RESUMO
The Brazilian Wilms' Tumour Study Group carried out a hospital-based multicentre case-control study of potential risk factors for the disease between April 1987 and January 1989. The parents of 109 cases of Wilms' tumour (WT) were interviewed when they were admitted to hospital for diagnosis and treatment. Also interviewed were the parents of two controls per case, matched for age, sex and interviewer, who were admitted to the same or nearby hospitals for treatment of non-neoplastic conditions. Odds ratios adjusted for family income and parental education were calculated by conditional logistic regression. Among cases diagnosed before 25 months of age there was a marked gradient of increasing risk of WT with increasing maternal age at the time of the child's birth. There was no increased risk for cases diagnosed after 25 months of age. The effects of paternal age were less marked. Possible explanations for these results are discussed.
Assuntos
Neoplasias Renais/epidemiologia , Idade Materna , Idade Paterna , Tumor de Wilms/epidemiologia , Adulto , Idade de Início , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Intervalos de Confiança , Feminino , Humanos , Lactente , Recém-Nascido , Neoplasias Renais/etiologia , Modelos Logísticos , Masculino , Razão de Chances , Fatores de Risco , Fatores Socioeconômicos , Tumor de Wilms/etiologiaRESUMO
The Brazilian Wilms' Tumour Study Group carried out a hospital-based multicentre case-control study of potential risk factors for the disease between April 1987 and January 1989. The parents of 109 cases of Wilms' tumour (WT) were interviewed when they were admitted to hospital for diagnosis and treatment. Also interviewed were the parents of two controls per case, matched for age, sex and interviewer, who were admitted to the same or nearby hospitals for treatment of non-neoplastic conditions. Odds ratios adjusted for family income and parental education were calculated by conditional logistic regression. Among cases diagnosed before 25 months of age there was a marked gradient of increasing risk of WT with increasing maternal age at the time of the child's birth. There was no increased risk for cases diagnosed after 25 months of age. The effects of paternal age were less marked. Possible explanations for these results are discussed.
Assuntos
Humanos , Fatores de Risco , Tumor de WilmsRESUMO
We evaluated the risk of Wilms' tumor in the offspring of women taking various medications during pregnancy in a case, control study conducted in Brazil. The study accrued 109 cases and 218 age- and gender-matched hospital controls. After adjustment for known confounders, we found a strong association with ingestion of dipyrone (odds ratio = 10.9; 95% confidence interval = 2.4-50) particularly in women from low-income families. Although dipyrone-containing analgesics are banned in Europe and North America, they are widely prescribed in Brazil and are given as free samples in neighborhood clinics providing free health care. The strong effect specific to low-income women may result from higher individual consumption compared with women at higher income levels.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Dipirona/efeitos adversos , Neoplasias Renais/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal , Tumor de Wilms/induzido quimicamente , Antieméticos/efeitos adversos , Feminino , Humanos , Renda , Masculino , Metoclopramida/efeitos adversos , Medicamentos sem Prescrição , Razão de Chances , Pobreza , Gravidez , Fatores de RiscoRESUMO
We evaluated the risk of Wilms' tumor in the offspring of women taking various medications during pregnancy in a case, control study conducted in Brazil. The study accrued 109 cases and 218 age- and gender-matched hospital controls. After adjustment for known confounders, we found a strong association with ingestion of dipyrone (odds ratio = 10.9; 95% confidence interval = 2.4-50) particularly in women from low-income families. Although dipyrone-containing analgesics are banned in Europe and North America, they are widely prescribed in Brazil and are given as free samples in neighborhood clinics providing free health care. The strong effect specific to low-income women may result from higher individual consumption compared with women at higher income levels.
Assuntos
Dipirona , Neoplasias , Gravidez , Complicações na Gravidez , Tumor de WilmsRESUMO
Wilms' tumor is one of the most common abdominal childhood malignancies. Wilms' tumor rates in Brazil are among the highest in the world. This prompted the Brazilian Wilms' Tumor Study Group to conduct a hospital-based, multicenter, case-control investigation of environmental risk factors for the disease. Between April 1987 and January 1989, the authors collected information on relevant occupational exposures by interviewing the parents of 109 Wilms' tumor cases admitted to hospitals in Sao Paulo, Salvador, Belo Horizonte, and Jau. Also interviewed were the parents of 218 age- and sex-matched control children who had been admitted for treatment of nonneoplastic diseases to the same or nearby hospitals. Odds ratios (ORs) adjusted for income and education were calculated by conditional logistic regression. Consistently elevated risks were seen for farm work involving frequent use of pesticides by both the father (OR = 3.24, 95% confidence interval (CI) 1.2-9.0) and the mother (OR = 128.6, 95% CI 6.4-2,569). These risk elevations were restricted to cases diagnosed after 2 years of age (ORs > 4), for paternal exposure, and after 4 years of age (OR = 14.8, 95% CI 2.2-98.8), for maternal exposure. Risk elevations were also more pronounced among boys (paternal exposure OR = 8.56, 95% CI 2.1-35.1; maternal exposure OR = 4.60, 95% CI 0.8-26.4) than among girls (paternal exposure OR = 1.31, 95% CI 0.4-4.1; maternal exposure OR = 2.03, 95% CI 0.5-8.9).
Assuntos
Neoplasias Renais/epidemiologia , Exposição Materna , Exposição Paterna , Praguicidas/intoxicação , Tumor de Wilms/etiologia , Fatores Etários , Agricultura , Brasil/epidemiologia , Pré-Escolar , Feminino , Humanos , Neoplasias Renais/etiologia , Masculino , Exposição Ocupacional , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Tumor de Wilms/epidemiologiaRESUMO
Wilms' tumor is one of the most common abdominal childhood malignancies. Wilms' tumor rates in Brazil are among the highest in the world. This prompted the Brazilian Wilms' Tumor Study Group to conduct a hospital-based, multicenter, case-control investigation of environmental risk factors for the disease. Between April 1987 and January 1989, the authors collected information on relevant occupational exposures by interviewing the parents of 109 Wilms' tumor cases admitted to hospitals in Sao Paulo, Salvador, Belo Horizonte, and Jau. Also interviewed were the parents of 218 age- and sex-matched control children who had been admitted for treatment of nonneoplastic diseases to the same or nearby hospitals. Odds ratios (ORs) adjusted for income and education were calculated by conditional logistic regression. Consistently elevated risks were seen for farm work involving frequent use of pesticides by both the father (OR = 3.24, 95% confidence interval (CI) 1.2-9.0) and the mother (OR = 128.6, 95% CI 6.4-2,569). These risk elevations were restricted to cases diagnosed after 2 years of age (ORs > 4), for paternal exposure, and after 4 years of age (OR = 14.8, 95% CI 2.2-98.8), for maternal exposure. Risk elevations were also more pronounced among boys (paternal exposure OR = 8.56, 95% CI 2.1-35.1; maternal exposure OR = 4.60, 95% CI 0.8-26.4) than among girls (paternal exposure OR = 1.31, 95% CI 0.4-4.1; maternal exposure OR = 2.03, 95% CI 0.5-8.9).