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  • Epidemiology
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Vitamin K and childhood cancer: analysis of individual patient data from six case–control studies

British Journal of Cancer volume 86, pages 63–69 (2002)Cite this article

Abstract

To investigate the hypothesis that neonates who receive intramuscular vitamin K are at an increased risk of developing cancer, particularly leukaemia, a pooled analysis of individual patient data from six case–control studies conducted in Great Britain and Germany has been undertaken. Subjects comprised 2431 case children diagnosed with cancer before 15 years of age and 6338 control children. The retrospective assessment of whether or not an individual baby received vitamin K is not straightforward. In many cases no record was found in stored medical notes and two types of analysis were therefore conducted; in the first it was assumed that where no written record of vitamin K was found it had not been given, and in the second, where no written record of administration was found, information on hospital policy and perinatal morbidity was used to ‘impute’ whether or not vitamin K had been given. In the first analysis, no association was found between neonatal administration of intramuscular. vitamin K and childhood cancer: odds ratios adjusted for mode of delivery, admission to special care baby unit and low birth weight were 1.09 (95% confidence interval 0.92–1.28) for leukaemia and 1.05 (0.92–1.20) for other cancers. In the second analysis, the adjusted odds ratios increased to 1.21 (1.02–1.44) for leukaemia and 1.10 (0.95–1.26) for other cancers. This shift did not occur in all studies, and when data from the hypothesis generating Bristol study were excluded, the adjusted odds ratios for leukaemia became 1.06 (0.89–1.25) in the first analysis and 1.16 (0.97–1.39) when data on prophylaxis imputed from hospital policy and perinatal morbidity were used. We conclude that whilst the broad nature of the diagnostic groups and the poor quality of some of the vitamin K data mean that small effects cannot be entirely ruled out, our analysis provides no convincing evidence that intramuscular vitamin K is associated with childhood leukaemia.

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Acknowledgements

We would like to thank all those involved in the original studies, since without their work the present project would not have been possible. We are particularly indebted to researchers from the Bristol and Newcastle study regions for providing us with their data. In addition, we would like to thank Paul Appleby, Ed Juszczak, Uwe Kaletsch and Gillian Reeves for statistical advice, and Ray Cartwright for chairing the various group meetings. This research was funded by The Department of Health and The Leukaemia Research Fund. The views expressed in this publication are those of the authors and not necessarily the Department of Health and give no conflicts of interest.

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Authors and Affiliations

  1. Leukaemia Research Fund, Institute of Epidemiology, University of Leeds, 30 Hyde Terrace, Leeds, LS2 9LN, UK

    E Roman, N T Fear & P Ansell

  2. Cancer Epidemiology Unit, Imperial Cancer Research Fund, Radcliffe Infirmary, Oxford, OX2 6HE, UK

    D Bull

  3. Childhood Cancer Research Group, 57 Woodstock Road, Oxford, OX2 6HJ, UK

    G Draper & S J Passmore

  4. Information and Statistics Division, Trinity Park House, South Trinity Road, Edinburgh, EH5 3SQ, UK

    P McKinney

  5. Institute of Medical Statistics and Documentation, Mainz, Germany

    J Michaelis

  6. Institute for Social Paediatrics and Adolescent Medicine, Munchen, Germany

    R von Kries

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  1. E Roman
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Correspondence to E Roman.

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Roman, E., Fear, N., Ansell, P. et al. Vitamin K and childhood cancer: analysis of individual patient data from six case–control studies. Br J Cancer 86, 63–69 (2002). https://doi.org/10.1038/sj.bjc.6600007

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