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Biomedical subjects

G J Draper

Publications and source records attributed to G J Draper.

14 recordsLinked to original sources
PubMed1992

An overview of reports and current research concerning childhood leukaemia and cancer around nuclear installations in the UK.

Studies around UK nuclear installations suggest that it is possible that the incidence of leukaemia in young persons may be increased in the vicinity of such installations. However, the results of these studies are inconsistent and the cause or causes of the apparent increases are unknown; they may be at least in part attributable to chance variations in incidence, to selection factors, or to variations in completeness of recording. The cluster in Seascale, the village closest to the Sellafield reprocessing plant, may be the result of germ cell mutations in the fathers of the affected children.

Adolescent↗
PubMed1992

Patterns of risk of hereditary retinoblastoma and applications to genetic counselling.

A registry including information about nearly 1,600 cases of retinoblastoma diagnosed in Britain has been created at the Childhood Cancer Research Group. Cases have been classified as 'old germ cell mutation', 'new germ cell mutation' or 'sporadic non-hereditary'. For a population-based group of 918 cases diagnosed between 1962 and 1985 we have calculated the proportions of unilateral/bilateral and hereditary/non-hereditary cases. Bilateral cases represent 40% of the total number over this period; the proportion known to be hereditary is 44%, a higher proportion than has been reported elsewhere. By following up selected groups of cases, an estimate has been made of the proportions of siblings of retinoblastoma patients and offspring of survivors from retinoblastoma who are themselves affected with the disease. Where there is no previous family history, the risk for siblings of retinoblastoma patients of developing the disease is approximately 2% if the disease in the affected child is bilateral and 1% if it is unilateral, assuming that there are no other siblings; if there are unaffected siblings the risks for subsequent children are lower. Children of patients with hereditary retinoblastoma have a one in two chance of carrying the germ cell mutation and for those who are carriers the probability of developing retinoblastoma is very close to the accepted figure of 90% if the parents have bilateral retinoblastoma but probably less if they have the unilateral form. For children of patients not known to be carriers, the probability of developing retinoblastoma is estimated to be about 1%, considerably lower than the previously accepted figure of about 5%. Retinoblastoma kindreds consist mainly of bilateral cases but there is evidence that some kindreds have a high proportion of unilateral cases. The ways in which these findings may be used in conjunction with modern techniques of molecular biology for prenatal and postnatal genetic counselling are discussed.

Child↗
PubMed1990

The inter-regional epidemiological study of childhood cancer (IRESCC): case-control study of children with central nervous system tumours.

Tumours of the central nervous system comprise 23% of all childhood cancers and form the most common group of solid malignancies. Little is know about their aetiology. The present report concerns the results of a case-control study of 78 incident cases of central nervous system tumours in children. No case-control differences were detected for the following: pre-natal diagnostic X-rays, general anaesthetics during pregnancy, pregnancy infections, pregnancy drugs (including sedatives, tranquillizers and anti-convulsants), alcohol consumption in pregnancy, child's birthweight, breast-feeding, childhood illnesses, previous medication in the child. A significant excess of case mothers had suffered from diseases of the nervous system (RR 2.6). There was a deficit of children who had been immunised among the case children which approached significance, and an excess of congenital abnormalities among cases which also approached significance. There was a small excess of neoplastic disease among case parents. The results of this study suggest that in our patients genetic rather than environmental factors are more important, but the small numbers included in the present study meant that no definite conclusions could be reached.

Abnormalities, Multiple↗
PubMed1989

General overview of studies of multigeneration carcinogenesis in man, particularly in relation to exposure to chemicals.

This overview is concerned mainly with possible effects on the offspring of individuals exposed preconceptually to therapeutic drugs and radiotherapy. The studies reported so far give no evidence for transgenerational carcinogenesis by these agents; however, the length of follow-up of the offspring has often been short and the numbers of offspring studied too small to detect even important risks. Similarly, there is no evidence of transgenerational carcinogenesis in other groups exposed to potential mutagens. (Transgenerational effects of radiation other than radiotherapy, and transplacental effects, are discussed by other contributors.) Suggestions are given for groups which might be included in cohort studies, and estimates made of the numbers required for such studies. Any such study should include other indicators of genotoxic damage as well as cancer; this is likely to increase the scientific interest and value of the study and to make it more relevant to wider concerns about environmental mutagens.

Environmental Exposure↗
PubMed1985

Endodermal sinus tumor and embryonal carcinoma of the ovary in children.

The clinicopathological features of 26 pure endodermal sinus tumors (EST) and for embryonal carcinomas of the ovary occurring in children under age 15 years in Britain over the period 1962-1978 are described. Endodermal sinus tumor has shown a significant increase (P less than 0.001) over the 17-year period considered. Compared to controls, EST and embryonal carcinoma have not shown an association with the use of hormones or tranquilizers during pregnancy, with radiological investigations, or with infections in pregnancy though the numbers of cases studied were very small. The histological and immunohistological features of EST and embryonal carcinoma in children do not differ substantially from the descriptions of these tumors in adolescents and adults. Using the FIGO staging classification 23% were Stage I tumors; 3% were Stage II; 70% were Stage III; and 3% were Stage IV neoplasms. The 5-year actuarial survival rate was 39% among 26 cases of EST and 1 of the 4 cases of embryonal carcinoma also survived for 5 years. Clinical stage at diagnosis was the only indicator of prognosis, but the introduction of polychemotherapy (vincristine, actinomycin-D, cyclophosphamide/cis-platinum, vincristine, bleomycin) resulted in long-term survival in 7 of 7 cases of EST (2 Stage I and 5 Stage III) and 1 of 2 cases of embryonal carcinoma (Stage III). Radiotherapy appears to have little role to play in the treatment of pure EST or embryonal carcinoma.

Actuarial Analysis↗
PubMed1979

Childhood cancer and drugs in pregnancy.

A study was carried out on 11 169 matched case-control pairs of children aged up to 15 years included in the Oxford Survey of Childhood Cancers to see whether an association exists between cancer in children and drugs given to their mothers during pregnancy. The mothers of children who developed cancer reported about 25% more illnesses during pregnancy than mothers of healthy control children. Two specific illnesses, pulmonary tuberculosis and epilepsy, were investigated. For these there was a higher than average case-control excess of reports and there had been a suggestion that the drugs used in treatment, isoniazid and phenytoin, might be carcinogenic. The results of this investigation provide no real evidence for any association between the drugs taken by the mothers during pregnancy and subsequent cancer in the child.

Adolescent↗
PubMed1977

Occurrence of childhood cancers among sibs and estimation of familial risks.

An analysis which includes the majority of the cases of childhood cancer occurring in Britain over a period of about 20 years suggests that there is a small familial element in the aetiology of these diseases; aggregations within sibships were observed more frequently than would be expected by chance. Possible explanations of these findings are considered. Some, perhaps many, of the cases within such sibships may be due to associations between malignant disease and various genetically determined conditions at a suclinical level or in the heterozygous state. Alternatively, the observed familial aggregations may be attributable to the fact that sibs share a common environment. Childhood cancer in twins is discussed and findings compared with those from the United States. Attention is drawn to a number of interesting combinations of tumours in sibs, particularly brain tumours and bone cancers. The implications of the findings for genetic counselling are discussed; it is emphasized that, though there appears to be an increased risk that sibs of children with malignant disease will also be affected by such diseases, this amounts overall only to a doubling of the general population risk. Whether or not the explanation is a genetic one, the actual magnitude of the risk for such sibs is only about 1 in 300.

Adrenal Gland Neoplasms↗
PubMed1975

Retinoblastoma: a study of natural history and prognosis of 268 cases.

The natural history and prognosis of retinoblastoma were analysed using data relating to the 268 cases registered during 1962-8 in England, Scotland, and Wales. The children were followed up for a minimum of four years; the proportion surviving for four years was 86%. The most important factors affecting survival rate were the stage of the tumour at diagnosis and the hospital of treatment. Of children surviving for three years after treatment only three died during the subsequent period of follow-up, which varied from one to seven years. Among children with retinoblastoma treated between 1949 and 1968 nine died between seven and 13 years later of other cancers: seven from osteosarcomas, one from angiosarcoma, and one from fibrosarcoma.

Age Factors↗
PubMed1975

Letter.

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Neoplasms, Radiation-Induced↗