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The spatial epidemiology of childhood cancer in Switzerland

Applicant Spycher Ben
Number 147987
Funding scheme Ambizione
Research institution Institut für Sozial- und Präventivmedizin Universität Bern
Institution of higher education University of Berne - BE
Main discipline Cancer
Start/End 01.09.2013 - 31.12.2016
Approved amount 559'676.00
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All Disciplines (4)

Discipline
Cancer
Medical Statistics
Radiobiology
Methods of Epidemiology and Preventive Medicine

Keywords (12)

epidemiology; cohort study; leukaemia; childhood cancer; spatial clustering; spatio-temporal clustering; risk factors; aetiology; ionising radiation; benzene; air pollution; traffic

Lay Summary (German)

Lead
In der Schweiz erkranken jährlich etwa 200 Kinder an Krebs. Wir wissen wenig über die Ursachen dieser Erkrankungen und es gibt keine Möglichkeit zur Vorbeugung. Einige mögliche Risikofaktoren, sind stark vom Wohnort der Kinder abhängig, wie z.B. Luftverschmutzung. Diese Studie untersucht solche Risikofaktoren mit Methoden der räumlichen Epidemiologie. Im Zeitraum von 1985 bis heute vergleicht sie Daten aller Kinder, die in der Schweiz wohnten, mit jenen von Kindern, die an Krebs erkrankten.
Lay summary

Inhalt und Ziel des Forschungsprojekts

Mein Ziel ist es, Faktoren zu untersuchen, die im Verdacht stehen, Krebs bei Kindern auszulösen. Insbesondere möchte ich den Einfluss ionisierender Hintergrundstrahlung aus Weltall und Erdboden, von Strahlungsbelastung durch Einatmen von Radon, von Luftverschmutzung durch Strassenverkehr und von Bevölkerungsströmen, wie starke Zuströme von Einwanderern in kleine Gemeinden, analysieren. Letztere könnten zu lokalen Häufungen von Infektionen führen, welche Krebs verursachen könnten. Weiterhin werde ich untersuchen, ob Krebs bei Kindern räumlich und zeitlich gehäuft auftritt. Dies könnte ein weiterer Hinweis dafür sein, dass Infektionen bei Kindern Krebs auslösen könnten.

Wissenschaftlicher und gesellschaftlicher Kontext

Diese Arbeit untersucht einige der vermuteten Ursachen von Krebs bei Kindern mit einer besseren zeitlichen und räumlichen Auflösung als bisherige Studien. Die gewonnen Erkenntnisse werden dazu beitragen, die wahren Kosten von vermeidbaren Umweltbelastungen, wie z.B. starker Strassenverkehr, abzuschätzen und Möglichkeiten zur Vorbeugung aufzuzeigen.

Direct link to Lay Summary Last update: 08.10.2014

Responsible applicant and co-applicants

Employees

Publications

Publication
Lung function in patients with primary ciliary dyskinesia: an iPCD Cohort study
Halbeisen Florian S., Goutaki Myrofora, Spycher Ben D., Amirav Israel, Behan Laura, Boon Mieke, Hogg Claire, Casaulta Carmen, Crowley Suzanne, Haarman Eric G., Karadag Bulent, Koerner-Rettberg Cordula, Loebinger Michael R., Mazurek Henryk, Morgan Lucy, Nielsen Kim G., Omran Heymut, Santamaria Francesca, Schwerk Nicolaus, Thouvenin Guillaume, Yiallouros Panayiotis, Lucas Jane S., Latzin Philipp, Kuehni Claudia E. (2018), Lung function in patients with primary ciliary dyskinesia: an iPCD Cohort study, in European Respiratory Journal, 52(2), 1801040-1801040.
Longitudinal Associations Between Respiratory Infections and Asthma in Young Children
Ramette Alban, Spycher Ben D, Wang Jingying, Goutaki Myrofora, Beardsmore Caroline S, Kuehni Claudia E (2018), Longitudinal Associations Between Respiratory Infections and Asthma in Young Children, in American Journal of Epidemiology, 187(8), 1714-1720.
Respiratory rate in infants with cystic fibrosis throughout the first year of life and association with lung clearance index measured shortly after birth
Korten Insa, Kieninger Elisabeth, Yammine Sophie, Cangiano Giulia, Nyilas Sylvia, Anagnostopoulou Pinelopi, Singer Florian, Kuehni Claudia E., Regamey Nicolas, Frey Urs, Casaulta Carmen, Spycher Ben D., Latzin Philipp (2018), Respiratory rate in infants with cystic fibrosis throughout the first year of life and association with lung clearance index measured shortly after birth, in Journal of Cystic Fibrosis.
Exploring variation in human papillomavirus vaccination uptake in Switzerland: a multilevel spatial analysis of a national vaccination coverage survey
Riesen Maurane, Konstantinoudis Garyfallos, Lang Phung, Low Nicola, Hatz Christoph, Maeusezahl Mirjam, Spaar Anne, Bühlmann Marc, Spycher Ben D, Althaus Christian L (2018), Exploring variation in human papillomavirus vaccination uptake in Switzerland: a multilevel spatial analysis of a national vaccination coverage survey, in BMJ Open, 8(5), e021006-e021006.
Spatial clustering of childhood cancers in Switzerland: a nationwide study
Konstantinoudis Garyfallos, Kreis Christian, Ammann Roland A., Niggli Felix, Kuehni Claudia E., Spycher Ben D. (2018), Spatial clustering of childhood cancers in Switzerland: a nationwide study, in Cancer Causes & Control, 29(3), 353-362.
Overweight in childhood cancer patients at diagnosis and throughout therapy: A multicentre cohort study
Belle Fabiën N., Wenke-Zobler Juliane, Cignacco Eva, Spycher Ben D., Ammann Roland A., Kuehni Claudia E., Zimmermann Karin (2018), Overweight in childhood cancer patients at diagnosis and throughout therapy: A multicentre cohort study, in Clinical Nutrition.
Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort
Goutaki Myrofora, Halbeisen Florian S., Spycher Ben D., Maurer Elisabeth, Belle Fabiën, Amirav Israel, Behan Laura, Boon Mieke, Carr Siobhan, Casaulta Carmen, Clement Annick, Crowley Suzanne, Dell Sharon, Ferkol Thomas, Haarman Eric G., Karadag Bulent, Knowles Michael, Koerner-Rettberg Cordula, Leigh Margaret W., Loebinger Michael R., Mazurek Henryk, Morgan Lucy, Nielsen Kim G., Phillipsen Maria, et al. (2017), Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort, in European Respiratory Journal, 50(6), 1701659-1701659.
Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort
Goutaki Myrofora, Halbeisen Florian S., Spycher Ben D., Maurer Elisabeth, Belle Fabiën, Amirav Israel, Behan Laura, Boon Mieke, Carr Siobhan, Casaulta Carmen, Clement Annick, Crowley Suzanne, Dell Sharon, Ferkol Thomas, Haarman Eric G., Karadag Bulent, Knowles Michael, Koerner-Rettberg Cordula, Leigh Margaret W., Loebinger Michael R., Mazurek Henryk, Morgan Lucy, Nielsen Kim G., Phillipsen Maria, et al. (2017), Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort, in European Respiratory Journal, 50(6), 1701659-1701659.
Temporal stability of multitrigger and episodic viral wheeze in early childhood
Spycher Ben D., Cochrane Cara, Granell Raquel, Sterne Jonathan A.C., Silverman Michael, Pedersen Eva, Gaillard Erol A., Henderson John, Kuehni Claudia E. (2017), Temporal stability of multitrigger and episodic viral wheeze in early childhood, in European Respiratory Journal, 50(5), 1700014-1700014.
Parental occupational exposure to benzene and the risk of childhood cancer: A census-based cohort study
Spycher Ben Daniel, Lupatsch Judith Eva, Huss Anke, Rischewski Johannes, Schindera Christina, Spoerri Adrian, Vermeulen Roel, Kuehni Claudia Elisabeth (2017), Parental occupational exposure to benzene and the risk of childhood cancer: A census-based cohort study, in Environment International, 108, 84-91.
Age-related changes in childhood wheezing characteristics: A whole population study
Jurca Maja, Pescatore Anina M., Goutaki Myrofora, Spycher Ben D., Beardsmore Caroline S., Kuehni Claudia E. (2017), Age-related changes in childhood wheezing characteristics: A whole population study, in Pediatric Pulmonology, 52(10), 1250-1259.
Spatial clustering of childhood leukaemia in Switzerland: A nationwide studySpatial clustering of childhood leukaemia in Switzerland
Konstantinoudis Garyfallos, Kreis Christian, Ammann Roland A., Niggli Felix, Kuehni Claudia E., Spycher Ben D. (2017), Spatial clustering of childhood leukaemia in Switzerland: A nationwide studySpatial clustering of childhood leukaemia in Switzerland, in International Journal of Cancer, 141(7), 1324-1332.
Space-Time Clustering of Childhood Leukemia: Evidence of an Association with ETV6-RUNX1 (TEL-AML1) Fusion
Kreis C, Lupatsch JE, Niggli F, Egger M, Kuehni CE, Spycher BD (2017), Space-Time Clustering of Childhood Leukemia: Evidence of an Association with ETV6-RUNX1 (TEL-AML1) Fusion, in PLOS ONE, 12(1), e0170020.
Asthma phenotypes in childhood: conceptual thoughts on stability and transition
Spycher BD, Kuehni CE (2016), Asthma phenotypes in childhood: conceptual thoughts on stability and transition, in European Respiratory Society, 47(2), 362-365.
Clinical manifestations in primary ciliary dyskinesia: systematic review and meta-analysis
Goutaki M, Meier AB, Halbeisen FS, Lucas JS, Dell SD, Maurer E, Casaulta C, Jurca M, Spycher BD (2016), Clinical manifestations in primary ciliary dyskinesia: systematic review and meta-analysis, in European Respiratory Journal, 48(4), 1081-1095.
Income in adult survivors of childhood cancer
Wengenroth L, Sommer G, Schindler M, Spycher BD, von der Weid NX, Stutz-Grunder E, Michel G, Kuehni CE (2016), Income in adult survivors of childhood cancer, in PLoS ONE, 11(5), e0155546.
Rhinovirus Infections and Associated Respiratory Morbidity in Infants: A Prospective Cohort Study
Mack I, Kieninger E, Cangiano G, Tapparel C, Kuehni CE, Spycher BD, Kaise L, Frey U, Regamey N, Latzin P (2016), Rhinovirus Infections and Associated Respiratory Morbidity in Infants: A Prospective Cohort Study, in The Pediatric Infectious Disease Journal, 35(10), 1069-1074.
Space-time clustering of childhood cancer in Switzerland: A nationwide study
Kreis C, Grotzer M, Hengartner H, Spycher BD (2016), Space-time clustering of childhood cancer in Switzerland: A nationwide study, in International Journal of Cancer, 138(9), 2127-2135.
Temporal association between childhood leukaemia and population growth in Swiss municipalities
Lupatsch JE, Kreis C, Zwahlen M, Niggli F, Ammann RA, Kuehni CE, Spycher BD (2016), Temporal association between childhood leukaemia and population growth in Swiss municipalities, in European Journal of Epidemiology, 31(8), 763-774.
"Attacks" or "Whistling": Impact of Questionnaire Wording on Wheeze Prevalence Estimates.
Pescatore Anina M, Spycher Ben D, Beardsmore Caroline S, Kuehni Claudia E (2015), "Attacks" or "Whistling": Impact of Questionnaire Wording on Wheeze Prevalence Estimates., in PloS one, 10(6), 0131618-0131618.
Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study.
Spycher Ben D, Lupatsch Judith E, Zwahlen Marcel, Röösli Martin, Niggli Felix, Grotzer Michael A, Rischewski Johannes, Egger Matthias, Kuehni Claudia E, Swiss Pediatric Oncology Group, Swiss National Cohort Study Group (2015), Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study., in Environmental health perspectives, 123(6), 622-8.
Breastfeeding, lung volumes and alveolar size at school-age
Dogaru C. M., Narayanan M., Spycher B. D., Pescatore A. M., Owers-Bradley J., Beardsmore C. S., Silverman M., Kuehni C. E. (2015), Breastfeeding, lung volumes and alveolar size at school-age, in BMJ Open Respir Res, 2(1), e000081.
Childhood cancer and residential exposure to highways: a nationwide cohort study
Spycher BD, Feller M, Röösli M, Gueler A, Ammann RA, Diezi M, Egger M, Kuehni CE (2015), Childhood cancer and residential exposure to highways: a nationwide cohort study, in Eur J Epidemiol, 30(12), 1263-1275.
Environmental and socioeconomic data do not improve the Predicting Asthma Risk in Children (PARC) tool
Pescatore Anina M, Spycher Ben D, Jurca Maja, Gaillard Erol A, Kuehni Claudia E (2015), Environmental and socioeconomic data do not improve the Predicting Asthma Risk in Children (PARC) tool, in The Journal of allergy and clinical immunology, 135(5), 1395-1397.
Lung function in the children of immigrant and UK-born south-Asian mothers.
Kuehni Claudia E, Strippoli Marie-Pierre F, Spycher Ben D, Silverman Michael, Beardsmore Caroline S (2015), Lung function in the children of immigrant and UK-born south-Asian mothers., in The European Respiratory Journal, 45(4), 1163-6.
Population mixing and the risk of childhood leukaemia in Switzerland: a census-based cohort study.
Lupatsch Judith E, Kuehni Claudia E, Niggli Felix, Ammann Roland A, Egger Matthias, Spycher Ben D (2015), Population mixing and the risk of childhood leukaemia in Switzerland: a census-based cohort study., in European journal of epidemiology, 30(12), 1287-1298.
Social Meets Molecular: Combining Phylogenetic and Latent Class Analyses to Understand HIV-1 Transmission in Switzerland
Avila Dorita, Keiser Olivia, Egger Matthias, Kouyos Roger, Boeni Juerg, Yerly Sabine, Klimkait Thomas, Vernazza Pietro L., Aubert Vincent, Rauch Andri, Bonhoeffer Sebastian, Guenthard Huldrych F., Stadler Tanja, Spycher Ben D. (2014), Social Meets Molecular: Combining Phylogenetic and Latent Class Analyses to Understand HIV-1 Transmission in Switzerland, in AMERICAN JOURNAL OF EPIDEMIOLOGY, 179(12), 1514-1525.

Collaboration

Group / person Country
Types of collaboration
Environmental Exposures and Health, Swiss Tropical Public Health Institute, Basel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Environmental Epidemiology, Institute of Risk Assessment Sciences, Utrecht University Netherlands (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Paediatric Oncology, University Children's Hospital Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
5th International Workshop on the Causes of Childhood Leukemia Talk given at a conference Spatial clustering of childhood leukaemia 14.11.2016 München, Germany Kreis Christian; Spycher Ben;
5th International Workshop on the Causes of Childhood Leukemia Talk given at a conference Environmental risk factors: Natural background radiation and traffic-related air pollution 14.11.2016 München, Germany Spycher Ben;
5th International Workshop on the Causes of Childhood Leukemia Talk given at a conference Space-time clustering of childhood leukaemia: a systematic review and meta-analysis 14.11.2016 München, Germany Spycher Ben; Kreis Christian;
The 6th Citizen-Scientist International Symposium on Radiation Protection Talk given at a conference Background ionizing radiation and the risk of childhood cancer – results from recent studies 07.10.2016 Nihonmatsu, Japan Spycher Ben;
40 Years Swiss Childhood Cancer Registry, Scientific Symposium Talk given at a conference Infections as a cause of leukaemia: smoking gun or blind alley? 08.09.2016 Bern, Switzerland Kreis Christian; Spycher Ben;
40 Years Swiss Childhood Cancer Registry, Scientific Symposium Talk given at a conference Risk factors of childhood cancer: does it matter where you live? 08.09.2016 Bern, Switzerland Spycher Ben;
28th International Society of Environmental Epidemiology (ISEE) conference Poster Space-time clustering of childhood leukaemia: a systematic review and meta-analysis 01.09.2016 Rom, Italy Spycher Ben; Kreis Christian;
28th International Society of Environmental Epidemiology (ISEE) conference Poster Spatial clustering of childhood leukaemia 01.09.2016 Rom, Italy Spycher Ben; Kreis Christian;
Symposium – 40 years Swiss Paediatric Oncology Group Poster Space-time clustering of childhood leukaemia: evidence of an association with ETV6-RUNX1 (TELAML1) fusion 03.06.2016 Bern, Switzerland Kreis Christian; Spycher Ben;
Symposium – 40 years Swiss Paediatric Oncology Group Talk given at a conference Spatial clustering of childhood leukaemia 03.06.2016 Bern, Switzerland Spycher Ben; Kreis Christian;
Seminar für Mitarbeiter von Landesbehörden und Sitzung des Arbeitskreises Strahlenbiologie/ Strahlenwirkung (AKS) des deutsch-schweizerischen Fachverband für Strahlenschutz Talk given at a conference Kindliche Leukämie- und ZNS-Tumorraten durch natürliche Strahlenexposition 23.11.2015 Berlin, Germany Spycher Ben;
9th international, interdisciplinary conference on spatial statistics, geographical epidemiology and geographical aspects of public health GEOMED Talk given at a conference Space-time clustering of childhood cancers in Switzerland 10.09.2015 Florenz, Italy Spycher Ben; Kreis Christian;
European Congress of Epidemiology 2015 – Healthy Living Poster Space-time clustering of childhood cancers in Switzerland 27.06.2015 Maastricht, Netherlands Kreis Christian; Spycher Ben;
European Congress of Epidemiology 2015 – Healthy Living Poster Population mixing and risk of childhood leukaemia in Switzerland 26.06.2015 Maastricht, Netherlands Kreis Christian; Spycher Ben;
Séminaire ASN (Autorité de Sûreté Nucléaire): Risques de leucémies et exposition aux rayonnements ionisants Individual talk Synthèse des études internationales et nouvelle étude Suisse 09.06.2015 Paris, France Spycher Ben;
International Society of Environmental Epidemiology (ISEE) - Annual Conference Talk given at a conference Parental occupational exposure to benzene and risk of childhood cancer: A census-based cohort study 27.08.2014 Seattle, United States of America Spycher Ben;
International Society of Environmental Epidemiology (ISEE) - Annual Conference Poster Population mixing and the risk of childhood leukemia: a national cohort study 26.08.2014 Seattle, United States of America Spycher Ben;
Swiss Public Health Conference 2014 Poster Parental occupational exposure to benzene and risk of childhood cancer: a census-based cohort study 21.08.2014 Olten, Switzerland Spycher Ben;
Swiss Public Health Conference 2014 Poster Population mixing and the risk of childhood leukemia: a national cohort study 21.08.2014 Olten, Switzerland Spycher Ben;
Swiss Public Health Conference 2014 Poster Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study 21.08.2014 Olten, Switzerland Spycher Ben;
In utero exposures and cancer in children Poster Parental occupational exposure to benzene and risk of childhood cancer: A census-based cohort study 02.06.2014 London, Great Britain and Northern Ireland Spycher Ben;
Swiss Paediatric Oncology Group Annual Conference Talk given at a conference Population mixing and the risk of childhood leukaemia: A population-based cohort study 01.02.2014 Lugano, Switzerland Spycher Ben;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Seminar für Mitarbeiter von Landesbehörden und Sitzung des Arbeitskreises Strahlenbiologie/ Strahlenwirkung (AKS) des deutsch-schweizerischen Fachverband für Strahlenschutz Talk 23.11.2015 Berlin, Germany Spycher Ben;
Sitzung des Direktionsbereichs Verbraucherschutz des Bundesamts für Gesundheit Talk 03.11.2015 Bern, Switzerland Spycher Ben;
Sitzung der Eidgenössische Kommission für Strahlenschutz Talk 01.06.2015 Bern, Switzerland Spycher Ben;


Communication with the public

Communication Title Media Place Year
New media (web, blogs, podcasts, news feeds etc.) Background ionising radiation affects cancer risk in children Instituts Homepage Italian-speaking Switzerland Rhaeto-Romanic Switzerland International German-speaking Switzerland Western Switzerland 2015
New media (web, blogs, podcasts, news feeds etc.) Background Radiation & Cancer in Children YouTube International 2015
Media relations: radio, television Das NDR Info Wissenschaftsmagazin Norddeutscher Rundfunk (NDR) International 2015
Print (books, brochures, leaflets) Den Ursachen von Kinderleukämie auf der Spur Western Switzerland Rhaeto-Romanic Switzerland Italian-speaking Switzerland German-speaking Switzerland 2015
Media relations: print media, online media Erhöhtes Krebsrisiko bei Kindern, die neben Autobahnen wohnen Medienmitteilung der Uni Bern German-speaking Switzerland 2015
Media relations: print media, online media Gefährliche kleine Strahlendosen Der Bund German-speaking Switzerland Western Switzerland 2015
Media relations: print media, online media Im Kinderkrebsregister lagern knapp 10 000 Dossiers NZZ German-speaking Switzerland Western Switzerland 2015
Media relations: print media, online media Kinder an Autobahnen bekommen eher Krebs 20 Minuten German-speaking Switzerland 2015
Media relations: print media, online media Natürliche Hintergrundstrahlung - Studie belegt erhöhtes Risiko für Krebs bei Kindern NZZ Western Switzerland German-speaking Switzerland 2015
Media relations: print media, online media Natürliche Hintergrundstrahlung erhöht das Risiko für Kinderkrebs Medienmitteilung Uni Bern German-speaking Switzerland Western Switzerland 2015
Media relations: print media, online media Natürliche Strahlen erhöhen Krebsrisiko bei Kindern Berner Zeitung Western Switzerland German-speaking Switzerland 2015
Media relations: print media, online media Schon wenig Strahlung kann Hirntumor auslösen Die Welt International 2015
Media relations: print media, online media Der Geburtsort beeinflusst das Krebsrisiko Sonntagszeitung German-speaking Switzerland 2014

Awards

Title Year
Outstanding Abstract by a New Investigator. International Society of Environmnetal Epidemiology. Annual Congress 2014. Seattle, USA, Aug 24-28. 2014

Associated projects

Number Title Start Funding scheme
176218 Low dose ionising radiation and the risk of childhood cancer 01.11.2017 Project funding (Div. I-III)

Abstract

BackgroundChildhood cancer is a major cause of death in children but the associated risk factors are still largely unknown. Numerous environmental causes, such as background ionising radiation, air pollution, or electromagnetic fields have been suspected and infections in early life may also play a role. Many of these hypotheses imply a spatially heterogeneous distribution of cancer incidence making them potentially testable with methods of spatial epidemiology. For instance, the putative effects of cosmic ionizing radiation could lead to detectable differences in incidence according to altitude, particularly in a mountainous country like Switzerland. Outbreaks of infections caused by a rapid influx of people into an isolated area could lead to clusters of cancer cases. Many previous studies were limited by poor exposure measurements and a lack of spatial and temporal resolution. In Switzerland, the combination of two rich data sets, the Swiss National Cohort (SNC) and the Swiss Childhood Cancer Registry (SCCR), makes it possible to study spatially defined exposures in a national cohort study. Geocodes of the place of residence are available for the entire Swiss population and for cancer patients, both at diagnosis and at birth. Aims I aim to investigate 1) whether the incidence of childhood cancer in Switzerland during the period 1985 to present was associated with natural ionizing radiation (cosmic, terrestrial, domestic radon) and traffic related air pollution, and whether there is an interaction between traffic related air pollution and domestic radon 2) whether the incidence of childhood cancer was elevated in communities that experienced rapid population influxes (population mixing) and 3) whether there is evidence for a general tendency of cases to cluster in space and in space-time (spatial and spatio-temporal clustering).MethodsI will include the entire Swiss resident population aged <20 years. Data on cancer diagnoses in this population will be obtained from the SCCR and data on the population at risk from the SNC. Outcomes will be any childhood cancer and major diagnostic subgroups such as leukaemia, lymphomas, and tumours of the central nervous system. Among leukaemias, I will separately investigate acute lymphoblastic leukaemia (ALL), and important cytogenetic subtypes of ALL. I will use annual population figures at the national and community level to interpolate person years at risk between census years for defined spatial units. Dose rates of outdoor cosmic and terrestrial ionising radiation at places of residence will be estimated from existing radiation maps and indoor radon gas concentrations using a previously developed prediction model. Proxy measures for traffic related air pollution will include distance of place of residence to near major roads, to nearest petrol stations or motor vehicle service stations, and predicted outdoor concentrations of specific pollutants (benzene, NO2 and PM10 and PM2.5) based on dispersion and land-use regression models. To investigate associations between cancer incidence and these environmental exposures, I will use Poisson regression and Cox-regression models. To assess spatial and spatio-temporal clustering I will apply novel statistical methods that are potentially superior but have been under-utilised because they require precise spatial data on the general population. SignificanceThe planned work will importantly advance our understanding of the role of environmental risk factors (or the lack thereof) in the aetiology of childhood cancer. Based on a national cohort study with very high spatial resolution, the study will allow me to do analyses on a scale and resolution that has not been possible in previous studies. The detailed data on the leukaemia phenotypes (cytogenetic and immunophenotypes) are another strength of this study. Ultimately, I hope the proposed work will contribute to a better understanding of the risk factors of childhood cancer and their prevention.
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