Birth characteristics and risk of early-onset synovial sarcoma
Menée aux Etats-Unis à partir de données portant sur 244 patients atteints d'un sarcome synovial diagnostiqué entre 1988 et 2015, leurs frères et soeurs et sur 12 200 témoins, cette étude analyse l'association entre des caractéristiques de naissance (âge parental, âge gestationnel, poids à la naissance et ordre de naissance) et le risque de développer la maladie
Background: Synovial sarcoma is a rare cancer with peak incidence in the young adult period. Despite poor outcomes of this aggressive cancer, there is little epidemiologic research addressing its etiology. Methods: We collected birth characteristic data on synovial sarcoma cases born 1978-2015 and diagnosed 1988-2015 in California (n=244), and 12,200 controls frequency-matched on year of birth. We also constructed a dataset of cancer cases in siblings of sarcoma subjects to assess familial risk. Results: In multivariable logistic regression analyses, synovial sarcoma was more frequent in Hispanics compared to non-Hispanic whites [odds ratio (OR) = 1.48; 95% confidence interval (CI): 1.06-2.08]. Higher birthweight was a risk factor in Hispanics - each 500 g increase in birthweight was associated with a 22% increase in disease risk (OR = 1.22; 95% CI:1.00- 1.48). Also, a strong role for birth order was suggested, with highest risk for the first born (second child compared to first: OR = 0.61, 95% CI: 0.44-0.84; third or later compared to first: OR = 0.53, 95% CI: 0.36-0.77). Siblings of synovial sarcoma patients did not display elevated cancer incidence, suggesting the low likelihood that strong familial predisposition alleles play a significant role in this disease. Conclusions: The associations with birthweight and birth order suggest that nutritional, developmental, and environmental factors may play a role in the etiology of synovial sarcoma. Impact: Further epidemiologic research on synovial sarcoma should evaluate epigenetic and developmental mechanisms and the formation of the archetypical t(X;18) translocation that defines this disease.