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Arthur Varner, Re: Trends in Reported Incidence of Primary Malignant Brain Tumors in Children in the United States, JNCI: Journal of the National Cancer Institute, Volume 91, Issue 11, 2 June 1999, Pages 973A–973, https://doi.org/10.1093/jnci/91.11.973a
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In the report by Smith et al. (1), the authors' conclusion is that the increasing incidence of brain tumors in children is best explained by a “jump model” with the optimum point of change being around 1985, the time of rapidly increasing availability of magnetic resonance imaging. The authors discount environmental factors, since the change seemed to occur rapidly. However, a rapid change in the environment of children did occur at this time. The switch to use of acetaminophen in children, as opposed to aspirin due to concerns with Reye's syndrome, led to the rapid decline in use of pediatric aspirin in the early 1980s (2). The anti-inflammatory effect of aspirin, as opposed to acetaminophen, may have been an unrecognized protective factor in the development of brain tumors, as has been demonstrated for other cancers (3). Did the authors consider this change in the environment of children in the United States before reaching their conclusion?
