Childhood cancer is a rare event in the general population, but may be somewhat more common in children born with birth defects. To better understand the link between cancer risk and congenital malformations, a collaborative team of scientists led by Baylor College of Medicine brought together the largest study to date to assess cancer risk in children with birth defects. The the study appears in JAMA Oncology.
"While the risk of cancer in children with some chromosomal defects such as Down syndrome is well established, much less is known for children with birth defects in which there is no known genetic cause, sometimes called non-chromosomal defects," he said Dr. Philip Lupo, associate professor of pediatrics – hematological oncology and member of the Complex of Overall Cancer Dan L Duncan of Baylor. "Non-chromosomal defects, as a group, affect more children, but one of the main challenges of understanding the risk among these children is that the limited size of the sample makes it difficult to study specific defects, such as spina bifida."
The research team collected data from birth records, birth defects and cancer in Texas, Arkansas, Michigan and North Carolina to generate a birth cohort of over 10 million children born between 1992 and 2013. Investigators examined cancer diagnoses up to 18 years of age to determine differences in cancer risk among those with and without birth defects.
The researchers found that children with chromosomal defects were almost 12 times more likely to develop cancer than children without birth defects, while children with non-chromosomal defects were 2.5 times more likely to develop cancer . Furthermore, children with more than one non-chromosomal defect have had a corresponding increase in cancer risk.
"Our two key objectives in this study were to identify children who are at the greatest risk of cancer, because the subsets of these children could one day benefit from screening and better clinical management and uncover clues as to why the cancer it occurs more frequently in this population, "he said Dr. Jeremy Schraw, post-doctoral associate in Baylor's section on epidemiology and population sciences. "These results consolidate our understanding of the risk of cancer in these children and show that we need further research in this area."
The types of cancer that were more frequent in children with non-chromosomal defects included hepatoblastoma and neuroblastoma.
While these findings identify specific and strong associations between birth defects and cancer, Schraw stated that it is important to remember that both birth defects and cancer are still rare events.
"This study is important as it is the largest and most informative of its kind. The large sample size allowed us to evaluate the risk of cancer in children with both chromosomal and non-chromosomal defects and revealed links between specific tumors and birth defects. These data can also help us to study and understand the differences in ongoing results for children with cancer, "he said. Dr. Sharon Plon, professor of pediatrics – oncology and molecular and human genetics and co-director of the Pediatric Cancer Program at the Center for Cancer Control of Dan L Duncan in Baylor.
"In the future, we hope to identify the specific genes behind these associations and to systematically research what happens from the moment of birth until the time of cancer's onset to understand even if environmental factors can contribute to the development of cancer," he said. said Wolf. "This study provides a new understanding of the biology and mechanisms that can lead to these complex outcomes in this population."
This study was supported by the Cancer Prevention and Research Institute of Texas, Alex's Lemonade Stand Foundation, the National Cancer Institute and the Arkansas Biosciences Institute. For a complete list of contributors, visit newspaper website.
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