Article | Published:

Childhood cancer research in Oxford I: the Oxford Survey of Childhood Cancers

British Journal of Cancervolume 119pages756762 (2018) | Download Citation



Significant research on the epidemiology and natural history of childhood cancer took place in the Universities of Oxford and Birmingham over sixty years. This is the first of three papers recording this work and describes the Oxford Survey of Childhood Cancers (OSCC), the largest case-control survey of childhood cancer ever undertaken.


The OSCC studied deaths in Britain from 1953 to 1981. Parents were interviewed and medical records from ante-natal clinics and treatment centres were followed up and abstracted. The survey left Oxford in 1975 and was run subsequently from Birmingham. The data are now being documented and archived to make them available for future study.


Many papers have resulted from this survey, most notably those relating to the association first reported therein between childhood cancer and ante-natal X-raying. This paper is a historical review of the OSCC.


In spite of many analyses of the study, this historic data set has continuing value because of the large number of examples of some very rare tumours and the detailed clinical and family history data that are available; and also because of the possibility of carrying out new analyses to investigate emerging research issues.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Additional information

Note: This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License.


  1. 1.

    Draper, G.J., Bithell, J.F., Bunch, K.J., Kendall, G.M., Murphy, M.F.G. & Stiller, C.A. Childhood cancer research in Oxford II: the Childhood Cancer Research Group. Br. J. Cancer (2018)

  2. 2.

    Kendall, G.M., Bithell, J.F., Bunch, K.J., Draper, G.J, Kroll, M.E., Murphy, M.F.G. et al. Childhood cancer research in Oxford III: the work of Childhood Cancer Research Group on ionising radiation. Br. J. Cancer (2018)

  3. 3.

    Stewart, A. & Kneale, G. W. Role of local infections in the recognition of haemopoietic neoplasms. Nature 223, 741–742 (1969).

  4. 4.

    Stewart, A., Webb, J. & Hewitt, D. A survey of childhood malignancies. Br. Med. J. 1, 1495–1508 (1958).

  5. 5.

    Greene, G. The woman who knew too much: Alice Stewart and the secrets of radiation. (University of Michigan, Michigan, 2000).

  6. 6.

    Wakeford R. The Woman Who Knew Too Much: Alice Stewart and the Secrets of Radiation. J. Radiol. Prot. 20 (2000)

  7. 7.

    Swerdlow, A. J. Cancer registration in England and Wales: Some aspects relevant to interpretation of the data. J. R. Stat. Soc. Ser. A. Stat. Soc. 149, 146–160 (1986).

  8. 8.

    Boyle, P. & Robertson, C. Statistical modeling of lung-cancer and laryngeal-cancer incidence in Scotland, 1960–1979. Am. J. Epidemiol. 125, 731–744 (1987).

  9. 9.

    Court Brown, W. M., Doll, R. & Bradford Hill, A. Incidence of leukaemia after exposure to diagnostic radiation in utero. Br. Med. J. 2, 1539–1545 (1960).

  10. 10.

    Doll, R. & Wakeford, R. Risk of childhood cancer from foetal irradiation. Br. J. Radiol. 70, 130–139 (1997).

  11. 11.

    Wakeford, R. Childhood leukaemia following medical diagnostic exposure to ionizing radiation in utero or after birth. Radiat. Prot. Dosim. 132, 166–174 (2008).

  12. 12.

    World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. 6th revision, 1948. (HMSO, London, 1949).

  13. 13.

    American Cancer Society. Manual of Tumor Nomenclature and Coding, 1968 ed. American Cancer Society, Inc: Washington, DC, 1968.

  14. 14.

    Steliarova-Foucher, E., Stiller, C., Lacour, B. & Kaatsch, P. International classification of childhood cancer, third edition. Cancer 103, 1457–1467 (2005).

  15. 15.

    General Register Office. Classification of Occupations 1960. (HMSO, London, 1960).

  16. 16.

    Stewart, A., Webb, J., Giles, D. & Hewitt, D. Malignant disease in childhood and diagnostic irradiation in utero. Lancet 268, 447–448 (1956).

  17. 17.

    Bithell, J. F. & Stewart, A. M. Pre-natal irradiation and childhood malignancy: a review of British data from the Oxford Survey. Br. J. Cancer 31, 271–287 (1975).

  18. 18.

    Bithell, J. F. & Stiller, C. A. A new calculation of the carcinogenic risk of obstetric X-raying. Stat. Med. 7, 857–864 (1988).

  19. 19.

    Breslow, N. E. & Day, N. E. Statistical Methods in Cancer Research Volume 1–The Analysis of Case-Control Studies IARC Scientific Publications No.32. (International Agency for Research on Cancer, Lyon, 1980).

  20. 20.

    Knox, E. G., Stewart, A. M., Kneale, G. W. & Gilman, E. A. Prenatal irradiation and childhood cancer. J. Soc. Radiol. Prot. 7, 3–15 (1987).

  21. 21.

    Muirhead, C. R. & Kneale, G. W. Prenatal irradiation and childhood cancer. J. Radiol. Prot. 9, 209–212 (1989).

  22. 22.

    Wakeford, R. & Little, M. P. Risk coefficients for childhood cancer after intrauterine irradiation: a review. Int. J. Radiat. Biol. 79, 293–309 (2003).

  23. 23.

    Gilman, E. A., Kneale, G. W., Knox, E. G. & Stewart, A. M. Pregnancy x-rays and childhood cancers: effects of exposure age and radiation dose. J. Radiol. Prot. 8, 3–8 (1988).

  24. 24.

    Mole, R. H. Childhood cancer after prenatal exposure to diagnostic x-ray examinations in Britain. Br. J. Cancer 62, 152–168 (1990).

  25. 25.

    Gilman, E. A., Stewart, A. M., Knox, E. G. & Kneale, G. W. Trends in obstetric radiography, 1939–81. J. Radiol. Prot. 9, 93 (1989).

  26. 26.

    Kinnier Wilson, L. M. & Waterhouse, J. A. H. Obstetric ultrasound and childhood malignancies. Lancet 324, 997–999 (1984).

  27. 27.

    MacMahon, B. Prenatal x-ray exposure and childhood cancer. J. Natl Cancer Inst. 28, 1173–1191 (1962).

  28. 28.

    Berrington de Gonzalez, A. et al. Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions. Br. J. Cancer 114, 388–394 (2016).

  29. 29.

    Wakeford, R. The risk of childhood leukaemia following exposure to ionising radiation-a review. J. Radiol. Prot. 33, 1–25 (2013).

  30. 30.

    Stewart, A. & Hewitt, D. Oxford survey of childhood cancers: progress report I. Mon. Bull. Minist. Health Public Health Lab. Serv. 22, 182–192 (1963).

  31. 31.

    Barber, R. & Spiers, P. Oxford survey of childhood cancers: progress report II. Mon. Bull. Minist. Health Public Health Lab. Serv. 23, 46–52 (1964).

  32. 32.

    Lashof, J. C. & Stewart, A. Oxford Survey of childhood cancers progress report III: Leukaemia and Down’s syndrome. Mon. Bull. Minist. Health Public Health Lab. Serv. 24, 136–143 (1965).

  33. 33.

    Hewitt, D., Sanders, B. & Stewart, A. Oxford Survey of Childhood Cancers: progress report IV. Reliability of data reported by case and control mothers. Mon. Bull. Minist. Health Public Health Lab. Serv. 25, 80–85 (1966).

  34. 34.

    Fedrick, J. & Alberman, E. D. Reported influenza in pregnancy and subsequent cancer in the child. Br. Med. J. 2, 485–488 (1972).

  35. 35.

    Bithell, J. F., Draper, G. J. & Gorbach, P. D. Association between malignant disease in children and maternal virus infections. Br. Med. J. 1, 706–708 (1973).

  36. 36.

    Blot, W. J., Draper, G. J., Kinlen, L. & Kinnier Wilson, L. M. Childhood cancer in relation to prenatal exposure to chickenpox. Br. J. Cancer 42, 342–344 (1980).

  37. 37.

    Kinnier-Wilson, L. M., Kneale, G. W. & Stewart, A. M. Childhood cancer and pregnancy drugs. Lancet 2, 314–315 (1981).

  38. 38.

    Sanders, B. M. & Draper, G. J. Childhood cancer and drugs in pregnancy. Br. Med. J. 1, 717–718 (1979).

  39. 39.

    Gilman, E. A., Kinnier Wilson, L. M., Kneale, G. W. & Waterhouse, J. A. Childhood cancers and their association with pregnancy drugs and illnesses. Paediatr. Perinat. Epidemiol. 3, 66–94 (1989).

  40. 40.

    Sorahan, T., Lancashire, R., Prior, P., Peck, I. & Stewart, A. Childhood cancer and parental use of alcohol and tobacco. Ann. Epidemiol. 5, 354–359 (1995).

  41. 41.

    Sorahan, T., Lancashire, R. J., Hultén, M. A., Peck, I. & Stewart, A. M. Childhood cancer and parental use of tobacco: deaths from 1953 to 1955. Br. J. Cancer 75, 134–138 (1997).

  42. 42.

    Sorahan, T. et al. Childhood cancer and parental use of tobacco: deaths from 1971 to 1976. Br. J. Cancer 76, 1525–1531 (1997).

  43. 43.

    Draper, G. J., Heaf, M. M. & Kinnier Wilson, L. M. Occurrence of childhood cancers among sibs and estimation of familial risks. J. Med. Genet. 14, 81–90 (1977).

  44. 44.

    Hewitt, D., Lashof, J. C. & Stewart, A. M. Childhood cancer in twins. Cancer 19, 157–161 (1966).

  45. 45.

    Knox, E. G., Stewart, A. M., Gilman, E. A. & Kneale, G. W. Background radiation and childhood cancers. J. Radiol. Prot. 8, 9–18 (1988).

  46. 46.

    Knox, E. G. & Gilman, E. A. Spatial clustering of childhood cancers in Great Britain. J. Epidemiol. Community Health 50, 313–319 (1996).

  47. 47.

    Knox, E. G. Roads, railways, and childhood cancers. J. Epidemiol. Community Health 60, 136–141 (2006).

  48. 48.

    Draper, G. J. et al. Cancer in the offspring of radiation workers: a record linkage study. Br. Med. J. 315, 1181–1188 (1997).

  49. 49.

    Kinlen, L. J., Clarke, K. & Balkwill, A. Paternal preconceptional radiation exposure in the nuclear industry and leukaemia and non-Hodgkin’s lymphoma in young people in Scotland. Br. Med. J. 306, 1153–1158 (1993).

  50. 50.

    Sorahan, T. et al. Cancer in the offspring of radiation workers: an investigation of employment timing and a reanalysis using updated dose information. Br. J. Cancer 89, 1215–1220 (2003).

Download references


The desire to preserve this data set is driven largely by its scientific value but also by an appreciation of how much dedicated work went into the data collection, coding and analysis, not only by staff in Oxford, Limpsfield and Birmingham but also by interviewers all over Britain. The authors wish to record for posterity their appreciation of the value of this work and of the many agencies who funded it. The archiving work has been made possible by a generous grant from Children with Cancer UK and we express our appreciation and gratitude for this support.

Author information


  1. Department of Statistics, University of Oxford, 24-29 St Giles’, Oxford, OX1 3LB, UK

    • JF Bithell
    •  & GJ Draper
  2. Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

    • T Sorahan
  3. National Cancer Registration and Analysis Service, Public Health England, 4150 Chancellor Court, Oxford, OX4 2GX, UK

    • CA Stiller


  1. Search for JF Bithell in:

  2. Search for GJ Draper in:

  3. Search for T Sorahan in:

  4. Search for CA Stiller in:

Competing interests

The authors declare no competing interests.

Ethics approval

Granted by NRES Committee South Central−Oxford B, refs 12/SC/0531 and 18/SC/0092. The subjects interviewed implicitly consented to be so.


This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0).

Corresponding author

Correspondence to JF Bithell.

Electronic supplementary material

About this article

Publication history





Issue Date


Further reading