An infectious aetiology for childhood brain tumours? Evidence from space-time clustering and seasonality analyses

Br J Cancer. 2002 Apr 8;86(7):1070-7. doi: 10.1038/sj.bjc.6600228.

Abstract

To investigate whether infections or other environmental exposures may be involved in the aetiology of childhood central nervous system tumours, we have analysed for space-time clustering and seasonality using population-based data from the North West of England for the period 1954 to 1998. Knox tests for space-time interactions between cases were applied with fixed thresholds of close in space, <5 km, and close in time, <1 year apart. Addresses at birth and diagnosis were used. Tests were repeated replacing geographical distance with distance to the Nth nearest neighbour. N was chosen such that the mean distance was 5 km. Data were also examined by a second order procedure based on K-functions. Tests for heterogeneity and Edwards' test for sinusoidal variation were applied to examine changes of incidence with month of birth or diagnosis. There was strong evidence of space-time clustering, particularly involving cases of astrocytoma and ependymoma. Analyses of seasonal variation showed excesses of cases born in the late Autumn or Winter. Results are consistent with a role for infections in a proportion of cases from these diagnostic groups. Further studies are needed to identify putative infectious agents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Astrocytoma / epidemiology
  • Astrocytoma / etiology*
  • Astrocytoma / microbiology
  • Birth Certificates
  • Brain Neoplasms / epidemiology
  • Brain Neoplasms / etiology*
  • Brain Neoplasms / microbiology
  • Child
  • Child, Preschool
  • Ependymoma / epidemiology
  • Ependymoma / etiology*
  • Ependymoma / microbiology
  • Female
  • Geography
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Infections / complications*
  • Male
  • Seasons