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A record-based case–control study of natural background radiation and the incidence of childhood leukaemia and other cancers in Great Britain during 1980–2006

Abstract

We conducted a large record-based case–control study testing associations between childhood cancer and natural background radiation. Cases (27 447) born and diagnosed in Great Britain during 1980–2006 and matched cancer-free controls (36 793) were from the National Registry of Childhood Tumours. Radiation exposures were estimated for mother’s residence at the child’s birth from national databases, using the County District mean for gamma rays, and a predictive map based on domestic measurements grouped by geological boundaries for radon. There was 12% excess relative risk (ERR) (95% CI 3, 22; two-sided P=0.01) of childhood leukaemia per millisievert of cumulative red bone marrow dose from gamma radiation; the analogous association for radon was not significant, ERR 3% (95% CI −4, 11; P=0.35). Associations for other childhood cancers were not significant for either exposure. Excess risk was insensitive to adjustment for measures of socio-economic status. The statistically significant leukaemia risk reported in this reasonably powered study (power 50%) is consistent with high-dose rate predictions. Substantial bias is unlikely, and we cannot identify mechanisms by which confounding might plausibly account for the association, which we regard as likely to be causal. The study supports the extrapolation of high-dose rate risk models to protracted exposures at natural background exposure levels.

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Acknowledgements

We are grateful for the detailed and helpful comments of the two referees. This work was supported by the Department of Health for England and Wales, Scottish Government and CHILDREN with CANCER (UK), but these organisations had no role in study design, the collection, analysis, and interpretation of data, the writing of the article nor in the decision to submit it for publication. We thank the British Geological Survey for allowing the use of the HPA/BGS radon map and to Royal Mail and Ordnance Survey for making available ADDRESS-POINT data (Crown Copyright. All rights reserved). Colleagues at the Childhood Cancer Research Group undertook the geocoding of addresses and social class codings for occupations. We also thank Dr Gerald Draper and Mr Charles Stiller for advice and to Drs Ethel Gilbert, Colin Muirhead and Mark Pearce for commenting on a draft manuscript.

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Correspondence to G M Kendall.

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Dr Wakeford undertakes work as a paid consultant. All other authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Leukemia website

Supplementary information

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Kendall, G., Little, M., Wakeford, R. et al. A record-based case–control study of natural background radiation and the incidence of childhood leukaemia and other cancers in Great Britain during 1980–2006. Leukemia 27, 3–9 (2013). https://doi.org/10.1038/leu.2012.151

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Keywords

  • cancer
  • childhood
  • radiation
  • radon
  • gamma rays

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