دورية أكاديمية
Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California.
| العنوان: | Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California. |
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| المؤلفون: | Newman TB; Departments of Epidemiology and Biostatistics, and Pediatrics, University of California, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California; and newman@epi.ucsf.edu., Wickremasinghe AC; Departments of Epidemiology and Biostatistics, and Department of Pediatrics, Kaiser Permanente Santa Clara, Santa Clara, California., Walsh EM; Division of Research, Kaiser Permanente Northern California, Oakland, California; and., Grimes BA; Departments of Epidemiology and Biostatistics, and., McCulloch CE; Departments of Epidemiology and Biostatistics, and., Kuzniewicz MW; Pediatrics, University of California, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California; and. |
| المصدر: | Pediatrics [Pediatrics] 2016 Jun; Vol. 137 (6). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 0376422 Publication Model: Print Cited Medium: Internet ISSN: 1098-4275 (Electronic) Linking ISSN: 00314005 NLM ISO Abbreviation: Pediatrics Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Elk Grove Village Il : American Academy of Pediatrics Original Publication: Springfield, Ill., Thomas. |
| مواضيع طبية MeSH: | Hyperbilirubinemia, Neonatal/*therapy , Neoplasms/*etiology , Phototherapy/*adverse effects, Bilirubin/blood ; California/epidemiology ; Child ; Child, Preschool ; Confounding Factors, Epidemiologic ; Female ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Neoplasms/epidemiology ; Propensity Score ; Proportional Hazards Models ; Retrospective Studies |
| مستخلص: | Objective: To investigate the association between neonatal phototherapy use and childhood cancer. Methods: This retrospective cohort study included 499 621 children born at ≥35 weeks' gestation from 1995 to 2011 in Kaiser Permanente Northern California hospitals, who survived to hospital discharge and were followed ≥60 days. We obtained data on home and inpatient phototherapy, covariates, and cancer incidence from electronic records. We used propensity-adjusted Cox and Poisson models to control for confounding and unequal follow-up times. Results: There were 60 children with a diagnosis of cancer among 39 403 exposed to phototherapy (25 per 100 000 person-years), compared with 651 of 460 218 unexposed children (18 per 100 000 person-years; incidence rate ratio [IRR] 1.4; P = .01). Phototherapy was associated with increased rates of any leukemia (IRR 2.1; P = .0007), nonlymphocytic leukemia (IRR 4.0; P = .0004), and liver cancer (IRR 5.2; P = .04). With adjustment for a propensity score that incorporated bilirubin levels, chromosomal disorders, congenital anomalies, and other covariates, associations were no longer statistically significant: Adjusted hazard ratios (95% confidence intervals) were 1.0 (0.7-1.6) for any cancer, 1.6 (0.8-3.5) for any leukemia, 1.9 (0.6-6.9) for nonlymphocytic leukemia, and 1.4 (0.2-12) for liver cancer. Upper limits of 95% confidence intervals for adjusted 10-year excess risk were generally <0.1% but reached 4.4% for children with Down syndrome. Conclusions: Although phototherapy use was associated with increased cancer rates (particularly nonlymphocytic leukemia), control for confounding variables eliminated or attenuated the associations. Nonetheless, the possibility of even partial causality suggests that avoiding unnecessary phototherapy may be prudent. (Copyright © 2016 by the American Academy of Pediatrics.) |
| التعليقات: | Comment in: Pediatrics. 2016 Jun;137(6):. (PMID: 27217479) Comment in: Evid Based Med. 2017 Mar;22(1):39-40. (PMID: 27849162) |
| معلومات مُعتمدة: | R01 HS020618 United States HS AHRQ HHS |
| المشرفين على المادة: | RFM9X3LJ49 (Bilirubin) |
| تواريخ الأحداث: | Date Created: 20160525 Date Completed: 20170615 Latest Revision: 20191210 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1542/peds.2015-1354 |
| PMID: | 27217477 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-4275 |
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| DOI: | 10.1542/peds.2015-1354 |