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G Draper

Publications and source records attributed to G Draper.

17 recordsLinked to original sources
PubMed2002

Vitamin K and childhood cancer: analysis of individual patient data from six case-control studies.

To investigate the hypothesis that neonates who receive intramuscular vitamin K are at an increased risk of developing cancer, particularly leukaemia, a pooled analysis of individual patient data from six case-control studies conducted in Great Britain and Germany has been undertaken. Subjects comprised 2431 case children diagnosed with cancer before 15 years of age and 6338 control children. The retrospective assessment of whether or not an individual baby received vitamin K is not straightforward. In many cases no record was found in stored medical notes and two types of analysis were therefore conducted; in the first it was assumed that where no written record of vitamin K was found it had not been given, and in the second, where no written record of administration was found, information on hospital policy and perinatal morbidity was used to 'impute' whether or not vitamin K had been given. In the first analysis, no association was found between neonatal administration of intramuscular. vitamin K and childhood cancer: odds ratios adjusted for mode of delivery, admission to special care baby unit and low birth weight were 1.09 (95% confidence interval 0.92-1.28) for leukaemia and 1.05 (0.92-1.20) for other cancers. In the second analysis, the adjusted odds ratios increased to 1.21 (1.02-1.44) for leukaemia and 1.10 (0.95-1.26) for other cancers. This shift did not occur in all studies, and when data from the hypothesis generating Bristol study were excluded, the adjusted odds ratios for leukaemia became 1.06 (0.89-1.25) in the first analysis and 1.16 (0.97-1.39) when data on prophylaxis imputed from hospital policy and perinatal morbidity were used. We conclude that whilst the broad nature of the diagnostic groups and the poor quality of some of the vitamin K data mean that small effects cannot be entirely ruled out, our analysis provides no convincing evidence that intramuscular vitamin K is associated with childhood leukaemia.

Adolescent↗
PubMed2001

Case-control study of parental age, parity and socioeconomic level in relation to childhood cancers.

BACKGROUND: Parental ages, parity, and social class have been found in some studies to be associated with particular childhood cancers. Further investigation is warranted because of conflicting findings, biases, and the need to test specific hypotheses. METHODS: A case-control study was conducted (England and Wales, ages 0-14 years). Cases were ascertained from the National Registry of Childhood Tumours, and were born and diagnosed during 1968-1986. Birth record controls were matched 1:1 to cases on date of birth, sex and area. Information on variables of interest for both groups came from birth records. In all, 10 162 pairs could contribute to matched analyses. RESULTS: The odds ratio (OR) for retinoblastoma resulting from assumed new germ cell mutations among children of fathers aged > or =45 years was 3.0 (95% CI : 0.2-41.7). The risk of childhood acute lymphoblastic leukaemia (ALL) was significantly higher among children of older mothers and fathers, and significant trends with increasing mothers' (P < 0.001) and fathers' (P = 0.002) ages were found. There was a strong and significant protective effect of increasing parity on risk of childhood ALL. The adjusted OR for parity of > or =5 (versus 0) was 0.5 (95% CI : 0.3-0.8). Children in more deprived communities had a lower risk of ALL; but this was not significant after confounders were allowed for. There was no significant effect of social class based on parental occupation on ALL risk, but the numbers were small in those analyses. CONCLUSIONS: The associations between ALL and parental ages did not disappear when children with Down syndrome were excluded, suggesting an additional explanation beyond known links. The strong ALL association with parity may be because of an unknown environmental risk factor.

Adolescent↗
PubMed2000

Constraining the Late Mesozoic and Early Tertiary Tectonic Evolution of Southern Mexico: Structure and Deformation History of the Tierra Caliente Region.

We analyze the structure and assess the deformation history of the Tierra Caliente Metamorphic Complex (TCMC) of southern Mexico, where Laramide accretion of exotic terranes is in debate. The TCMC consists of a south-plunging antiform fault that is bounded on both its eastern and western flanks. Tierra Caliente Metamorphic Complex rocks show at least two phases of compressional deformation. The first and most prominent records a mean tectonic transport direction of 068 degrees. This phase is responsible for east-verging asymmetrical folding and thrusting of both metamorphic and superjacent sedimentary rocks. The second phase has an average transport direction of 232 degrees and is restricted to the western portion of the TCMC. A third phase is responsible for normal faulting. Lack of discernible deformation before Late Cretaceous time indicates that the main deformation phase is coincident with Laramide orogenesis elsewhere in the North American Cordillera. The stratigraphy, structure, and deformational history of the TCMC do not require accretion of exotic terranes. We explain the Mesozoic tectonostratigraphic evolution of the TCMC in terms of deposition and deformation of Mesozoic volcanic and sedimentary strata over the attenuated continental crust of the North American plate.

Journal Article↗
PubMed1998

Case-control studies of relation between childhood cancer and neonatal vitamin K administration.

OBJECTIVE: To investigate the possible link between neonatal administration of intramuscular vitamin K and childhood cancer. DESIGN: Matched case-control study. SETTING: Selected large maternity units in England and Wales. SUBJECTS: Children with cancer born 1968-85, diagnosed 1969-86; controls matched for sex, month of birth, and hospital of birth. MAIN EXPOSURE MEASURES: Neonatal administration of vitamin K, length of gestation, birth weight, type of delivery, admission to special care baby unit. RESULTS: After exclusion of cases with missing notes or unknown hospital vitamin K policy, 597 cases and matched controls were studied. Written records on the use of vitamin K were available for only about 40% of these, and to avoid possible bias from selective recording it was assumed that the stated hospital policy was followed. The association between cancer generally and intramuscular vitamin K was of borderline significance (odds ratio 1.44, P = 0.05); the association was strongest for leukaemia. There was, however, also an effect of abnormal delivery, which could explain some of the findings. CONCLUSIONS: The lack of consistency between the various studies so far published, including this one, and the low relative risks found in most of them suggest that the risk, if any, attributable to the use of vitamin K cannot be large, but the possibility that there is some risk cannot be excluded. A comparison of the predicted consequences of various policies shows that even a 10% increase would imply that prophylaxis using the commonly recommended 1 mg intramuscular dose should be restricted to babies at particularly high risk of vitamin K deficiency bleeding; alternatively a lower dose might be given to a larger proportion of those at risk.

Adolescent↗
PubMed1998

Ecological studies of relation between hospital policies on neonatal vitamin K administration and subsequent occurrence of childhood cancer.

OBJECTIVE: To investigate the possible link between neonatal administration of intramuscular vitamin K and childhood cancer. DESIGN: Ecological studies comparing incidence of cancer in groups of children classified by the vitamin K policy in operation at their hospital of birth. SETTING: Selected large maternity units in England, Scotland, and Wales. SUBJECTS: Children born in these units in varying periods between 1966 and 1991. MAIN OUTCOME MEASURES: Cancer occurring among these children before age 15 years identified by using the National Registry of Childhood Tumours. Ratios of observed to expected numbers of these conditions calculated for hospitals where the policy was to give all babies intramuscular vitamin K (non-selective) and where the policy was to use this treatment only for a selected minority of babies at increased risk of vitamin K deficiency bleeding (selective). RESULTS: These ratios were calculated for children born in 94 hospitals with varying vitamin K policies. A raised risk was occasionally associated with vitamin K, but the overall results were not significant, and there was no evidence to support the previously suggested doubling of the risk of childhood cancer. CONCLUSIONS: On the basis of the results reported here it is unlikely that there is a greatly increased risk of childhood cancer attributable to intramuscular vitamin K given to newborns, if indeed there is any.

Adolescent↗
PubMed1990

Granuloma inguinale of the cervix: a carcinoma look-alike.

Granuloma inguinale of the cervix presents as a proliferative growth and may mimic carcinoma. Over a 3 year period 18 patients with cervical granuloma inguinale were detected. Nine (50%) had a clinical diagnosis of carcinoma of the cervix on admission, five of whom had extensive investigations to exclude a malignancy. In communities where these two conditions are commonly seen it is recommended that granuloma inguinale be considered in young women with granulomatous lesions of the cervix, so as to avoid extensive and financially costly investigations, and unnecessary psychological stress for patients.

Adult↗
PubMed1989

[Incidence of cancer in children throughout the world].

The International Agency for Research on Cancer has coordinated a worldwide study of the incidence of cancer in childhood. Contributors from over 50 countries have provided data. This paper presents a summary of some of the major results. The incidence rates and relative frequencies of childhood cancers are described according to 12 diagnostic groups, defined mainly in terms of tumour morphology. Variations in the risk of those tumours between different countries and different ethnic groups provide important information on the relative importance of environmental and genetic factors in their aetiology.

Adolescent↗
PubMed1986

The risk of diagnostic radiation of the newborn.

The amount of diagnostic radiation received by neonates at a large maternity hospital in 1982 was calculated. The risk of inducing neoplasia is unlikely to be greater than one in 280,000 for each radiograph of chest or abdomen. Provided that the exposure of the newborn to radiation at the John Radcliffe Hospital is typical of the rest of the country, and excluding cardiac catheterisation and computed tomography, we estimate that at most one to two cases of malignant disease per year may be caused by diagnostic radiation in the United Kingdom. Genetic risks appear to be negligible. The risks of not using radiography in newborn patients outweigh the risks of inducing malignant or genetic disease.

Cardiac Catheterization↗
PubMedDate not supplied

Spatial variation of natural radiation and childhood leukaemia incidence in Great Britain.

This paper describes an analysis of the geographical variation of childhood leukaemia incidence in Great Britain over a 15 year period in relation to natural radiation (gamma and radon). Data at the level of the 459 district level local authorities in England, Wales and regional districts in Scotland are analysed in two complementary ways: first, by Poisson regressions with the inclusion of environmental covariates and a smooth spatial structure; secondly, by a hierarchical Bayesian model in which extra-Poisson variability is modelled explicitly in terms of spatial and non-spatial components. From this analysis, we deduce a strong indication that a main part of the variability is accounted for by a local neighbourhood 'clustering' structure. This structure is furthermore relatively stable over the 15 year period for the lymphocytic leukaemias which make up the majority of observed cases. We found no evidence of a positive association of childhood leukaemia incidence with outdoor or indoor gamma radiation levels. There is no consistent evidence of any association with radon levels. Indeed, in the Poisson regressions, a significant positive association was only observed for one 5-year period, a result which is not compatible with a stable environmental effect. Moreover, this positive association became clearly non-significant when over-dispersion relative to the Poisson distribution was taken into account.

Air Pollution, Indoor↗