BMJ: Risk of cancer in individuals with birth defects

In 2017, birth defects and childhood cancer were the third and ninth causes of the burden of childhood diseases (excluding injuries and perinatal diseases), respectively.
in the Nordic countries, about 3 per cent of live births are born with severe birth defects.
birth defects, especially chromosomal abnormalities and, of course, non-chromosomal defects, are one of the most fatal risk factors for childhood cancer.
suggests that birth defects and childhood cancer may have a common cause - genetics, the environment or a combination of both.
For birth defects and childhood cancers, few identified risk factors exist, and identifying a link between specific birth defects and childhood cancers may facilitate further research into factors that influence disease development.
have been reported in children with congenital defects have different risks of cancer depending on the type of abnormality that occurs.
, for example, children with Down's syndrome have an increased risk of leukemia, and children with non-chromosomal defects appear to have an increased risk of cancer, which appears to be mainly caused by embryonic tumors.
have been observed in previous studies, and the risk gradient appears to increase with the number of birth defects.
have the highest risk of cancer in young children, but few studies have looked at the risk in childhood and beyond.
, the effects of birth defects on adult cancer risk are largely unknown.
the rarity of birth defects and childhood cancer makes it difficult to study their associations, and extensive research is needed to identify enough individuals with birth defects to accurately and steadily estimate cancer risk.
researchers conducted a nested case-control study to determine the association between birth defects and cancer, assess whether cancer risk changes with the number of birth defects, and determine whether these associations persist into adulthood.
a total of 62,295 cancer cases (0-46 years old) born between 1967 and 2014 and 724,542 frequency-matched control groups (country and year of birth matching).
major event was the relative risk of cancer associated with birth defects, which was estimated by the logic regression model to have a ratio of 99% confidence interval.
total number of cases of severe birth defects at birth was 3.5 per cent (2160/62295) and 2.2 per cent in the control group (15826/724 542).
people with severe birth defects had a 1.74 (99 percent confidence interval of 1.63 to 1.84) compared to those without birth defects.
For people without chromosomal birth defects, the advantage ratio of cancer is 1.54 (1.44 to 1.64);
many structural birth defects are associated with subsequent cancers in the same organ system or anatomical location, such as defects in the eye, nervous system and urinary organs.
for non-chromosomal and chromosomal abnormalities, the risk of cancer increases with the number of defects and decreases with age.
in adults (≥20 years: 1.21, 1.09 to 1.33), people with any non-chromosomal birth defect are more likely to develop cancer than in adolescents (15-1) 9 years old: 1.58, 1.31 to 1.90) and children (0-14 years: 2.03, 1.85 to 2.23).
overall cancer risk in adults with chromosomal abnormalities decreased significantly from 11.3 (9.35 to 13.8) in children to 1.50 (1.01 to 2.24).
in adults, bone dysplosomes (ratios 3.54, 1.54 to 8.15), neurological defects (1.76, 1.16 to 2.65), and chromosomal abnormalities (1.50, 1 .01 to 2.24), genital defects (1.43, 1.14 to 1.78) and congenital heart defects (1.28, 1.02 to 1.59) are associated with overall cancer risk.
study data show that in four Nordic countries, people with chromosomal and non-chromosomal birth defects have an increased risk of developing overall cancer as adults (for people under 46 years of age).
people with non-chromosomal birth defects are at increased risk of developing cancer in several different organ systems, while the main malignant tumors in people with chromosomal abnormalities are leukemia.
many structural birth defects are associated with advanced cancers in the same organ system or anatomical location, and the relative risk of cancer increases with the number of birth defects.
that although this association is usually stronger in children than in adults, their effects actually continue into adulthood.
For example, adults with two of the most common birth defects, congenital heart defects and genital defects, have an increased risk of cancer (≥20 years old) compared to people without severe birth defects.
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