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Paolo Boffetta,¹ Jean Trédaniel,² and Antonia Greco³

¹International Agency for Research on Cancer, Lyon, France
²Saint Louis Hospital, Paris, France; ³University of Lyon, Lyon, France

Abstract

We identified more than 30 studies on the association between exposure to maternal tobacco smoke during pregnancy and cancer in childhood. We combined their results in meta-analyses based on a random effects model. The results of the meta-analyses suggest a small increase in risk of all neoplasms [relative risk (RR) 1.10 ; 95% confidence interval (CI) , 1.03-1.19 ; based on 12 studies], but not of specific neoplasms such as leukemia (RR 1.05 ; CI, 0.82-1.34 ; 8 studies) and central nervous system tumors (RR 1.04 ; CI, 0.92-1.18 ; 12 studies) . Results for other specific neoplasms were sparse, but the available data did not suggest a strong association for any type of tumor. No clear evidence of dose response was present in the studies that addressed this issue. The results on exposure to maternal tobacco smoke before or after pregnancy are too sparse to allow a conclusion. The results on exposure to paternal tobacco smoke suggest an association with brain tumors (RR 1.22 ; CI, 1.05-1.40 ; based on 10 studies) and lymphomas (RR 2.08 ; CI, 1.08-3.98 ; 4 studies) . The data are too sparse for the other neoplasms, although the results of a few recent large studies are compatible with a weak carcinogenic effect of paternal smoke. For exposure from either maternal or paternal smoke, bias and confounding cannot yet be ruled out. Further studies are needed to confirm the hypothesis that parental tobacco smoke, from the father in particular, is a risk factor of childhood cancer. Results on the risk of lung cancer in adulthood and childhood passive smoking exposure are available from 11 studies: they do not provide evidence of an increased risk (summary RR 0.91 ; CI, 0.80-1.05) . Key words: childhood neoplasms, lung cancer, meta-analysis, parental smoke, passive smoke. Environ Health Perspect 108:73-82 (2000) . [Online 15 December 1999]

http://ehpnet1.niehs.nih.gov/docs/2000/108p73-82boffetta/ abstract.html

Address correspondence to P. Boffetta, IARC, 150 cours Albert-Thomas, 69008 Lyon, France. Telephone: 33 4 72738441. Fax: 33 4 72738342. E-mail: boffetta@iarc.fr

This paper originated at the World Health Organization International Consultation on Environmental Tobacco Smoke and Child Health (Geneva, 11-14 January 1999) . We thank J. Jinot, B. Zolty, and J. Samet for useful comments on previous versions of the manuscript.

Received 27 April 1999 ; accepted 4 August 1999.