Sir,
Kroll et al (2011) report a significant relationship over an extended period (1976–2005) between childhood lymphoid leukaemia in Britain and a measure of affluence, incidence declining across five levels of increasing relative deprivation. Among several potential explanations for their finding, the authors incline towards the disturbing possibility of uneven investigation of ill children by British paediatricians, mentioning in support only that ‘health service inequalities undoubtedly persist in modern Britain’. Many factors are related to the deprivation including family size, therefore, adjusting for any known to influence childhood leukaemia risk is clearly relevant. In a notable study by the Childhood Cancer Research Group, Dockerty et al (2001) found that adjusting for maternal parity and maternal age removed statistical significance from the relationship with deprivation shown in their data. It would be of great interest if the effects of such adjustment on the relation with deprivation could be reported.
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References
Dockerty JD, Draper G, Vincent T, Rowan SD, Bunch KJ (2001) Case-control study of parental age, parity and socioeconomic level in relation to childhood cancers. Int J Epidemiol 30: 1428–1437
Kroll ME, Stiller CA, Murphy MF, Carpenter LM (2011) Childhood leukaemia and socioeconomic status in England and Wales 1976–2005: evidence of higher incidence in relatively affluent communities persists over time. Br J Cancer 105: 1783–1787
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Franceschi, S. Childhood leukaemia and socioeconomic status. Br J Cancer 107, 215 (2012). https://doi.org/10.1038/bjc.2012.170
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DOI: https://doi.org/10.1038/bjc.2012.170
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