PDF(Pubmed)
Abstract：
BACKGROUND: Acute lymphocytic leukaemia (ALL) and non-Hodgkin lymphoma (NHL) are among the commonest types of childhood cancer. Some previous studies suggested that elevated ultraviolet radiation (UVR) exposures increase ALL risk; many more indicate NHL risk is reduced.
METHODS: We assessed age<20 ALL/NHL incidence in Surveillance, Epidemiology and End Results data using AVGLO-derived UVR irradiance/cumulative radiant exposure measures, using quasi-likelihood models accounting for underdispersion, adjusted for age, sex, racial/ethnic group and other county-level socioeconomic variables.
RESULTS: There were 30,349 cases of ALL and 8062 of NHL, with significant increasing trends of ALL with UVR irradiance (relative risk (RR) = 1.200/mW/cm2 (95% CI 1.060, 1.359, p = 0.0040)), but significant decreasing trends for NHL (RR = 0.646/mW/cm2 (95% CI 0.512, 0.816, p = 0.0002)). There was a borderline-significant increasing trend of ALL with UVR cumulative radiant exposure (RR = 1.444/MJ/cm2 (95% CI 0.949, 2.197, p = 0.0865)), and significant decreasing trends for NHL (RR = 0.284/MJ/cm2 (95% CI 0.166, 0.485, p < 0.0001)). ALL and NHL trend RR is substantially increased among those aged 0-3. All-age trend RRs are most extreme (increasing for ALL, decreasing for NHL) for Hispanics for both UVR measures.
CONCLUSIONS: Our more novel finding, of excess UVR-related ALL risk, is consistent with some previous studies, but is not clear-cut, and in need of replication.
METHODS: We assessed age<20 ALL/NHL incidence in Surveillance, Epidemiology and End Results data using AVGLO-derived UVR irradiance/cumulative radiant exposure measures, using quasi-likelihood models accounting for underdispersion, adjusted for age, sex, racial/ethnic group and other county-level socioeconomic variables.
RESULTS: There were 30,349 cases of ALL and 8062 of NHL, with significant increasing trends of ALL with UVR irradiance (relative risk (RR) = 1.200/mW/cm2 (95% CI 1.060, 1.359, p = 0.0040)), but significant decreasing trends for NHL (RR = 0.646/mW/cm2 (95% CI 0.512, 0.816, p = 0.0002)). There was a borderline-significant increasing trend of ALL with UVR cumulative radiant exposure (RR = 1.444/MJ/cm2 (95% CI 0.949, 2.197, p = 0.0865)), and significant decreasing trends for NHL (RR = 0.284/MJ/cm2 (95% CI 0.166, 0.485, p < 0.0001)). ALL and NHL trend RR is substantially increased among those aged 0-3. All-age trend RRs are most extreme (increasing for ALL, decreasing for NHL) for Hispanics for both UVR measures.
CONCLUSIONS: Our more novel finding, of excess UVR-related ALL risk, is consistent with some previous studies, but is not clear-cut, and in need of replication.
摘要：
背景：急性淋巴细胞白血病（ALL）和非霍奇金淋巴瘤（NHL）是儿童癌症中最常见的类型。以前的一些研究表明，紫外线辐射（UVR）暴露增加了ALL风险;更多表明NHL风险降低。
方法：我们在监测中评估年龄<20岁的ALL/NHL发病率，使用AVGLO衍生的UVR辐照度/累积辐射暴露测量的流行病学和最终结果数据，使用准似然模型来解释欠分散，根据年龄调整，性别,种族/族裔群体和其他县级社会经济变量。
结果：ALL30,349例，NHL8062例，随着UVR辐照度（相对风险（RR）=1.200/mW/cm2（95％CI1.060，1.359，p=0.0040）），但NHL呈显著下降趋势(RR=0.646/mW/cm2(95%CI0.512,0.816,p=0.0002))。随着UVR累积辐射暴露，ALL有临界显著增加趋势(RR=1.444/MJ/cm2(95%CI0.949,2.197,p=0.0865))，NHL呈显著下降趋势(RR=0.284/MJ/cm2(95%CI0.166，0.485，p<0.0001))。在0-3岁的人群中，ALL和NHL趋势RR显著增加。所有年龄趋势RR都是最极端的(所有人都在增加，NHL的减少)对于两种UVR措施的西班牙裔。
结论：我们更新颖的发现，过度的UVR相关的所有风险，与以前的一些研究一致，但并不明确，并且需要复制。
方法：我们在监测中评估年龄<20岁的ALL/NHL发病率，使用AVGLO衍生的UVR辐照度/累积辐射暴露测量的流行病学和最终结果数据，使用准似然模型来解释欠分散，根据年龄调整，性别,种族/族裔群体和其他县级社会经济变量。
结果：ALL30,349例，NHL8062例，随着UVR辐照度（相对风险（RR）=1.200/mW/cm2（95％CI1.060，1.359，p=0.0040）），但NHL呈显著下降趋势(RR=0.646/mW/cm2(95%CI0.512,0.816,p=0.0002))。随着UVR累积辐射暴露，ALL有临界显著增加趋势(RR=1.444/MJ/cm2(95%CI0.949,2.197,p=0.0865))，NHL呈显著下降趋势(RR=0.284/MJ/cm2(95%CI0.166，0.485，p<0.0001))。在0-3岁的人群中，ALL和NHL趋势RR显著增加。所有年龄趋势RR都是最极端的(所有人都在增加，NHL的减少)对于两种UVR措施的西班牙裔。
结论：我们更新颖的发现，过度的UVR相关的所有风险，与以前的一些研究一致，但并不明确，并且需要复制。
