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Int J Cancer. 2020 Jan 19. doi: 10.1002/ijc.32875. [Epub ahead of print]

Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern-Eastern European population-based registries.

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Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
National Cancer Registry of Ukraine, National Cancer Institute & Taras Shevchenko National University of Kyiv, Kyiv, Ukraine.
OGYR, Hun Childhood Cancer Registry, Semmelweis University, Budapest, Hungary.
Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Childhood Cancer Sub-registry of Belarus, Minsk, Belarus.
Bulgarian National Cancer Registry, National Oncology Hospital, Sofia, Bulgaria.
Central Serbia Cancer Registry, Institute of Public Health of Serbia, Belgrade, Serbia.
Greater Poland Cancer Registry, Greater Poland Cancer Center, Poznan, Poland.
Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb, Croatia.
North Region Cancer Registry of Portugal (RORENO), Portuguese Oncology Institute of Porto, Porto, Portugal.
Cancer Registry of Slovenia, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Ankara, Turkey.
Registo Oncológico Regional do Centro (ROR-Centro), Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, Portugal.
Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus.
Department for Policy in Health Information and Research, Malta National Cancer Registry, Pieta, Malta.
Cluj Regional Cancer Registry, The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania.
Regional Cancer Registry, National Institute of Public Health, Iasi, Romania.
Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece.
Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI.
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.


Season of birth, a surrogate of seasonal variation of environmental exposures, has been associated with increased risk of several cancers. In the context of a Southern-Eastern Europe (SEE) consortium, we explored the potential association of birth seasonality with childhood (0-14 years) central nervous system (CNS) tumors. Primary CNS tumor cases (n = 6,014) were retrieved from 16 population-based SEE registries (1983-2015). Poisson regression and meta-analyses on birth season were performed in nine countries with available live birth data (n = 4,987). Subanalyses by birth month, age, gender and principal histology were also conducted. Children born during winter were at a slightly increased risk of developing a CNS tumor overall [incidence rate ratio (IRR): 1.06, 95% confidence intervals (CI): 0.99-1.14], and of embryonal histology specifically (IRR: 1.13, 95% CI: 1.01-1.27). The winter peak of embryonal tumors was higher among boys (IRR: 1.24, 95% CI: 1.05-1.46), especially during the first 4 years of life (IRR: 1.33, 95% CI: 1.03-1.71). In contrast, boys <5 years born during summer seemed to be at a lower risk of embryonal tumors (IRR: 0.73, 95% CI: 0.54-0.99). A clustering of astrocytomas was also found among girls (0-14 years) born during spring (IRR: 1.23, 95% CI: 1.03-1.46). Although the present exploratory results are by no means definitive, they provide some indications for age-, gender- and histology-related seasonal variations of CNS tumors. Expansion of registration and linkage with cytogenetic reports could refine if birth seasonality is causally associated with CNS tumors and shed light into the complex pathophysiology of this lethal disease.


central nervous system tumors; childhood; epigenetics; perinatal origin; population-based cancer registries; season of birth; seasonality


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