Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium

doi:10.1007/s10552-023-01746-3

Meta-Analysis

. 2023 Nov;34(11):1005-1015.

doi: 10.1007/s10552-023-01746-3. Epub 2023 Jul 8.

Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium

Jeremy M Schraw^{1

2}, Eleni Th Petridou^{3

4}, Audrey Bonaventure⁵, John D Dockerty⁶, Maria Karalexi⁴, Evangelia Ntzani^{7

8}, Claire Infante-Rivard⁹, Jacqueline Clavel^{5

10}, Paige M Bracci^{11

12}, Roberta McKean-Cowdin¹³, Eve Roman¹⁴, Eleanor Kane¹⁴, Friederike Erdmann^{15

16}, Joachim Schüz¹⁷, Beth A Mueller^{18

19}, Michael E Scheurer^{20

21}

Affiliations

¹ Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA. schraw@bcm.edu.
² Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. schraw@bcm.edu.
³ Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁴ Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece.
⁵ UMR-1153, CRESS, Université de Paris, INSERM, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France.
⁶ Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
⁷ Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.
⁸ Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110, Ioannina, Greece.
⁹ Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
¹⁰ National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, Villejuif, and CHU de Nancy, Vandoeuvre-Lès-Nancy, France.
¹¹ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
¹² Hellen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
¹³ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
¹⁴ Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
¹⁵ Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France.
¹⁶ Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany.
¹⁷ Section of Environment and Radiation, International Agency for Research On Cancer (IARC/WHO), Lyon, France.
¹⁸ Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹⁹ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
²⁰ Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.
²¹ Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.

PMID: 37421504
DOI: 10.1007/s10552-023-01746-3

Free article

Meta-Analysis

Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium

Jeremy M Schraw et al. Cancer Causes Control. 2023 Nov.

Free article

. 2023 Nov;34(11):1005-1015.

doi: 10.1007/s10552-023-01746-3. Epub 2023 Jul 8.

Authors

Affiliations

¹ Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA. schraw@bcm.edu.
² Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. schraw@bcm.edu.
³ Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁴ Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece.
⁵ UMR-1153, CRESS, Université de Paris, INSERM, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France.
⁶ Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
⁷ Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.
⁸ Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110, Ioannina, Greece.
⁹ Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
¹⁰ National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, Villejuif, and CHU de Nancy, Vandoeuvre-Lès-Nancy, France.
¹¹ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
¹² Hellen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
¹³ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
¹⁴ Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
¹⁵ Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France.
¹⁶ Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany.
¹⁷ Section of Environment and Radiation, International Agency for Research On Cancer (IARC/WHO), Lyon, France.
¹⁸ Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹⁹ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
²⁰ Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.
²¹ Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.

PMID: 37421504
DOI: 10.1007/s10552-023-01746-3

Abstract

Purpose: Studies report mixed findings regarding the association of breastfeeding with childhood brain tumors (CBT), the leading causes of cancer-related mortality in young people. Our objective was to determine whether breastfeeding is associated with CBT incidence.

Methods: We pooled data on N = 2610 cases with CBT (including 697 cases with astrocytoma, 447 cases with medulloblastoma/primitive neuroectodermal tumor [PNET], 167 cases with ependymoma) and N = 8128 age- and sex-matched controls in the Childhood Cancer and Leukemia International Consortium. We computed unconditional logistic regression models to estimate the odds ratio (OR) and 95% confidence interval (CI) of CBT, astrocytoma, medulloblastoma/PNET, and ependymoma according to breastfeeding status, adjusting for study, sex, mode of delivery, birthweight, age at diagnosis/interview, maternal age at delivery, maternal educational attainment, and maternal race/ethnicity. We evaluated any breastfeeding versus none and breastfeeding ≥ 6 months versus none. We subsequently performed random effects meta-analysis to confirm our findings, identify potential sources of heterogeneity, and evaluate for outliers or influential studies.

Results: Breastfeeding was reported by 64.8% of control mothers and 64.5% of case mothers and was not associated with CBT (OR 1.04, 95% CI 0.94-1.15), astrocytoma (OR 1.01, 95% CI 0.87-1.17), medulloblastoma/PNET (OR 1.11, 95% CI 0.93-1.32), or ependymoma (OR 1.06, 95% CI 0.81-1.40). Results were similar when we restricted to breastfeeding ≥ 6 months and in meta-analyses.

Conclusion: Our data suggest that breastfeeding does not protect against CBT.

Keywords: Breastfeeding; Childhood Cancer; Childhood brain tumors; Childhood cancer; Epidemiology; Infant feeding; Leukemia International Consortium.

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References

1. Curtin SC, Minino AM, Anderson RN (2016) Declines in cancer death rates among children and adolescents in the United States, 1999–2014. NCHS Data Brief 2016 Sep;(257):1–8. https://pubmed.ncbi.nlm.nih.gov/27648773/
1. Pollack IF, Jakacki RI (2011) Childhood brain tumors: Epidemiology, current management and future directions. Nat Rev Neurol 7:495–506. https://doi.org/10.1038/nrneurol.2011.110 - DOI - PubMed
1. Udaka YT, Packer RJ (2018) Pediatric brain tumors. Neurol Clin 36:533–556. https://doi.org/10.1016/j.ncl.2018.04.009 - DOI - PubMed
1. Johnson KJ, Cullen J, Barnholtz-Sloan JS et al (2014) Childhood brain tumor epidemiology: A brain tumor epidemiology consortium review. Cancer Epidemiol Biomarkers Prevention Publ Am Assoc Cancer Res Cospons Am Soc Prevent Oncol 23:2716–2736. https://doi.org/10.1158/1055-9965.EPI-14-0207 - DOI
1. Adel Fahmideh M, Scheurer ME (2021) Pediatric brain tumors: Descriptive epidemiology, risk factors, and future directions. Cancer Epidemiol Biomarkers Prev 30:813–821. https://doi.org/10.1158/1055-9965.Epi-20-1443 - DOI - PubMed

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[1] Curtin SC, Minino AM, Anderson RN (2016) Declines in cancer death rates among children and adolescents in the United States, 1999–2014. NCHS Data Brief 2016 Sep;(257):1–8. https://pubmed.ncbi.nlm.nih.gov/27648773/

[2] Curtin SC, Minino AM, Anderson RN (2016) Declines in cancer death rates among children and adolescents in the United States, 1999–2014. NCHS Data Brief 2016 Sep;(257):1–8. https://pubmed.ncbi.nlm.nih.gov/27648773/

[3] Pollack IF, Jakacki RI (2011) Childhood brain tumors: Epidemiology, current management and future directions. Nat Rev Neurol 7:495–506. https://doi.org/10.1038/nrneurol.2011.110 - DOI - PubMed

[4] Pollack IF, Jakacki RI (2011) Childhood brain tumors: Epidemiology, current management and future directions. Nat Rev Neurol 7:495–506. https://doi.org/10.1038/nrneurol.2011.110 - DOI - PubMed

[5] Udaka YT, Packer RJ (2018) Pediatric brain tumors. Neurol Clin 36:533–556. https://doi.org/10.1016/j.ncl.2018.04.009 - DOI - PubMed

[6] Udaka YT, Packer RJ (2018) Pediatric brain tumors. Neurol Clin 36:533–556. https://doi.org/10.1016/j.ncl.2018.04.009 - DOI - PubMed

[7] Johnson KJ, Cullen J, Barnholtz-Sloan JS et al (2014) Childhood brain tumor epidemiology: A brain tumor epidemiology consortium review. Cancer Epidemiol Biomarkers Prevention Publ Am Assoc Cancer Res Cospons Am Soc Prevent Oncol 23:2716–2736. https://doi.org/10.1158/1055-9965.EPI-14-0207 - DOI

[8] Johnson KJ, Cullen J, Barnholtz-Sloan JS et al (2014) Childhood brain tumor epidemiology: A brain tumor epidemiology consortium review. Cancer Epidemiol Biomarkers Prevention Publ Am Assoc Cancer Res Cospons Am Soc Prevent Oncol 23:2716–2736. https://doi.org/10.1158/1055-9965.EPI-14-0207 - DOI

[9] Adel Fahmideh M, Scheurer ME (2021) Pediatric brain tumors: Descriptive epidemiology, risk factors, and future directions. Cancer Epidemiol Biomarkers Prev 30:813–821. https://doi.org/10.1158/1055-9965.Epi-20-1443 - DOI - PubMed

[10] Adel Fahmideh M, Scheurer ME (2021) Pediatric brain tumors: Descriptive epidemiology, risk factors, and future directions. Cancer Epidemiol Biomarkers Prev 30:813–821. https://doi.org/10.1158/1055-9965.Epi-20-1443 - DOI - PubMed

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Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium

Affiliations

Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium

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