Sociodemographic and Environmental Risk Factors for Childhood Leukemia and Solid Tumors: A 10-Year Hospital-Based Study

Abstract

Background: Childhood cancers, particularly leukemia and solid tumors, are leading causes of morbidity and mortality globally. Objectives: This study examines environmental and sociodemographic risk factors associated with these cancers in children under 18 years in Tehran, Iran. Methods: A hospital-based case-control study was conducted at Ali-Asghar Children’s Hospital from 2013 to 2023. The study included 114 children diagnosed with leukemia or solid tumors and 114 controls admitted for non-oncologic reasons. Data on environmental exposures, parental characteristics, and lifestyle factors were collected through medical records and structured interviews. Multinomial logistic regression was used to identify significant risk factors. Results: In the adjusted model, maternal age ≥ 35 years (AOR = 3.45, 95% CI: 1.30 - 9.09; reference: < 35 years) was associated with significantly higher odds of leukemia, while a higher maternal education level (> diploma) was a protective factor [AOR = 0.35, 95% CI: 0.15 - 0.80]. Low birth weight showed a strong but non-significant association with leukemia after adjustment [AOR = 3.18, 95% CI: 0.97 - 10.44]. For solid tumors, no factors reached statistical significance in the adjusted model, though point estimates suggested potential associations with maternal age ≥ 35 [AOR = 1.54, 95% CI: 0.37 - 6.68] and higher maternal education [AOR = 0.54, 95% CI: 0.18 - 1.63]. Conclusions: Maternal age and education are important independent risk factors for childhood leukemia. For solid tumors, no significant associations were identified, a finding that is likely limited by the small sample size. Prenatal environmental factors may also contribute, highlighting the need for targeted public health interventions focused on maternal health and education to reduce childhood cancer risk.