Cancer mortality in cerebral palsy in California
Résumé
Exposure to lifestyle, occupational, and environmental risk factors for cancer are undoubtedly different in cerebral palsy (CP) than in the general population, and these differences and others may result in a specific pattern of cancer mortality in CP. Objective: To study the cancer mortality of CP in California. Study group: 40,482 CP cases (contributing 357,928 person-years) among 210,155 persons having received annual evaluations from the California Department of Developmental Services over the period 1988-2002 were followed. Methods: Mortality due to malignant and non-malignant neoplasms (ICD9 codes 140-239) in CP was compared with that in the Californian general population using age-standardized mortality ratios (SMRs). Results: An excess of overall cancer mortality (SMR 2.6, 95% CI 2.0-3.2) was found. Cancer mortality was elevated in CP for some sites, and others cancer deaths were underrepresented in CP. Deaths due to cancer of the esophagus (SMR = 5.40, 95% CI 3.09-8.77), colon (2.16, 1.35-3.27), liver (2.21, 1.06-4.06), breast (1.83, 1.24-2.62), and bladder (4.57, 2.09-8.68) were significantly overrepresented in CP, while deaths due to cancer of the trachea, bronchus and lung were underrepresented (0.22, 0.09-0.43). Conclusion: Cancer mortality in cerebral palsy has specific differences with the population at large, and these differences may illuminate important contributing behavioral, environmental, or health care factors.