OBJECTIVES

McClarin, L 1,2, Wallace, A. 1, Holmes, L Jr.1,3

Nemours Office of Health Equity & Inclusion, 2200 Concord Pike Wilmington, DE, 198031, Epidemiology and Biostatistics Department, University of

Maryland-College Park, College Park, MD, 20742 2 University of Delaware, Biological Sciences Department, Newark, DE 197133

CONCLUSION

METHODS

• We performed a systematic literature review and

quantitative evidence synthesis (QES).

• We searched through MEDLINE via PubMed with relevant

search terms and only included studies that met the

following criteria:

• Studies published in English between the years 2004

and 2014

• Sample size larger than 20 human cases

• Measured the risk for pediatric cancer by assessing its

association to birth weight.

• All eligible studies were compared to assess the

association of birth weight on pediatric cancer risk for the

qualitative synthesis.

• For the QES, we extracted data from all eligible studies

based on four predetermined outcome categories.

• Heterogeneity test was performed indicating significant

variability between studies.

• Random effect method for the pooled summary estimate of

risk was used.

RESULTS

• Of the 980 studies identified through searching, 16 were

eligible for the qualitative synthesis and 7 studies were

eligible for the QES.

• A direct correlation between overall childhood cancer risk

and birth weight was observed, with children at lower birth

weight associated with lower risk for overall cancer

(<2500g, odds ratio, 0.91,99%CI,0.72-1.09) relative to

children at higher birth weight (≥2500g, Odds ratio, 1.31,

99%CI, 1.10-1.52).

RESULTS

• Cancer is the leading cause of disease-related mortality

among children.

• Birth weight has been shown to be associated with

pediatric cancer risk.

• There remains inconsistent findings as to the impact of low

versus high birth weight on pediatric cancer risk.

• The purpose of this study was to identify and synthesize

the findings of non-experimental studies which assessed

the association between birth weight and pediatric cancer

risk.

Birth Weight and Pediatric Cancer Carcinogenesis: A systematic review and quantitative

evidence synthesis

• Acute Lymphocytic Leukemia inversely corrected with birth

weight; <2500 g (18.% 95% CI -11.3-47.08); Birth weight ≥

2500 g (15.3% 95% CI 8.2-22.4)

• The observed data may be due to sparse data bias as few

children in the lowest birth weight strata may not survive

long enough to be diagnosed or may expire with cancer

without being diagnosed.

• In summary, neither direct nor inverse correlation between

prematurity and childhood cancer risk can be established

on the basis of this QES.

• With the observed significant heterogeneity among the

studies that constitute this QES, caution should be

exercised in the interpretation and application of these

data.

• These inconsistent findings are suggestive of the need for

prospective cohort designs in the assessment of the effect

of prematurity on childhood cancer development.