title: Risk factors for central nervous system tumors in children: New findings from a case-control study.
abstract: BACKGROUND
  Central nervous system tumors (CNS) are the most frequent solid tumor in children. Causes of CNS tumors are mainly unknown and only 5% of the cases can be explained by genetic predisposition. We studied the effects of environmental exposure on the incidence of CNS tumors in children by subtype, according to exposure to industrial and/or urban environment, exposure to crops and according to socio-economic status of the child.
  
  
  METHODS
  We carried out a population-based case-control study of CNS tumors in Spain, covering 714 incident cases collected from the Spanish Registry of Childhood Tumors (period 1996-2011) and 4284 controls, individually matched by year of birth, sex, and autonomous region of residence. We built a covariate to approximate the exposure to industrial and/or urban environment and a covariate for the exposure to crops (GCI) using the coordinates of the home addresses of the children. We used the 2001 Census to obtain information about socio-economic status (SES). We fitted logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs).
  
  
  RESULTS
  The results for all CNS tumors showed an excess risk (OR = 1.37; 95%CI = 1.09-1.73) for SES, i.e., children living in the least deprived areas had 37% more risk of CNS tumor than children living in the most deprived areas. For GCI, an increase of 10% in crop surface in the 1-km buffer around the residence implied an increase of 22% in the OR (OR = 1.22; 95%CI = 1.15-1.29). Children living in the intersection of industrial and urban areas could have a greater risk of CNS tumors than children who live outside these areas (OR = 1.20; 95%CI = 0.82-1.77). Living in urban areas (OR = 0.90; 95%CI = 0.65-1.24) or industrial areas (OR = 0.96; 95%CI = 0.81-1.77) did not seem to increase the risk for all CNS tumors together. By subtype, Astrocytomas, Intracranial and intraspinal embryonal tumors, and other gliomas showed similar results.
  
  
  CONCLUSIONS
  Our results suggest that higher socioeconomic status and exposure to crops could increase the risk of CNS tumors in children.
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.|Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
authors.forename: Rebeca
authors.identifier: http://orcid.org/0000-0001-6154-9142
authors.initials: R
authors.lastname: Ramis
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: Ibon
authors.initials: I
authors.lastname: Tamayo-Uria
authors.affiliation: Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.|National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Gómez-Barroso
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.|Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: López-Abente
authors.affiliation: Rare Disease Research Institute (IIER), Carlos III Institute of Health, Madrid, Spain.|Consortium for Biomedical Research in Rare Diseases (CIBERER), Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Morales-Piga
authors.affiliation: Spanish Registry of Childhood Tumors (RETI-SEHOP), University of Valencia, Valencia, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Pardo Romaguera
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.|Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.|Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Pérez
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000009:adverse effects; D016022:Case-Control Studies; D016543:Central Nervous System Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010575:Pesticides / Q000633:toxicity; D012307:Risk Factors; D012923:Social Class; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000393:Air Pollutants; D010575:Pesticides