Risk factors for neuroblastoma at different stages of disease. Results from a population-based case-control study in Germany

Neuroblastoma is one of the childhood cancers included in two recent popula tion-based case-control studies in West Germany. Altogether, 183 children u nder the age of 8 with neuroblastoma diagnosed in 1988-1994 and 1785 contro l children sampled from population registration files participated. Informa tion on potential risk factors was obtained from the children's parents by a self-administered questionnaire and subsequent telephone interview. We ob served positive associations with the use of oral contraceptives or other s ex hormones during pregnancy (particularly with male offspring), a shorter gestational duration, lower birth weight, and maternal alcohol consumption during pregnancy. While the association with maternal use of oral contracep tives or sex hormones was strong for stages I/II (odds ratio 4.5, 95% confi dence interval 1.2-16.5), the associations with shorter gestation duration (odds ratio 3.4, 95% confidence interval 1.7-6.7) as well as maternal alcoh ol consumption during pregnancy (>7 glasses/week odds ratio 5.2, 95% confid ence interval 13-20.6) were observed only for the unfavourable advanced sta ges. It is notable that the associations in our study were either observed only for the advanced stages of disease or only for the less advanced stage s, but not for both subgroups. This adds to evidence for the hypothesis tha t neuroblastoma consists of at least two distinct disease entities, which d iffer in clinical stage at the time of diagnosis. (C) 2001 Elsevier Science Inc. All rights reserved.