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Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern-Eastern European population-based registries

Season of birth, a surrogate of seasonal variation of environmental exposures, has been associated with increased risk ofseveral cancers. In the context of a Southern-Eastern Europe (SEE) consortium, we explored the potential association of birthseasonality with childhood (0–14years) central nervous system (CNS) tumors. Primary CNS tumor cases (n=6, 014) wereretrieved from16population-based SEE registries (1983–2015). Poisson regression and meta-analyses on birth season wereperformed in nine countries with available live birth data (n=4, 987). Subanalyses by birth month, age, gender and principalhistology were also conducted. Children born during winter were at a slightly increased risk of developing a CNS tumor overall[incidence rate ratio (IRR):1.06, 95% confidence intervals (CI):0.99– 1.14], and of embryonal histology specifically (IRR:1.13, 95% CI:1.01–1.27). The winter peak of embryonal tumors was higher among boys (IRR:1.24, 95% CI:1.05–1.46), especiallyduring thefirst4years of life (IRR:1.33, 95% CI:1.03– 1.71). In contrast, boys <5years born during summer seemed to be at alower risk of embryonal tumors (IRR:0.73, 95% CI:0.54–0.99). A clustering of astrocytomas was also found among girls(0– 14years) born during spring (IRR:1.23, 95% CI:1.03– 1.46). Although the present exploratory results are by no meansdefinitive, they provide some indications for age-, gender- and histology- related seasonal variations of CNS tumors. Expansionof registration and linkage with cytogenetic reports could refine if birth seasonality is causally associated with CNS tumors andshed light into the complex pathophysiology of this lethal disease.

central nervous system tumors, childhood, season of birth, seasonality, perinatal origin, epigenetics, population-based cancer registries

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