Children with Specific Birth Defects Have a Higher Cancer Risk

Children with nonchromosomal birth defects incur a higher cancer risk, according to the findings of a study published in JAMA Oncology.

While birth defects, which are known to occur in approximately 1 in 33 children, have been linked to childhood cancers such as acute leukemia, according to the study authors, “comprehensive evaluations of childhood cancer risk in those with birth defects have been limited in previous studies by insufficient sample sizes.”

In a multistate, large population-based registry linkage study, researchers collected statewide data from Texas, Arkansas, Michigan, and North Carolina on births, birth defects, and cancer data on 10,181,074 children who were born between 1992 and 2013. All children were followed up to the age of 18 for a cancer diagnosis. Cox regression models were implemented to generate hazard ratios (HRs) and 95% CIs to assess birth defect-childhood cancer (BD-CC) associations as well as the correlation between the number of nonchromosomal defects and cancer risk. The researchers retrieved data between September 26, 2016, and September 21, 2017, and analyzed all data from September 2, 2017, to March 21, 2019.

Chromosomal Anomalies Linked to Cancer

According to the results, when juxtaposed with children without any birth defects, children with chromosomal anomalies (n = 539,567) were 11.6 (95% CI, 10.4-12.9) times more likely to develop cancer, and children with nonchromosomal birth defects (n = 2,123) were 2.5 (95% CI, 2.4-2.6) times more likely to be diagnosed with cancer before the age of 18. Moreover, the study found that an increasing number of nonchromosomal birth defects was linked to a corresponding increase in the risk of developing childhood cancer. Furthermore, children with four or more major birth defects were found to be 5.9 (95% CI, 5.4-6.5) times more likely to be diagnosed with cancer juxtaposed with those without a birth defect. Overall, the researchers found that in the analysis of 72 specific BD-CC patterns, 40 HRs were deemed statistically significant (adjusted P < .05) after accounting for multiple comparisons. The cancers most frequently correlated with nonchromosomal defects were hepatoblastoma and neuroblastoma.

.@bcmhouston study finds that children with chromosomal defects are almost 12 times more likely to develop cancer, while children with non-chromosomal defects are 2.5 times more likely to develop cancer.https://t.co/W6izCIBFSN

— Markian Hawryluk (@MarkianHawryluk) June 20, 2019

“Several significant and novel associations were observed between specific birth defects and cancers,” the study authors wrote in their conclusion. “Among children with nonchromosomal birth defects, the number of major birth defects diagnosed was significantly and directly associated with cancer risk”

In looking ahead to the future, the authors added that “these findings could inform clinical treatment for children with birth defects and may elucidate mechanisms that lead to these complex outcomes.”

Birth Defects and Cancer Risk in Children and Adolescents https://t.co/Bh9r6WYIee

— Seth Corey, MD MPH (@sethcorey) June 21, 2019

Birth Defects and Cancer Risk in Children and Adolescents. Children with chromosomal anomalies were 11.6X & children with nonchromosomal birth defects were 2.5X more likely to be diagnosed with cancer compared to children without these abnormalities. https://t.co/I8I2M16DsY

— Marwan Shinawi, M.D. (@marshinawi) June 26, 2019

Source: JAMA Oncology