1. The association between major birth defects and cancer risk was present in children, adolescents, and adults, although the risk was lower in adults.
2. Chromosomal abnormalities were associated with a 5.5 times higher risk of cancer, compared to 1.5 times greater risk for non-chromosomal abnormalities.
Evidence Rating Level: 3 (Average)
Birth defects have consistently been shown to be one of the strongest predictors of childhood cancers. However, very little research has been conducted on whether this association continues for cancer in adulthood. The current study was a case-control examining the association between different types of birth defects and cancer risk in children, adolescents, and adults. The study population consisted of individuals from 4 Nordic countries: Norway, Sweden, Finland, and Denmark. There were 62,295 cases (individuals with a cancer diagnosis) and 724,542 controls (living individuals with no cancer diagnosis): The controls were matched to cases by country and year of birth in a 1:10 ratio. Overall, the study found that 3.5% of cases and 2.2% of controls had major birth defects. The odds ratio for overall cancer risk in those with major birth defects compared to those without, was 1.74 (99% CI 1.63-1.84). The risk was greater for individuals with chromosomal abnormalities compared to non-chromosomal abnormalities (OR 5.53, 99% CI 4.67-6.54 and OR 1.54, 99% CI 1.44-1.64 respectively). Furthermore, although the risk for cancer was elevated in all age groups, the risk was lower in adults (20 years of age and older) than in adolescents and children (15-19 years and 0-14 years respectively). For instance, in adults with non-chromosomal abnormalities, the OR was 1.21 (99% CI 1.09-1.33) compared to 1.58 (99% CI 1.31-1.90) in adolescents and 2.03 (99% CI 1.85-2.23) in children. In conclusion, the elevated risk for developing cancer persists through to adulthood, although the risk is lower compared to childhood.
Click to read the study in BMJ
Image: PD
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