Population mixing, socioeconomic status and incidence of childhood acute lymphoblastic leukaemia in England and Wales: analysis by census ward

C. A. Stiller, M. E. Kroll, Paul Joseph Boyle, Zhiqiang Feng

    Research output: Contribution to journalArticlepeer-review

    38 Citations (Scopus)

    Abstract

    In this population-based study of acute lymphoblastic leukaemia (ALL) diagnosed among children aged under 15 years in England and Wales during 1986-1995, we analysed incidence at census ward level in relation to a range of variables from the 1991 census, which could be relevant to theories of infectious aetiology. 'Population-mixing' measures, used as surrogates for quantity and diversity of infections entering the community, were calculated from census data on the origins and destinations of migrants in the year before the census. Incidence at ages 1-4 years tended independently to be higher in rural wards, to increase with the diversity of origin wards from which in-migrants had moved during the year before the census, and to be lower in the most deprived areas as categorised by the Carstairs index. This last association was much weaker when urban/rural status and in-migrants' diversity were allowed for. There was no evidence of association with population mixing or deprivation for ALL diagnosed at ages 0 or 5-14 years. The apparent specificity to the young childhood age group suggests that these associations are particularly marked for precursor B-cell ALL, with the disease more likely to occur when delayed exposure to infection leads to increased immunological stress, as predicted by Greaves. The association with diversity of incomers, especially in rural areas, is also consistent with the higher incidence of leukaemia predicted by Kinlen, where population mixing results in below average herd immunity to an infectious agent.

    Original languageEnglish
    Pages (from-to)1006-1011
    Number of pages6
    JournalBritish Journal of Cancer
    Volume98
    DOIs
    Publication statusPublished - 4 Mar 2008

    Keywords

    • leukaemia
    • child
    • population mixing
    • urbanisation
    • deprivation
    • population density
    • NON-HODGKINS-LYMPHOMA
    • INFECTIVE BASIS
    • RISK
    • CHILDREN
    • URBANIZATION
    • CANADA
    • SITES

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