© 1997 by Oxford University Press
Journal Of The National Cancer Institute, Vol 89, 238-244, Copyright © 1997 by Oxford University Press
BT Ji, XO Shu, MS Linet, W Zheng, S Wacholder, YT Gao, DM Ying and F Jin
BACKGROUND: Cigarette smoking has been shown to increase oxidative DNA
damage in human sperm cells. Assessment of the role of cigarette smoking in
the etiology of childhood cancer has focused primarily on the effect of
maternal smoking. Similar studies in relation to paternal smoking, however,
have been inconclusive. Few studies have evaluated the effect of paternal
smoking in the preconception period, and most of these could not
disentangle the effects of paternal from maternal smoking. PURPOSE: We
investigated the relationship of paternal smoking, particularly in the
preconception period, with childhood cancer among offspring of the
nonsmoking mothers. METHODS: We conducted a population- based, case-control
study in Shanghai, People's Republic of China, where the prevalence of
smoking is high among men but extremely low among women. The study included
642 childhood cancer case patients (<15 years of age) and their
individually matched control subjects. Information concerning parental
smoking, alcohol drinking, and other exposures of the index child was
obtained by direct interview of both parents of the study subjects. Odds
ratios (ORs), derived from conditional logistic regression models, were
used to measure the association between paternal smoking and risk of
childhood cancers. RESULTS AND CONCLUSIONS: Paternal preconception smoking
was related to a significantly elevated risk of childhood cancers,
particularly acute leukemia and lymphoma. The risks rose with increasing
pack-years of paternal preconception smoking for acute lymphocytic leukemia
(ALL) (P for trend = .01), lymphoma (P for trend = .07), and total cancer
(P for trend = .006). Compared with children whose fathers had never smoked
cigarettes, children whose fathers smoked more than five pack-years prior
to their conception had adjusted ORs of 3.8 (95% confidence interval [CI] =
1.3-12.3) for ALL, 4.5 (95% CI = 1.2-16.8) for lymphoma, 2.7 (95% CI =
0.8-9.9) for brain tumors, and 1.7 (95% CI = 1.2-2.5) for all cancers
combined. Statistically significant increased risks of cancer were
restricted to children under the age of 5 years at diagnosis or those whose
fathers had smoked during all of the 5 years prior to conception.
IMPLICATIONS: Further studies are needed to confirm the association of
paternal smoking with increased risk of cancer in offspring, to clarify the
pattern of risks in relation to the timing of cigarette smoking, and to
elucidate the biologic mechanism involved in predisposing the offspring to
cancer. For example, it may be that paternal smoking induces prezygotic
genetic damage that, in turn, acts as the predisposing factor.
ARTICLES
Paternal cigarette smoking and the risk of childhood cancer among offspring of nonsmoking mothers
Division of Epidemiology, Columbia University, School of Public Health, New York, USA.
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