Major European study to investigate the role of environmental factors in childhood cancer

Childhood cancer: environmental exposures may play a greater role than previously thought

An increase in cancer diagnoses among adolescents and young adults suggests that environmental exposures may play a greater role than previously thought. Through rigorous research into external causes of childhood cancer, the research team aims to contribute to improved regulations that could help prevent some cases of childhood cancer in the future. 

For a long time, childhood cancer was thought to be largely a matter of bad luck: cell growth in the developing body goes awry. The assumption was that children had not lived long enough to be exposed to carcinogenic substances or other environmental factors, such as air pollution. 

In approximately one in ten children with cancer, an inherited DNA mutation contributes to the development of the disease. Since the 1990s, however, there has been an increase in the number of adolescents and young adults diagnosed with cancer. There is growing evidence that environmental factors may be responsible for part of this increase.

Investigating exposures before birth and during early life

To investigate this, researchers from nine European countries and Canada, will search for substances that may be carcinogenic in children and young adults. The researchers in this EU Horizon project will focus on exposures before birth and during early life in children and young adults with blood cancers or brain tumors. 

The study, From Populations To Cells And Back: Carcinogen Unmasking and Effect characterization in early-onset CANcers (CUE-CAN), is funded by the European Union and officially started June 1st.  

In the first phase, researchers will link epidemiological data on the occurrence of childhood cancer to data on exposure to a wide range of environmental factors. Scientists at Utrecht University will measure environmental substances – such as those originating from air pollution and pesticides – in blood samples from people who developed cancer at a young age.  

Researchers at the Norwegian Institute of Public Health (NIPH) will examine a relatively new form of exposure; substances found in vaping products. Health data from cohort studies such as the Norwegian Mother, Father and Child Cohort Study (MoBa) will prove useful. 

Dana Kristjansson, senior researcher at NIPH, explains,

“We’re looking at how vaping, which many young people use, might increase the risk of cancer. By combining health data from large cohorts like MoBa with detailed biological information, we hope to identify early markers of cancer susceptibility linked to vaping. It’s an integrative approach that will help clarify causal pathways and provide evidence to guide effective regulation and preventive strategies for cancer risk in children and young adults.”  

Nur Duale, senior researcher at NIPH, elaborates,

“Our work focuses on the chemicals found in vaping products and how they might harm cells in the lungs. Using lab models and studying biological changes, we want to understand how vaping might be connected to cancer at a basic biological level. This information is important to help inform regulators on potential risks of vaping products.”

Researchers hope to help prevent some cases of cancer

Substances identified during the first phase will then undergo extensive laboratory testing. By exposing human stem cells to these substances, researchers will investigate their biological effects. This will help determine whether the substances are truly carcinogenic – that is, whether they directly or indirectly contribute to the development of cancer. 

Substances found to have a direct or indirect cancer-causing effect will be studied in even greater detail. In this final phase, researchers will investigate whether the biological ‘fingerprint’ left behind in DNA by a carcinogenic substance can also be detected in tissue from healthy individuals.

If so, this would provide scientific evidence to support changes in policies related to environmental exposures. Ultimately, the researchers hope their findings will help prevent some cases of cancer. 

Professor Ruben van Boxtel, research group leader at the Princess Máxima Center for pediatric oncology and Oncode Institute, is leading the European CUECAN consortium. He says: 

"If, in this large-scale study, we can identify even a single preventable exposure that increases cancer risk, it could represent a major breakthrough. It would open up new opportunities for prevention. 

Individuals have no control over many of the environmental factors to which they are exposed. That is precisely why it is so important to identify these external causes. Only then can we prevent children from becoming ill because of them in the future."

This article is based on a news story originally published by the Princess Máxima Center, coordinator of the CUECAN consortium. The version published here has been adapted and supplemented with comments from researchers at the Norwegian Institute of Public Health.