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Update for I4C The Jerusalem Perinatal Study (JPS)

Update for I4C The Jerusalem Perinatal Study (JPS). Ora Paltiel School of Public Health and Dept of Hematology, Hadassah-Hebrew University, Jerusalem Israel. JPS. Research cohort established in 1964-76

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Update for I4C The Jerusalem Perinatal Study (JPS)

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  1. Update for I4C The Jerusalem Perinatal Study(JPS) Ora Paltiel School of Public Health and Dept of Hematology, Hadassah-Hebrew University, Jerusalem Israel

  2. JPS • Research cohort established in 1964-76 • All births to residents of West Jerusalem (92,408 children; 42,956 mothers; 39,620 fathers) • Active surveillance of infant mortality, birth defects and pregnancy complications

  3. J e r u s a l e m P e r i n a t a l S t u d y Age 17 Follow up cancer and mortality Harlap et al Paed Perinatal Epidemiology 2007; 21:256-73.

  4. To what extent do events during early human development or peripartum affect cancer incidence and mortality over a lifetime in the Israeli population? Pregnancy complications and outcomes *Preconception Life events after delivery cancer mortality time

  5. Potential contributions of JPS to cancer epidemiology All Israeli Residents have a Unique Id used for administrative and Health Purposes Universal Health Insurance High Quality Cancer Registry Rich perinatal information, and for subcohorts, rich maternal exposure information All childhood cancers already ascertained (N=172)

  6. JPS cancer types age <15

  7. The Risk of Cancer following Hospitalization for Infection in Infancy Objective: to evaluate the relation between hospital admission in the 1st year of life due to infectious disease and the risk of developing malignancy in childhood and early adulthood. Paltiel O et al. Cancer Epidemiol Biomarkers Prev 2006.

  8. Controversial relation between infections in infancy and subsequent cancer risk in children and young adults Childhood ALL, Hodgkin’s lymphoma Protective effect of early infectious exposures • Non–Hodgkin’s lymphoma • Possibly induced by infectious stimulation • 2. Immune defects and immunosuppression known risk factors.

  9. Univariate analysis > 3-fold increased risk of non–Hodgkin’s lymphoma after 1st year hospitalizations due to infectious diseases. Paltiel O et al. Cancer Epidemiol Biomarkers Prev 2006.

  10. The Risk of NHL Following Hospitalization for Infection in InfancyMultivariate Analysis *Adjusted for sex, birth weight and mother’s education Cancer Epidemiology Biomarkers and Prevention, 2006

  11. Non-Hodgkin Lymphoma Infection ↑ High mortality in the past Higher survival at present Speculated mechanism: Children with a minor immunologic defects

  12. Could this be one of the causes of the increase in NHL incidence observed worldwide? Age-adjusted Incidence of non-Hodgkin Lymphoma (NHL) US

  13. A study of 1125 NHL patients and 4499 controls 1964-2004 Results: Aggressive B cell Lymphoma – Comparing exposed and non-exposed Odds ratio: 2.11 (95%CI 1.11-4.0)

  14. Birth Order and Sibship size and the risk of lymphoma and leukemia in the Jerusalem Perinatal Study Cohort Grace Apiyo, Ora Paltiel

  15. Objective and methods • We aimed to investigate whether birth order and sibship size were related to lymphoma and leukemia in children and young adults in the Jerusalem Perinatal Study Cohort • Historical cohort study using reported birth order and imputed sibship size

  16. What is known • “Hygiene hypothesis” states that exposure to infection may be protective for childhood cancer, especially leukemia • Birth order and sibship size are considered proxies for childhood exposure to infection • Case control studies (NHL) of birth order are marred by non-response and selection bias

  17. MV Analysis of sibship size and Birth Order with Hematopoietic Tumors

  18. Birth order appears to be related more to childhood than to adult leukemia/lymphoma

  19. Interaction between gender and birth order for leukemia

  20. Comparison with Literature

  21. Summary:JPS Pregnancy complications and outcomes Preconception Life events after delivery cancer • Unique population • Unique opportunities • Unique findings, requiring confirmation in other populations • Potential for collaborations • Funding urgently sought for infrastructure to support these projects time

  22. Acknowledgments • JPS staff 1964-2007: Investigators, nurses and field workers and statisticians • Current team: Investigators: R. Calderon-Margalit, Y. Friedlander, O. Manor,V. Meiner, O.Paltiel • PhD candidates: M Avgil, H Hochner, E. Tiram, Y Wolff • Statisticians and Programmers: L. Deutsch, N. Sharon, R. Yanetz, Y Polanker • Research collaborators for Israel: U. Elchalal, D. Hochner, R. Pollock A. Samuelov, D. Varon, E . Hayam • Ministry of Interior • Ministry of Health- Cancer Registry • Ministry of Justice • Central Bureau of Statistics • Hadassah: Legal Bureau and IRB • Hebrew University Cosell Center • AND ALL PARTICIPANTS IN JPS STUDIES • Columbia University, New York • K.R. Kleinhaus, M.C.Perrin, A.I.Neugut, M.B.Terry, S.Harlap • New York University D.Malaspina • Yale University E.Funai • U. of Washington D. Siscovick, M. Williams • Funding: NIH; NARSAD

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