1
|
Calderon-Hernandez J, Jarquin-Yañez L, Reyes-Arreguin L, Diaz-Padilla LA, Gonzalez-Compean JL, Gonzalez-Montalvo P, Rivera-Gomez R, Villanueva-Toledo JR, Pech K, Arrieta O, Leal YA. Childhood acute lymphoblastic leukemia survival and spatial analysis of socio-environmental risks in Mexico. Front Oncol 2023; 13:1236942. [PMID: 37901312 PMCID: PMC10603203 DOI: 10.3389/fonc.2023.1236942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/22/2023] [Indexed: 10/31/2023] Open
Abstract
Background Acute lymphoblastic leukemia (ALL) etiology remains largely unknown; incidence patterns by age, sex, and geographical distribution suggest a potential environmental role. Aim To identify ALL clusters from four contrasting urban areas of Mexico and to characterize the sources of environmental carcinogens. Methods Hospital-based ALL cases (n = 443) diagnosed in children <19 years old from the Metropolitan Zones of Merida and San Luis Potosi, the State of Mexico, and Tijuana were analyzed (2015-2020). ALL cases were coded according to the International Classification of Diseases for Oncology. ALL clusters were identified by Kernel Density, and excess risk was estimated. Data of particulate matter ≤2.5 µm (PM2.5) concentrations measured by community-monitoring stations were analyzed. Geocoded datasets of benzene, polycyclic aromatic hydrocarbons, and PM2.5 sources were analyzed to characterize patterns of exposure in ALL clusters. Results The survival rate for ALL ranged from 61.5% to 78.6%. Seven ALL clusters with excess risk (RR 1.4-2.3, p < 0.05) were identified. The carcinogen sources included artisanal brick kilns, gas stations, cement works, carpentry, paint, and chemical manufacturing establishments. PM2.5 levels ranged from 15 µg/m3 to 37 µg/m3 among study areas. Conclusion ALL clusters were identified at the community level; the excess risk could be explained by small-scale carcinogen sources. The levels of PM2.5 in outdoor air ranged from 3 to 6 times above the World Health Organization (WHO) air quality guidelines. Healthcare providers must raise awareness of the increased risk of ALL in children living near sources of environmental carcinogens; cancer control and prevention strategies must be steered from a multi-sectoral and multi-action perspective to protect children's health.
Collapse
Affiliation(s)
- Jaqueline Calderon-Hernandez
- Facultad de Medicina/CIAAS, Universidad Autónoma de San Luis Potosi, San Luis Potosi, Mexico
- Global Public Health Program, Boston College, Boston, MA, United States
| | - Lizet Jarquin-Yañez
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Ciudad de México, Mexico
| | - Luis Reyes-Arreguin
- Facultad de Medicina/CIAAS, Universidad Autónoma de San Luis Potosi, San Luis Potosi, Mexico
| | - Luis A Diaz-Padilla
- Servicio de Oncología Pediátrica de la Unidad Médica de Alta Especialidad (UMAE), Centro Médico Nacional "Ignacio García Téllez", Instituto Mexicano de Seguro Social (IMSS), Mérida, Yucatán, Mexico
| | - Jose Luis Gonzalez-Compean
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional Unidad Tamaulipas, Victoria, Tamaulipas, Mexico
| | - Pablo Gonzalez-Montalvo
- Servicio de Oncología Pediátrica, Hospital O'Horán, Servicios de Salud de Yucatán/Facultad de Medicina, Universidad Autónoma de Yucatán, Yucatán, Mexico
| | - Rebeca Rivera-Gomez
- Facultad de Ciencias de la Salud, Universidad Autónoma de Baja California, Tijuana, Baja California, Mexico
- Comisión de Salud Fronteriza Mexico-Estados, Registro Poblacional de Cáncer de Tijuana BajaREG, Tijuana, Baja California, Mexico
| | - Jairo R Villanueva-Toledo
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT) - Fundación IMSS, A.C., Ciudad de México, Mexico
| | - Kristal Pech
- Departamento de Epidemiología del Instituto Nacional de Cancerología, Ciudad de México, Mexico
| | - Oscar Arrieta
- Coordinación del Registro Nacional de Cáncer del Instituto Nacional de Cancerología, Ciudad de México, Mexico
| | - Yelda A Leal
- Coordinación del Registro Nacional de Cáncer del Instituto Nacional de Cancerología, Ciudad de México, Mexico
- Registro Poblacional de Cáncer Mérida, Unidad Médica de Alta Especialidad (UMAE), Centro Médico Nacional "Ignacio García Téllez", Instituto Mexicano de Seguro Social (IMSS), Mérida, Yucatán, Mexico
- Centro Institucional de Capacitación y Registro de Cáncer, Coordinación de Investigación en Salud, Instituto Mexicano de Seguro Social (IMSS), Ciudad de México, Mexico
| |
Collapse
|