Childhood cancer risk higher with birth defects

A multi-state study led by researchers at the University of Utah has revealed that the risk for childhood cancer is moderately increased among children and young adolescents with certain types of major birth defects.

Children born with non-chromosomal birth defects have a twofold higher risk of cancer before age 15, compared to children born without birth defects, according to this study published in PLOS ONE. However, cancer risk varies by the specific type of birth defect, and is not significantly increased in many of the more common birth defects.

Lorenzo Botto, MD and professor of paediatrics at the University of Utah School of Medicine and first author of this study, and his colleagues, analysed information from birth defect and cancer surveillance programmes in three states, and observed that cancer risk was increased in children born with eye defects, cleft palate, some heart and kidney defects, and microcephaly, a condition where the head is smaller than normal. The types of cancer for which risk was increased included neuroblastoma, retinoblastoma, and hepatoblastoma, all cancers that arise from immature cells and typically develop in early childhood.

“While there is an increased risk for cancer in young people with certain types of birth defects compared to children without birth defects, the overall cancer risk for a child with a birth defect is still relatively low, so it is important for health care providers to be careful not to produce unnecessary concern among parents and families,” said Botto. “In addition, we found that the incidence of cancer was highest in the first three to five years of life, so clinical surveillance can be focused by age, as well as by birth defect.”

The scientists also observed that cancer risk was 14 times higher among children with Down’s Syndrome, mainly due to leukemias. However, cancer risk was not increased with many common birth defects, including cleft lip, hydrocephalus, and hypospadias.
“It’s reassuring that many of the common major birth defects are not associated with any increase in cancer risk,” said Botto. “Our study helps to identify who is, and who is not, at an increased risk of cancer, and this information can be used to focus future research on potential genetic or environmental factors that contribute to cancer risk.”

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