Environmental risk factors of Wilms tumour: A systematic review and meta-analysis

Wilms tumour (WT) is the fourth leading cause of cancer death in children. Elucidating modifiable risk factors is crucial in identifying venues for primary prevention of the disease. This study aimed to review literature and synthesize environmental risk factors for WT. We conducted a systematic rev...

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Main Authors: Felix M. Onyije, Roya Dolatkhah, Ann Olsson, Liacine Bouaoun, Joachim Schüz
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:EJC Paediatric Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772610X24000370
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author Felix M. Onyije
Roya Dolatkhah
Ann Olsson
Liacine Bouaoun
Joachim Schüz
author_facet Felix M. Onyije
Roya Dolatkhah
Ann Olsson
Liacine Bouaoun
Joachim Schüz
author_sort Felix M. Onyije
collection DOAJ
description Wilms tumour (WT) is the fourth leading cause of cancer death in children. Elucidating modifiable risk factors is crucial in identifying venues for primary prevention of the disease. This study aimed to review literature and synthesize environmental risk factors for WT. We conducted a systematic review and meta-analysis of epidemiological studies using PubMed, Web of Science, and Embase databases. Studies were included if they were case-control or cohort studies of children under the age of 20 years at diagnosis and reported Relative Risks (RRs) with 95 % confidence intervals (CIs). Pooled effect sizes (ES) and 95 % CIs for risk factors associated with WT were estimated using random-effects models. We included 58 eligible studies from Asia, Europe, Latin and North America, and Oceania totalling approximately10000 cases of WT diagnosed between 1953 and 2019. We confirmed an association between high birthweight ((>4000 g) ES 1.54, CI 1.20–1.97) and WT. Similarly, consistent associations were suggested for Caesarean section (ES 1.23, CI 1.07–1.42), gestational age <37 weeks (ES 1.45, CI 1.21–1.74), and large-for-gestational age (ES 1.52, CI 1.09–2.12). Parental occupational exposure to pesticides during preconception / pregnancy also showed increased risks of WT (maternal ES 1.28, CI 1.02–1.60, paternal ES 1.48, CI 0.98–2.24). There were inverse associations for breastfeeding (ever breastfed = ES 0.71, CI 0.56–0.89; < 6 months ES 0.67, CI 0.49–0.91; and ≥6 months ES 0.75, CI 0.59–0.97), and maternal intake of vitamins (unspecified) and folic acid during pregnancy (ES 0.78, CI 0.69–0.89). Among factors showing no associations were low birthweight (<2500 g), small-for-gestational age, assisted reproductive technology, parental age, and smoking or alcohol consumption during preconception / pregnancy, paternal occupational extremely low frequency magnetic fields (ELF-MF) exposures, and maternal X-ray exposure during pregnancy. Our findings suggest that modifiable risk factors of WT are parental occupational exposure to pesticides, breastfeeding (beneficial), and intake of folic acid during preconception / pregnancy (beneficial), but all associations were rather modest in strength.
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spelling doaj-art-e4ea647889c045f0ad49413037de76672025-08-20T02:50:16ZengElsevierEJC Paediatric Oncology2772-610X2024-12-01410017810.1016/j.ejcped.2024.100178Environmental risk factors of Wilms tumour: A systematic review and meta-analysisFelix M. Onyije0Roya Dolatkhah1Ann Olsson2Liacine Bouaoun3Joachim Schüz4Corresponding author.; Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, Lyon Cedex 07 69366, FranceEnvironment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, Lyon Cedex 07 69366, FranceEnvironment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, Lyon Cedex 07 69366, FranceEnvironment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, Lyon Cedex 07 69366, FranceEnvironment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, Lyon Cedex 07 69366, FranceWilms tumour (WT) is the fourth leading cause of cancer death in children. Elucidating modifiable risk factors is crucial in identifying venues for primary prevention of the disease. This study aimed to review literature and synthesize environmental risk factors for WT. We conducted a systematic review and meta-analysis of epidemiological studies using PubMed, Web of Science, and Embase databases. Studies were included if they were case-control or cohort studies of children under the age of 20 years at diagnosis and reported Relative Risks (RRs) with 95 % confidence intervals (CIs). Pooled effect sizes (ES) and 95 % CIs for risk factors associated with WT were estimated using random-effects models. We included 58 eligible studies from Asia, Europe, Latin and North America, and Oceania totalling approximately10000 cases of WT diagnosed between 1953 and 2019. We confirmed an association between high birthweight ((>4000 g) ES 1.54, CI 1.20–1.97) and WT. Similarly, consistent associations were suggested for Caesarean section (ES 1.23, CI 1.07–1.42), gestational age <37 weeks (ES 1.45, CI 1.21–1.74), and large-for-gestational age (ES 1.52, CI 1.09–2.12). Parental occupational exposure to pesticides during preconception / pregnancy also showed increased risks of WT (maternal ES 1.28, CI 1.02–1.60, paternal ES 1.48, CI 0.98–2.24). There were inverse associations for breastfeeding (ever breastfed = ES 0.71, CI 0.56–0.89; < 6 months ES 0.67, CI 0.49–0.91; and ≥6 months ES 0.75, CI 0.59–0.97), and maternal intake of vitamins (unspecified) and folic acid during pregnancy (ES 0.78, CI 0.69–0.89). Among factors showing no associations were low birthweight (<2500 g), small-for-gestational age, assisted reproductive technology, parental age, and smoking or alcohol consumption during preconception / pregnancy, paternal occupational extremely low frequency magnetic fields (ELF-MF) exposures, and maternal X-ray exposure during pregnancy. Our findings suggest that modifiable risk factors of WT are parental occupational exposure to pesticides, breastfeeding (beneficial), and intake of folic acid during preconception / pregnancy (beneficial), but all associations were rather modest in strength.http://www.sciencedirect.com/science/article/pii/S2772610X24000370Wilms tumourHigh birthweightCaesarean sectionPesticidesVitamins and folic acidSystematic review and meta-analysis
spellingShingle Felix M. Onyije
Roya Dolatkhah
Ann Olsson
Liacine Bouaoun
Joachim Schüz
Environmental risk factors of Wilms tumour: A systematic review and meta-analysis
EJC Paediatric Oncology
Wilms tumour
High birthweight
Caesarean section
Pesticides
Vitamins and folic acid
Systematic review and meta-analysis
title Environmental risk factors of Wilms tumour: A systematic review and meta-analysis
title_full Environmental risk factors of Wilms tumour: A systematic review and meta-analysis
title_fullStr Environmental risk factors of Wilms tumour: A systematic review and meta-analysis
title_full_unstemmed Environmental risk factors of Wilms tumour: A systematic review and meta-analysis
title_short Environmental risk factors of Wilms tumour: A systematic review and meta-analysis
title_sort environmental risk factors of wilms tumour a systematic review and meta analysis
topic Wilms tumour
High birthweight
Caesarean section
Pesticides
Vitamins and folic acid
Systematic review and meta-analysis
url http://www.sciencedirect.com/science/article/pii/S2772610X24000370
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AT annolsson environmentalriskfactorsofwilmstumourasystematicreviewandmetaanalysis
AT liacinebouaoun environmentalriskfactorsofwilmstumourasystematicreviewandmetaanalysis
AT joachimschuz environmentalriskfactorsofwilmstumourasystematicreviewandmetaanalysis