The mortality from leukaemia and other cancers among patients with down’s syndrome (Mongols) and among their parents

Abstract

Two thousand and thirty-three persons with Down's syndrome have been followed for periods ranging from 1 to 14 years. During this period seven persons died of leukaemia and seven died of other types of cancer. The death rate from leukaemia was about 18 times greater than that in England and Wales as a whole. The excess mortality occurred in both sexes, but was limited to children under 20 years of age. The death rate from other types of cancer was 2-6 times greater than the national rate. No type of cancer other than leukaemia was responsible for more than one death. It is possible that Down's syndrome predisposes to the developmen of many or all types of cancer, but this cannot be concluded from the present data alone. If there is any predisposition to the development of other types of cancer, it is clearly less marked than the predisposition to leukaemia. The parents of 1620 affected children have been followed from the time their child first attended The Hospital for Sick Children or were first notified to the local authority. The mortality among them from all causes was somewhat lower than would have been expected on the basis of the national death rates during the same period. Three deaths occurred from leukaemia against 1-2 expected and 57 deaths occurred from other types of cancer against 64 expected. The three deaths from leukaemia all occurred in fathers of affected children and another father has died from leukaemia since the end of the follow-up period. A second case of leukaemia and a second case of Down's syndrome occurred in one family; but no chromosome abnormalities were detected in the 5 other members of the family examined. We are most grateful to Dr. A. Elliott, Medical Officer of Health, Kent County Council, Dr. C. Bennett, Mental Health Department, Middlesex County Council, Dr. D. Magrath, Botley's Park Hospital, Dr. E. F. Hewlltt and Dr. E. W. Shepperd, Leavesden Hospital, Dr. G. S. Mansell, Leybourne Grange Colony, Dr. B. Matheson, South Ockenden Institution for Mental Defectives and Dr. W. H. K. Carpenter, Stoke Park Hospital for access to their records and for tracing patients or their relatives. We are grateful also to many members of the local authority staff, and to Miss Flora Callaby and Mrs. K. Evans for much of the detailed work involved in the follow-up, to Mr. H. Whitfield for computing the numbers of expected deaths on the London University Computer Unit's Mercury, and to the Medical Research Council's Clinical Effects of Radiation Research Unit, Edinburgh, for the chromosome studies. © 1962, The British Empire Cancer Campaign for Research. All rights reserved.