Cancer incidence in children and young adults living in industrially contaminated sites: from the Italian experience to the development of an international surveillance system

Persistently high incidence rates of childhood acute leukemias from 2010 to 2017 in Mexico City: A population study from the MIGICCL

Introduction

Over the years, the Hispanic population living in the United States has consistently shown high incidence rates of childhood acute leukemias (AL). Similarly, high AL incidence was previously observed in Mexico City (MC). Here, we estimated the AL incidence rates among children under 15 years of age in MC during the period 2010-2017.

Methods

The Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia conducted a study gathering clinical and epidemiological information regarding children newly diagnosed with AL at public health institutions of MC. Crude age incidence rates (cAIR) were obtained. Age-standardized incidence rates worldwide (ASIRw) and by municipalities (ASIRm) were calculated by the direct and indirect methods, respectively. These were reported per million population <15 years of age; stratified by age group, sex, AL subtypes, immunophenotype and gene rearrangements.

Results

A total of 903 AL cases were registered. The ASIRw was 63.3 (cases per million) for AL, 53.1 for acute lymphoblastic leukemia (ALL), and 9.4 for acute myeloblastic leukemia. The highest cAIR for AL was observed in the age group between 1 and 4 years (male: 102.34 and female: 82.73). By immunophenotype, the ASIRw was 47.3 for B-cell and 3.7 for T-cell. The incidence did not show any significant trends during the study period. The ASIRm for ALL were 68.6, 66.6 and 62.8 at Iztacalco, Venustiano Carranza and Benito Juárez, respectively, whereas, other municipalities exhibited null values mainly for AML.

Conclusion

The ASIRw for childhood AL in MC is among the highest reported worldwide. We observed spatial heterogeneity of rates by municipalities. The elevated AL incidence observed in Mexican children may be explained by a combination of genetic background and exposure to environmental risk factors.

Patterns and trends of cancer incidence in children and adolescents in China, 2011-2015: A population-based cancer registry study

Background

Cancer is a major concern for children and adolescents worldwide. This study aims to report on cancer incidence patterns at age 0–19 years in 2011–2015 and their trends in 2000–2015.

Methods

We collected data on malignancies in population of 0–19 years submitted by high‐quality population‐based cancer registries in China. Age‐standardized rates by world standard population (WSR) and annual percent change (APC) were calculated.

Results

In total, 215 cancer registries from 30 provinces contributed datasets during 2011–2015. Twenty‐two registries provided continuous data for trend analysis from 2000 to 2015. In total 16,954 malignancies occurred in 177,416,582 person‐years. WSRs were 93.32 and 96.03 per million person‐years in children aged 0–14 and 0–19 years. Incidence rates were higher in boys than in girls and were higher in urban area than in rural area. In children aged 0–14 years, the top three common diagnostic groups were leukemia, central nervous system (CNS) tumors, and lymphomas in both sexes. In adolescents aged 15–19 years, the top three common diagnostic groups were leukemia, epithelial tumors and melanoma, and CNS tumors in boys and epithelial tumors and melanoma, leukemia, and germ cell and gonadal tumors in girls. WSRs for cancers in 0–19 years of age increased significantly in boys from 2000 to 2005 (APC = 5.3%, 95% CI: 2.3%–8.3%) and in girls from 2000 to 2015 (APC = 1.2%, 95% CI: 0.1%–2.4%).

Conclusions

Cancer incidence in children and adolescents is on the rise in China. The observed age, sex, and geographical variations in cancer incidence should be used to inform targeted prevention and control policies.

Long-term residential exposure to air pollution and Hodgkin lymphoma risk among adults in Denmark: a population-based case-control study

PURPOSE

The etiology of Hodgkin lymphoma (HL) is obscure. Research on air pollution and risk of HL provides inconsistent results. We aimed to investigate the association between long-term residential exposure to air pollution and risk of adult Hodgkin lymphoma in Denmark.

METHODS

We performed a nationwide register-based case-control study, including all (n = 2,681) Hodgkin lymphoma cases registered in the nationwide Danish Cancer Registry between 1989 and 2014. We randomly selected 8,853 age- and sex-matched controls from the entire Danish population using the Civil Registration System, and identified 20-year residential address history for all cases and controls. We modeled outdoor air pollution concentrations at all these addresses using the high-resolution multiscale air pollution model system DEHM/UBM/AirGIS. We used conditional logistic regression to estimate odds ratios adjusted for individual and neighborhood level sociodemographic variables.

RESULTS

There was no association between 1, 5, 10, and 20 years' time-weighted average exposure to fine particles (PM_2.5), O₃, SO_2, NO_2, or the PM_2.5 constituents OC, NH₄, NO₃, and SO₄ and risk of Hodgkin lymphoma.

CONCLUSION

Residential exposure to ambient air pollution does not seem to increase the risk of developing Hodgkin lymphoma.

Data-Quality Assessment Signals Toxic-Site Safety Threats and Environmental Injustices

Most hazardous-waste sites are located in urban areas populated by disproportionate numbers of children, minorities, and poor people who, as a result, face more severe pollution threats and environmental-health inequalities. Partly to address this harm, in 2017 the United Nations unanimously endorsed the New Urban Agenda, which includes redeveloping urban-infill-toxic-waste sites. However, no systematic, independent analyses assess the public-health adequacy of such hazardous-facility redevelopments. Our objective is to provide a preliminary data-quality assessment (PDQA) of urban-infill-toxic-site testing, conducted by private redevelopers, including whether it adequately addresses pollution threats. To this end, we used two qualitative, weight-of-evidence methods. Method 1 employs nine criteria to select assessments for PDQA and help control for confounders. To conduct PDQA, Method 2 uses three US Environmental Protection Agency standards—the temporal, geographical, and technological representativeness of sampling. Our Method 1 results reveal four current toxic-site assessments (by CBRE/Trammell Crow, the world’s largest commercial developer); at all of these sites the main risk drivers are solvents, volatile organic compounds, including trichloroethylene. Our Method 2 results indicate that all four assessments violate most PDQA standards and systematically underestimate health risk. These results reveal environmental injustice, disproportionate health threats to children/minorities/poor people at all four sites. Although preliminary, our conclusion is that alleviating harm and environmental-health inequalities posed by urban-infill-toxic-site pollution may require improving both the testing/cleanup/redevelopment requirements of the New Urban Agenda and the regulatory oversight of assessment and remediation performed by private redevelopers.

Cancer Incidence Trends in the Oil Shale Industrial Region in Estonia

Large oil shale resources are found in Eastern Estonia, where the mineral resource is mined, excavated, and used for electricity generation and shale oil extraction. During industrial activities in the last 100 years, pollutants have been emitted in large amounts, some of which are toxic and carcinogenic. The current study aims to analyse time trends in cancer incidence in the oil shale industry-affected areas and compare them with overall cancer incidence rates and trends in Estonia. We analysed Estonian Cancer Registry data on selected cancer sites that have been previously indicated to have relationships with industrial activities like oil shale extraction. We included lung cancer, kidney cancer, urinary bladder cancer, leukaemia, breast cancer, and non-Hodgkin's lymphoma. A statistically significantly higher lung cancer age-standardized incidence rate (ASIR) was found during the study period (1992-2015) only in males in the oil shale areas as compared to males in Estonia overall: 133.6 and 95.5 per 100,000, respectively. However, there appeared to be a statistically significant (p < 0.05) decrease in the lung cancer ASIR in males in the oil shale areas (overall decrease 28.9%), whereas at the same time, there was a significant increase (p < 0.05) in non-oil shale areas (13.3%) and in Estonia overall (1.5%). Other cancer sites did not show higher ASIRs in the oil shale industrial areas compared to other areas in Estonia. Possible explanations could be improved environmental quality, socio-economic factors, and other morbidities.

First Italian birth after cryopreserved ovarian tissue transplantation in a patient affected by non-Hodgkin's lymphoma

This case report describes the first Italian live birth obtained by cryopreserved ovarian tissue transplantation in a woman affected by non-Hodgkin's lymphoma. Before anticancer treatments, several fertility preservation options were proposed. At 29 years the patient underwent laparoscopy for ovarian tissue cryopreservation. After treatments she experienced premature ovarian failure (POF) and asked for cryopreserved ovarian tissue transplantation. Before transplantation, ovarian samples were analyzed to assess neoplastic contamination and tissue quality. Two subsequent ovarian tissue transplantations were performed 4 and 7 years after cryopreservation. The follicle-stimulating hormone and luteinizing hormone reduction, estradiol increase and first menstrual cycle appeared 2 months after the second transplantation. The woman conceived spontaneously 5 months after the second transplantation. After 39 weeks of uneventful gestation, a healthy male baby was born. Ovarian tissue cryopreservation, thawing and transplantation successfully restored ovarian function and fertility after tissue storage.