title: Geographical and ecological analyses of childhood Wilms' tumours and soft-tissue sarcomas in North West England.
abstract: The aim of this paper was to study the geographical distribution of Wilms' tumours (WT) and soft-tissue sarcomas (STS) for 0-14 year olds included in a population-based registry from North West England during 1976-2000. Standardised morbidity ratios (SMRs) were calculated. Relationships between incidence rates and small area (ward) population density, ethnic composition, deprivation index and urban-rural status were examined using Poisson regression. There was a non-linear relationship between WT incidence and population density (P=0.008), with a higher incidence associated with wards with low deprivation scores (P=0.02); and which included a greater proportion of whites (P=0.01). For STS, a higher incidence was associated with wards with low deprivation scores (P=0.04); and which were 'more rural/less urban' (P=0.03). These results are consistent with a role for localised environmental exposures, in combination with lifestyle factors, in the aetiology of WT. For STS, there is some evidence for the involvement of environmental and/or lifestyle factors.
authors.affiliation: Cancer Research UK Paediatric and Familial Cancer Research Group, Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, UK. richard.mcnally@man.ac.uk
authors.forename: Richard J Q
authors.initials: RJ
authors.lastname: McNally
authors.forename: Robert D
authors.initials: RD
authors.lastname: Alston
authors.forename: Donal P
authors.initials: DP
authors.lastname: Cairns
authors.forename: Osborn B
authors.initials: OB
authors.lastname: Eden
authors.forename: Anna M
authors.initials: AM
authors.lastname: Kelsey
authors.forename: Jillian M
authors.initials: JM
authors.lastname: Birch
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016012:Poisson Distribution; D012044:Regression Analysis; D012111:Residence Characteristics; D012208:Rhabdomyosarcoma / Q000453:epidemiology; D012423:Rural Health; D012509:Sarcoma / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014504:Urban Health; D009396:Wilms Tumor / Q000453:epidemiology*