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Prenatal and childhood immunization and the risk of childhood cancer
Risk factors for most childhood cancers are unknown. Currently, there are some protective factors acting via immunological pathways, like infections and particularly vaccinations, under discussion. However, findings of previous observational studies exploring the association between vaccination and childhood cancer are inconsistent.
In the PRECHIC (Prenatal and childhood immunization and the risk of childhood cancer) project, a cohort of newborns will be created to examine the Germany-wide impact of immunization on the risk of childhood cancer based on pseudonymized health insurance data from the German Pharmacoepidemiological Research Database (GePaRD with 20 Mio. insured persons). By linkage of mother-child pairs, not only immunizations of the children themselves but also immunizations of the mother during pregnancy are taken into account. This unique birth cohort will include more than 1 million children (17% of all German births) and will allow the observation of about 2300 cases of childhood cancer under the age of 18. The size of this birth cohort will facilitate detailed statistical analyses on different potential risk factors of childhood cancer and the consideration of numerous confounders (age, sex, socioeconomic status, vaccinations, inherited disorders, atopy, autoimmune diseases, infections, medications, medical examinations and therapies). Using this type of lifelong medical data from claims databases is highly valid. It can be analyzed in prevalence and incidence studies and potential recording errors by the study participants can be ruled out. In contrast to other countries, there is neither a compulsory vaccination program in Germany nor systematic registries for the administration of immunizations. Therefore initially, the vaccination prevalence will be investigated in this German birth cohort. Furthermore, the incidence of childhood cancer will be determined in this birth cohort and compared with available incidences from the German Childhood Cancer Registry. Subsequently, the association between immunization and the risk of childhood cancer will be analyzed throughout the lifespan.
The overall aim of this project is to identify immunological risk factors of specific childhood cancers, in particular individual vaccines. In the long term, a promising research approach arises out of this innovative study to examine further potential risk factors for childhood cancer using valid medical data from claims databases.