ABSTRACT
Wilms' tumor is a rare malignant neoplasm of childhood with a wide range of world wide variability due to risk variability. Several maternal, paternal and environmental risk factors have been reported to be strongly, moderately and potentially linked to Wilms' tumor. A hospital based case control study was conducted in 2002 to assess risk factors for Wilms' tumor in Alexandria. A total of 77 recently diagnosed and pathologically confirmed Wilms' tumor cases were enrolled from the hospitals currently covered by Alexandria Cancer registry. A total of 176 control subjects were randomly selected from outpatient's clinics of the same hospitals. Control subjects were matched by age and, sex. All mothers were subjected to a pre designed specific questionnaires about socio- demographics, lifestyles, paternal jobs and history of exposure to specific drugs and environmental agents. Univariate and multivariate analysis were performed to calculate the odds ratios [OR]. Populations attributable risk percent [PAR%] was reported. Interactions between risk factors were assessed and reported as Rothman synergy index [SI]. Maternal use of hair dyes during pregnancy showed a high risk of developing Wilms' tumor with an OR of 1.6 for occasional and of 6.2 for frequent use. Both edema during pregnancy and/or hypertension almost double the risk of developing Wilms' tumor. Among the paternal risk factors, blue collar occupations for at least 6 months after the age of 18 years were also reported to increase the risk [OR=4.9, 95% CI,2.5-9.6]. Likewise household exposure to pesticides was reported to increase the risk up to 4 times. Interaction between maternal vaginal infection and paternal occupation were significantly synergetic [SI=1.2]. An increased strength of associations were reported across the categories of paternal smoking, frequency of maternal use of hair dyes and/or coffee intake. The highest PAR% was reported for antenatal maternal use of hair dyes and coffee consumption. Avoidance of maternal exposure to hair dyes, coffee intake and, vaginal infection during pregnancy could minimize the risk of giving birth to a child threatened with Wilms' tumor. Larger comprehensive studies are recommended