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Cancers and immune related diseases associated with Down’s syndrome: a record linkage study
  1. M J Goldacre,
  2. C J Wotton,
  3. V Seagroatt,
  4. D Yeates
  1. Unit of Health-Care Epidemiology, Department of Health, University of Oxford, Oxford, UK
  1. Correspondence to:
    Professor Michael J Goldacre
    Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road, Oxford OX3 7LF, UK; michael.goldacredphpc.ox.ac.uk

Abstract

Objective: To determine the risk of cancers and selected immune related diseases in people with Down’s syndrome, relative to risk in other people.

Design: Cohort analysis of a linked dataset of abstracts of hospital and death records; results expressed as the ratios of rates of disease in people with and without Down’s syndrome.

Setting: The former Oxford health region, England, 1963–1999.

Subjects: Cohort of 1453 people with Down’s syndrome and cohort of 460 000 people with other conditions for comparison.

Main outcomes: As expected, the rate ratio for leukaemia was substantially elevated in people with Down’s syndrome: it was 19-fold higher (95% confidence intervals 10.4 to 31.5) than the rate in the comparison cohort. For other cancers combined, excluding leukaemia, the rate ratio was not significantly elevated (1.2; 0.6 to 2.2). The risk of testicular cancer was increased (12.0; 2.5 to 35.6), although this was based on only three cases in the cohort of subjects with Down’s syndrome. Significantly elevated risks were found for coeliac disease (4.7; 1.3 to 12.2), acquired hypothyroidism (9.4; 3.4, 20.5), other thyroid disorders, and type 1 diabetes mellitus (2.8; 1.0 to 6.1). A decreased risk was found for asthma (0.4; 0.2 to 0.6).

Conclusions: Our data add to the body of information on the risks of co-morbidity in people with Down’s syndrome. The finding on asthma needs to be confirmed or refuted by other studies.

  • 95% CI, 95% confidence intervals
  • NHS, National Health Service
  • ORLS, Oxford Record Linkage Study
  • asthma
  • autoimmune disease
  • cancer
  • Down’s syndrome
  • leukaemia

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Footnotes

  • The database was funded by the former Oxford Regional Health Authority. The Research and Development Directorate at the Department of Health funds the Unit of Health-Care Epidemiology to undertake research using the database.

  • Conflict of interest: none declared.