Relation Between Cancer and Congenital Defects: An Epidemiologic Evaluation

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Abstract
The extent to which childhood oncogenesis is accompanied by teratogenesis was evaluated. Among neoplasms with peaks in children under 5 years of age, leukemia was associated with certain inborn (or acquired) chromosomal abnormalities; glioma and medulloblastoma with certain phakomatoses; and Wilms' tumor, primary liver cancer, and adrenocortical neoplasia with congenital hemihypertrophy. Hemihypertrophy was, in turn, associated with two other forms of growth excess—hamartomas and congenital visceral cytomegaly. Neuroblastoma, unlike Wilms' tumor with which it shares a peak under 5 years of age and other characteristics suggestive of intrauterine origin, did not occur excessively with these growth excesses or any other congenital defects. Wilms' tumor was linked also with aniridia, independent of hemihypertrophy. Lack of a peak before 5 years of age did not signify lack of an association with congenital anomalies; there was an increased risk of lymphoma among persons with inherited immunologic disorders and of gonadoblastoma among persons with dysgenetic gonads. Among neoplasms not known to be related to congenital defects, Hodgkin's disease displayed an upturn in mortality at 11 years of age, which suggests a relationship to the involution of lymphatic tissue in children at 7 years, and the much higher risk of bone sarcoma in giant as compared with small breeds of dogs and in boys as compared with girls after adolescence suggests a relationship to rate of bone growth.