ArticleInternational journal of cancer2011
Birth order and risk of childhood cancer: a pooled analysis from five US States.
Article in International journal of cancer, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Pregnancy and Childhood Epigenetics Consortium (PACE) meta-analysis highlights potential relationships between birth order and neonatal blood DNA methylation.Communications biology · 2024Pooled it
- Cesarean section and risk of childhood leukemia: a systematic review and meta-analysis.World journal of pediatrics : WJP · 2020Pooled it
- Article
- Incidence patterns and temporal trends of childhood cancer in Germany, 1980-2019: Forty years of childhood cancer registration in Germany.International journal of cancer · 2026Article
- Application of an obstetric comorbidity index to predict childhood cancer risk: a population based case-control study in Denmark.British journal of cancer · 2025Article
- A first-born twin has a higher risk of acute leukemia in a population-based assessment of cancer in twins in California, and a lower than anticipated rate of twin concordance.Haematologica · 2025Article
- The relative contributions of genetic and non-genetic factors to the risk of neuroblastoma.Pediatric investigation · 2025Review
- Association between medically diagnosed postnatal infection and childhood cancers: A matched case-control study in Denmark, 1978 to 2016.International journal of cancer · 2023Article
- Exposure to nitrosatable drugs during pregnancy and childhood cancer: A matched case-control study in Denmark, 1996-2016.Pharmacoepidemiology and drug safety · 2023Article
- Outdoor artificial light at night, air pollution, and risk of childhood acute lymphoblastic leukemia in the California Linkage Study of Early-Onset Cancers.Scientific reports · 2023Article
- Cancer in children born after frozen-thawed embryo transfer: A cohort study.PLoS medicine · 2022Article
- Medication-Associated Phthalate Exposure and Childhood Cancer Incidence.Journal of the National Cancer Institute · 2022Article
- Birth characteristics and childhood leukemia in Switzerland: a register-based case-control study.Cancer causes & control : CCC · 2021Article
- Sibling rank and sibling number in relation to cardiovascular disease and mortality risk: a nationwide cohort study.BMJ open · 2021Article
- Birth Characteristics and Risk of Early-Onset Synovial Sarcoma.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- Risk of Acute Lymphoblastic Leukemia: Results of a Case-Control Study.Asian Pacific journal of cancer prevention : APJCP · 2019Article
- Is There Etiologic Heterogeneity between Subtypes of Childhood Acute Lymphoblastic Leukemia? A Review of Variation in Risk by Subtype.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2019Review
- The association between birth order and childhood leukemia may be modified by paternal age and birth weight. Pooled results from the International Childhood Cancer Cohort Consortium (I4C).International journal of cancer · 2019Article
- Intra-Familial Phenotypic Heterogeneity and Telomere Abnormality in von Hippel- Lindau Disease: Implications for Personalized Surveillance Plan and Pathogenesis of VHL-Associated Tumors.Frontiers in genetics · 2019Article
- The association between sex and most childhood cancers is not mediated by birthweight.Cancer epidemiology · 2018Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
The causes of childhood cancers are largely unknown. Birth order has been used as a proxy for prenatal and postnatal exposures, such as frequency of infections and in utero hormone exposures. We investigated the association between birth order and childhood cancers in a pooled case-control dataset. The subjects were drawn from population-based registries of cancers and births in California, Minnesota, New York, Texas and Washington. We included 17,672 cases <15 years of age who were diagnosed from 1980 to 2004 and 57,966 randomly selected controls born 1970-2004, excluding children with Down syndrome. We calculated odds ratios and 95% confidence intervals using logistic regression, adjusted for sex, birth year, maternal race, maternal age, multiple birth, gestational age and birth weight. Overall, we found an inverse relationship between childhood cancer risk and birth order. For children in the fourth or higher birth order category compared to first-born children, the adjusted OR was 0.87 (95% CI: 0.81, 0.93) for all cancers combined. When we examined risks by cancer type, a decreasing risk with increasing birth order was seen in the central nervous system tumors, neuroblastoma, bilateral retinoblastoma, Wilms tumor and rhabdomyosarcoma. We observed increased risks with increasing birth order for acute myeloid leukemia but a slight decrease in risk for acute lymphoid leukemia. These risk estimates were based on a very large sample size, which allowed us to examine rare cancer types with greater statistical power than in most previous studies, however the biologic mechanisms remain to be elucidated.
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