AN EXPLORATORY ANALYSIS OF RISK-FACTORS FOR CHILDHOOD MALIGNANT GERM-CELL TUMORS - REPORT FROM THE CHILDRENS CANCER GROUP (CANADA, UNITED-STATES)

A study of 105 patients with childhood malignant germ-cell tumors (MGC T) and 639 community controls was conducted utilizing a large epidemio logic database collected by the Childrens Cancer Group from 25 member institutions in the United States and Canada. This study was designed to explore the risk factors of this malignancy whose etiology remains poorly understood A structured, self-administered questionnaire was us ed to collect exposure information, and data were analyzed using an un conditional logistic regression model with adjustment for relevant con founders. Consistent with the findings from studies of adult MGCT, ges tational age was associated inversely with risk of MGCT, with a 70 to 75 percent reduction in risk for children born at term compared with t hose born pre-term. Parental, particularly maternal, self-reported exp osure to chemicals or solvents (odds ratio [OR] = 4.6, 95 percent conf idence interval [CI] = 1.9-11.3) and OR = 2.2, CI = 1.1-4.7 for matern al and paternal exposure, respectively) and plastic or resin fumes (OR = 12.0, CI = 1.9-75.0 [maternal] and OR = 2.5, CI = 1.0-6.5 [patemal] ) were associated with elevated risk of MGCT. New findings, not report ed previously, include a positive relationship of MGCT risk with birth weight and prolonged breastfeeding, an inverse association between MGC T risk and number of cigarettes smoked by the mother during pregnancy, and a 3.1-fold increased risk (CI = 1.5-6.6) associated with maternal urinary infections during index pregnancy. Although these findings ne ed confirmation from future studies, they suggest a potential influenc e of in utero exposure to maternal endogenous hormones, parental envir onmental exposures, and maternal diseases during pregnancy in the deve lopment of childhood MGCT.