Childhood cancer among twins and higher order multiples.

Publication Type:

Journal Article


Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, Volume 18, Issue 1, p.162-8 (2009)


2009, Adolescent, Case-Control Studies, Center-Authored Paper, Child, Child, Preschool, Clinical Research Division, Diseases in Twins, Epidemiology Core Facility, Female, Humans, Infant, Infant, Newborn, Kidney Neoplasms, Logistic Models, Male, Multiple Birth Offspring, Neoplasms, Public Health Sciences Division, Registries, Retinal Neoplasms, Retinoblastoma, Risk Factors, Shared Resources, United States, Wilms Tumor


Although several studies have found no change or a decreased risk of childhood cancer in twins, few have controlled for potential confounders such as birth weight. We examined the association of birth plurality and childhood cancer in pooled data from five U.S. states (California, Minnesota, New York, Texas, and Washington) using linked birth-cancer registry data. The data, excluding children with Down syndrome or who died before 28 days of life, included 17,672 cases diagnosed from 1980 to 2004 at ages 28 days to 14 years and 57,966 controls with all cases and controls born from 1970 to 2004. Analyses were restricted to children weighing <2 y of age there was a reduced risk of Wilms' tumor (OR, 0.27; 95% CI, 0.09-0.86) and neuroblastoma (OR, 0.46; 95% CI, 0.25-0.84) and an increased risk of fibrosarcoma (OR, 5.81; 95% CI, 1.53-22.11). Higher-order multiple birth (triplets or higher) was not associated with childhood cancer. Our analysis suggests that mechanisms other than birth weight and gestational age may influence the lower risk of Wilms' tumor and neuroblastoma in multiple births.