Risk factors for Wilms tumor: Report from the national Wilms tumor study

Authors

  • Andrew F. Olshan Ph.D.,

    Corresponding author
    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
    • The Childrens Cancer Group, 440 East Huntington Drive, Suite 300, P.O. Box 60012, Arcadia, CA 91066–6012
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    • Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.

  • Norman E. Breslow Ph.D.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Department of Biostatistics SC-32, University of Washington, Seattle, Washington.

  • John M. Falletta M.D.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Division of Hematology-Oncology, Duke University Medical Center, Durham, North Carolina.

  • Seymour Grufferman M.D., Dr.P.H.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Department of Clinical Epidemiology and Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

  • Thomas Pendergrass M.D., M.S.P.H.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Department of Pediatric Hematology-Oncology, University of Washington and Childrens Hospital and Medical Center, Seattle, Washington.

  • Leslie L. Robison Ph.D.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.

  • Mary Waskerwitz R.N.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Division of Pediatric Hematology-Oncology, Butterworth Hospital, Grand Rapids, Michigan.

  • William G. Woods M.D.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.

  • Teresa J. Vietti M.D.,

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Pediatric Oncology Group, St. Louis, Missouri.

  • G. Denman Hammond M.D.

    1. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
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    • Office of the Vice President for Health Affairs, University of Southern California, Arcadia, California.


Abstract

Background. Previous epidemiologic studies have indicated that several factors may be associated with an increased risk of Wilms tumor including paternal occupational exposures, maternal exposure during pregnancy to cigarettes, coffee or tea, oral contraceptives, hormonal pregnancy tests, hair-coloring products, maternal hypertension, vaginal infection during pregnancy, and higher birth weight of the child. The current study examines the nonoccupational risk factors using questionnaire data from a large national collaborative clinical trial.

Methods. Parents of 200 children registered with the National Wilms Tumor Study and 233 matched controls, identified using telephone random-digit dialing, completed a self-administered questionnaire about a variety of risk factors.

Results. As opposed to some previous studies, no association was found for mother's smoking during pregnancy (10+ cigarettes per day; odds ratio [OR] = 0.73; 95% confidence interval [CI] = 0.40–1.34), maternal consumption of coffee or tea during pregnancy (4+ cups per day; OR = 1.31; CI = 0.57–3.01), or hypertension during pregnancy (OR = 0.96; CI = 0.45–2.06). In addition, no association was found in this study for hormone exposure during pregnancy, hair dye use, vaginal infection during pregnancy, or high birth weight. A previously unreported association with a history of household insect extermination was found (OR = 2.16; CI = 1.24–3.75).

Conclusions. In general, the study failed to confirm most of the previously reported maternal risk factors for Wilms tumor. Understanding the possible role of paternal exposures may be the best objective for further research on potential risk factors for Wilms tumor.

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