时空聚类,与早期儿童的发病率高峰相一致。先前的研究表明,这一年龄组具有明显的遗传特征,可能具有独特的病因。
Clustering of childhood acute leukemia in Finland: a nationwide register-based study.
Purpose: Acute leukemia is the most common childhood malignancy, with suspected contributions from environmental factors and immune responses to common pathogens. A recent meta-analysis indicated possible spatiotemporal clustering, though the findings were hindered by data quality limitations. We investigated spatial and spatiotemporal clustering of childhood leukemia using advanced methods and complete residential histories.
Methods: We included patients aged 0-17 years diagnosed in 1990-2019, using data from the Finnish Cancer Registry. A 1:3 age- and sex-matched case-control design was employed and residential history data with exact coordinates was collected. Clustering was evaluated using the Cuzick-Edwards test, Knox test, Kulldorff's scan statistic, and Jacquez's Q statistic.
Results: The dataset included 1,626 childhood leukemia cases (median age 5.0 years, 54% male). The Knox test revealed no evidence of spatiotemporal clustering. However, the Cuzick-Edwards test revealed spatial clustering at diagnosis addresses for children under 1 year (OR 1.35, 95% CI 1.14-1.57). Further analysis with Jacquez's Q test using complete residential histories identified significant spatiotemporal clustering in young children (ages 1.5-5.99 years) with acute lymphoblastic leukemia (ALL, p = 0.037). We also tested for co-incidence between leukemia and type 1 diabetes but found no clustering.
Conclusion: Overall, we found limited evidence for clustering. In the subgroup analyses, significant spatiotemporal clustering in acute lymphoblastic leukemia cases among children aged 1.5-5.99 years was observed, coinciding with the peak incidence in early childhood. Previous research has shown that this age group has distinct genetic characteristics and may possess a unique etiology.
期刊介绍:
Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach.
The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues.
The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts.
Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.