Journal Article

Variation in the Seasonal Diagnosis of Acute Lymphoblastic Leukemia: Evidence from Singapore, the United States, and Sweden

Fei Gao, Per Nordin, Ingela Krantz, Kee-Seng Chia and David Machin

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 8, pages 753-763
Published in print October 2005 | ISSN: 0002-9262
Published online August 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi272
Variation in the Seasonal Diagnosis of Acute Lymphoblastic Leukemia: Evidence from Singapore, the United States, and Sweden

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This study investigated, by summing data over successive years, the evidence for the seasonal diagnosis of acute lymphoblastic leukemia. To do so, the authors estimated the dates of peak diagnosis over a range of geographic locations including Singapore (1968–1999), Hawaii and mainland United States (1973–1999), and western Sweden (1977–1994) at latitudes of 1.16°N to 58.24°N. In contrast to other studies, the authors used case-by-case information on dates, gender, and age rather than grouped data for analysis. The seasonal pattern was estimated by fitting a von Mises distribution to the data from each location. No seasonal pattern was found in Singapore, which is close to the equator and does not have marked climatic changes. Likewise, seasonality was not demonstrated in Hawaii or mainland United States despite a 26.18° range of latitudes. In contrast, a significant peak (early January) was observed for western Sweden that appeared strongest for males (December 22, 95% confidence interval: November 16, January 16) and those less than age 20 years (January 14, 95% confidence interval: December 8, March 27). Thus, despite a wide geographic range of localities, there is little evidence of any seasonality in the diagnosis of acute lymphoblastic leukemia in most populations studied and no strong evidence of any influence of climate (as expressed by latitude).

Keywords: leukemia, lymphoblastic, acute; seasons; ALL, acute lymphoblastic leukemia; SEER, Surveillance, Epidemiology, and End Results

Journal Article.  5823 words.  Illustrated.

Subjects: Public Health and Epidemiology

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