Affiliation:
1. Department of Epidemiology and Biostatistics
2. Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
3. Pediatrics
4. Division of Research, Kaiser Permanente Northern California, Oakland, California
Abstract
OBJECTIVES
We aimed to reassess the relationship between phototherapy and cancer in an extended version of a previous cohort and to replicate a report from Quebec of increased cancer risk after phototherapy beginning at age 4 years.
METHODS
This cohort study included 139 100 children born at ≥35 weeks’ gestation from 1995 to 2017, followed through March 16, 2019, in Kaiser Permanente Northern California hospitals who had a qualifying bilirubin level from −3 mg/dL to +4.9 mg/dL from the American Academy of Pediatrics phototherapy threshold; an additional 40 780 children and 5 years of follow-up from our previous report. The exposure was inpatient phototherapy (yes or no), and the outcomes were various types of childhood cancer. We used Cox proportional hazard models, controlling for propensity-score quintiles, and allowed for time-dependent exposure effects to assess for the risk of cancer after a latent period.
RESULTS
Over a mean (SD) follow-up of 8.2 (5.7) years, the crude incidence of cancer per 100 000 person-years was 25.1 among those exposed to phototherapy and 19.2 among those not exposed (233 cases of cancer). After propensity adjustment, phototherapy was not associated with any cancer (hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 0.83–1.54), hematopoietic cancer (HR: 1.17, 95% CI: 0.74–1.83), or solid tumors (HR: 1.01, 95% CI: 0.65–1.58). We also found no association with cancer diagnoses at age ≥4 years.
CONCLUSIONS
We did not confirm previous, concerning associations between phototherapy and adjusted risk of any cancer, nonlymphocytic leukemia, or brain and/or central nervous systems tumors in later childhood.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology and Child Health
Cited by
5 articles.
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