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An examination, with a meta-analysis, of studies of childhood leukaemia in relation to population mixing.

BACKGROUNDMarked influxes of people into rural areas, termed rural population mixing (PM), have been associated with excesses of childhood leukaemia (CL), consistent with mini-epidemics of a mainly immunising, subclinical infection to which CL is a rare response. For such situations of rural PM woul... Full description

Journal Title: British journal of cancer September 25, 2012, Vol.107(7), pp.1163-1168
Main Author: Kinlen, L J
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1532-1827 ; DOI: 10.1038/bjc.2012.402
Link: http://search.proquest.com/docview/1080882140/?pq-origsite=primo
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title: An examination, with a meta-analysis, of studies of childhood leukaemia in relation to population mixing.
format: Article
creator:
  • Kinlen, L J
subjects:
  • Adolescent–Epidemiology
  • Child–Epidemiology
  • Child, Preschool–Statistics & Numerical Data
  • Humans–Statistics & Numerical Data
  • Infant–Statistics & Numerical Data
  • Infant, Newborn–Statistics & Numerical Data
  • Infection–Statistics & Numerical Data
  • Leukemia–Statistics & Numerical Data
  • Risk Factors–Statistics & Numerical Data
  • Rural Health–Statistics & Numerical Data
  • Rural Population–Statistics & Numerical Data
ispartof: British journal of cancer, September 25, 2012, Vol.107(7), pp.1163-1168
description: BACKGROUNDMarked influxes of people into rural areas, termed rural population mixing (PM), have been associated with excesses of childhood leukaemia (CL), consistent with mini-epidemics of a mainly immunising, subclinical infection to which CL is a rare response. For such situations of rural PM would promote contacts between infected and susceptible individuals, the latter tending to have a higher than average prevalence in rural or isolated areas. Confusion has arisen from some workers applying the term PM to non-rural situations lacking known recent change. METHODSAvailable PM studies using the original definition of influxes were examined, a meta-analysis carried out of studies of CL in relation to exposure to high levels of rural PM, and also a detailed analysis by age group. RESULTSThe meta-analysis of 17 studies shows a significant CL excess in association with rural PM: overall relative risk (RR) at ages 0-14: 1.57; 95% confidence interval 1.44-1.72; at 0-4 years 1.72 (1.54-1.91). This contrasts with the absence of an excess of CL in similarly exposed urban areas (RR 1.00; 0.93-1.07), pointing to a high level of immunity there. The mixed results of studies using other definitions of PM were summarised. The excess associated with rural PM below age 2 years (RR 1.51; 1.17, 1.92) was not appreciably different from that at later childhood ages. CONCLUSIONMuch of the inconsistency among studies ostensibly about CL and PM reflects the use of definitions other than that originally proposed. The broad similarity of the CL excess below age 2 with that at older childhood ages is inconsistent with the Greaves' delayed infection hypothesis, since any infection underlying the former is difficult to consider as delayed.
language: eng
source:
identifier: E-ISSN: 1532-1827 ; DOI: 10.1038/bjc.2012.402
fulltext: fulltext
issn:
  • 15321827
  • 1532-1827
url: Link


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titleAn examination, with a meta-analysis, of studies of childhood leukaemia in relation to population mixing.
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descriptionBACKGROUNDMarked influxes of people into rural areas, termed rural population mixing (PM), have been associated with excesses of childhood leukaemia (CL), consistent with mini-epidemics of a mainly immunising, subclinical infection to which CL is a rare response. For such situations of rural PM would promote contacts between infected and susceptible individuals, the latter tending to have a higher than average prevalence in rural or isolated areas. Confusion has arisen from some workers applying the term PM to non-rural situations lacking known recent change. METHODSAvailable PM studies using the original definition of influxes were examined, a meta-analysis carried out of studies of CL in relation to exposure to high levels of rural PM, and also a detailed analysis by age group. RESULTSThe meta-analysis of 17 studies shows a significant CL excess in association with rural PM: overall relative risk (RR) at ages 0-14: 1.57; 95% confidence interval 1.44-1.72; at 0-4 years 1.72 (1.54-1.91). This contrasts with the absence of an excess of CL in similarly exposed urban areas (RR 1.00; 0.93-1.07), pointing to a high level of immunity there. The mixed results of studies using other definitions of PM were summarised. The excess associated with rural PM below age 2 years (RR 1.51; 1.17, 1.92) was not appreciably different from that at later childhood ages. CONCLUSIONMuch of the inconsistency among studies ostensibly about CL and PM reflects the use of definitions other than that originally proposed. The broad similarity of the CL excess below age 2 with that at older childhood ages is inconsistent with the Greaves' delayed infection hypothesis, since any infection underlying the former is difficult to consider as delayed.
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titleAn examination, with a meta-analysis, of studies of childhood leukaemia in relation to population mixing.
descriptionBACKGROUNDMarked influxes of people into rural areas, termed rural population mixing (PM), have been associated with excesses of childhood leukaemia (CL), consistent with mini-epidemics of a mainly immunising, subclinical infection to which CL is a rare response. For such situations of rural PM would promote contacts between infected and susceptible individuals, the latter tending to have a higher than average prevalence in rural or isolated areas. Confusion has arisen from some workers applying the term PM to non-rural situations lacking known recent change. METHODSAvailable PM studies using the original definition of influxes were examined, a meta-analysis carried out of studies of CL in relation to exposure to high levels of rural PM, and also a detailed analysis by age group. RESULTSThe meta-analysis of 17 studies shows a significant CL excess in association with rural PM: overall relative risk (RR) at ages 0-14: 1.57; 95% confidence interval 1.44-1.72; at 0-4 years 1.72 (1.54-1.91). This contrasts with the absence of an excess of CL in similarly exposed urban areas (RR 1.00; 0.93-1.07), pointing to a high level of immunity there. The mixed results of studies using other definitions of PM were summarised. The excess associated with rural PM below age 2 years (RR 1.51; 1.17, 1.92) was not appreciably different from that at later childhood ages. CONCLUSIONMuch of the inconsistency among studies ostensibly about CL and PM reflects the use of definitions other than that originally proposed. The broad similarity of the CL excess below age 2 with that at older childhood ages is inconsistent with the Greaves' delayed infection hypothesis, since any infection underlying the former is difficult to consider as delayed.
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abstractBACKGROUNDMarked influxes of people into rural areas, termed rural population mixing (PM), have been associated with excesses of childhood leukaemia (CL), consistent with mini-epidemics of a mainly immunising, subclinical infection to which CL is a rare response. For such situations of rural PM would promote contacts between infected and susceptible individuals, the latter tending to have a higher than average prevalence in rural or isolated areas. Confusion has arisen from some workers applying the term PM to non-rural situations lacking known recent change. METHODSAvailable PM studies using the original definition of influxes were examined, a meta-analysis carried out of studies of CL in relation to exposure to high levels of rural PM, and also a detailed analysis by age group. RESULTSThe meta-analysis of 17 studies shows a significant CL excess in association with rural PM: overall relative risk (RR) at ages 0-14: 1.57; 95% confidence interval 1.44-1.72; at 0-4 years 1.72 (1.54-1.91). This contrasts with the absence of an excess of CL in similarly exposed urban areas (RR 1.00; 0.93-1.07), pointing to a high level of immunity there. The mixed results of studies using other definitions of PM were summarised. The excess associated with rural PM below age 2 years (RR 1.51; 1.17, 1.92) was not appreciably different from that at later childhood ages. CONCLUSIONMuch of the inconsistency among studies ostensibly about CL and PM reflects the use of definitions other than that originally proposed. The broad similarity of the CL excess below age 2 with that at older childhood ages is inconsistent with the Greaves' delayed infection hypothesis, since any infection underlying the former is difficult to consider as delayed.
doi10.1038/bjc.2012.402
urlhttp://search.proquest.com/docview/1080882140/
issn00070920
date2012-09-25