The EpiChildCan project capitalizes on a network of international consortia in which the Epigenomics and Mechanisms Branch (EGM) has a lead or key role. These include the International Childhood Cancer Cohort Consortium (I4C), Project on Origins and Causes of Pediatric Cancers (PEDIAC), Childhood Cancer and Leukemia International Consortium (CLIC), Pregnancy And Childhood Epigenetics (PACE), and EXPOsOMICS. I4C provides a unique resource with the largest platform of prospective data and biospecimens (obtained before childhood cancer develops) from different cohorts across the globe (and for which IARC serves as the International Biospecimen Coordinating Centre).
One powerful tool that EGM invested in is neonatal blood spots, which are collected in many countries and can be linked to national cancer registries when available, hence yielding a large number of biospecimens obtained before childhood cancer develops. Accordingly, EGM has recently accessed neonatal blood spot data from the California Childhood Leukemia Study (USA), which is part of the retrospectively designed CLIC, and identified epigenetic precursors of childhood cancer that were comparable with those observed in neonatal blood from I4C (ongoing). EGM is expanding this approach to include neonatal blood spots linked to cancer registries in Australia, Brazil, France, Denmark, and Norway, as well as some low- and middle-income countries, and geographical representation of South America, Africa, and Asia, all of which are underrepresented in I4C and CLIC and are needed to increase the statistical power, ethnic diversity, and robustness of the findings.
These unique resources will be combined with cutting-edge methodologies for genome-wide profiling of epigenetic alterations and robust bioinformatics/biostatistics pipelines that have been established by EGM.
This study should improve our knowledge of the etiology of childhood cancer and identify both novel biomarkers and clues to causation, thus providing an evidence base for cancer prevention. This study also contributes to a larger international initiative aimed at characterizing the fetal exposome using -omics technologies (including metabolomics, infectomics, transcriptomics, genomics, and methylomics) profiled on surrogate (neonatal blood) and target cancer tissues in children. The ability to monitor exposure to cancer-promoting factors and to screen for early changes that suggest increased cancer risk will have an important impact on the design and follow-up of preventive measures, consistent with IARC’s global objective of reducing the cancer burden by enhancing prevention and early intervention. Research on childhood cancer was recognized as an IARC priority at the Scientific Council meeting in January 2019 and as a priority by the World Health Organization (WHO), which recently launched, in collaboration with St. Jude Children’s Research Network, the first Global Initiative for Childhood Cancer.