MedicalResearch.com Interview with:
Philip J. Lupo, PhD, MPH
Co-Director, Childhood Cancer Epidemiology and Prevention Program, Texas Children’s Cancer Center
Associate Professor, Department of Pediatrics
Section of Hematology-Oncology,
Member, Dan L. Duncan Comprehensive Cancer Center
Baylor College of Medicine
Adjunct Associate Professor, Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences
University of Texas School of Public Health
MedicalResearch.com: What is the background for this study?
Response: While cancer risk in children with certain chromosomal defects like Down syndrome is well established, much less is known for children with birth defects where there is no known genetic cause, sometimes called non-chromosomal defects. Non-chromosomal defects, as a group, affect more children, but one of the primary challenges of understanding risk among these children is that limited sample sizes make studying specific defects, like spina bifida, more difficult.
Because of that, we gathered data from birth, birth defect, and cancer registries across Texas, Arkansas, Michigan, and North Carolina to generate a birth cohort of more than 10 million children born between 1992 and 2013. We looked at diagnoses of cancer until 18 years of age to determine differences in cancer risk between those with and without birth defects.
MedicalResearch.com: What are the main findings?
Response: We found that, compared to children without any birth defect, children with chromosomal defects were almost 12 times more likely to develop cancer, while children with non-chromosomal defects were 2.5 times more likely to develop cancer. Additionally, children with more than one non-chromosomal defect had a corresponding increase in cancer risk. Cancer types that were more frequent in children with non-chromosomal defects included hepatoblastoma and neuroblastoma.
There were also important negative findings in this study. For example, they found bone tumors were not strongly associated with birth defects, and some cancers, such as acute lymphoblastic leukemia were associated with only a few categories of birth defects.
MedicalResearch.com: What should readers take away from your report?
Response: A key objective in this study was to identify children who are at an increased risk for cancer because subsets of these children may one day benefit from screening and better clinical management. While these findings identify specific, strong associations between birth defects and cancer, it is important to remember that the absolute risk of developing cancer remained small (less than 1%) because childhood cancer is a rare outcome.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: In the future, we hope to identify the specific genes behind these associations and systematically research what happens from the time of birth to the time of cancer onset to also understand if environmental factors may be contributing to cancer development in children with birth defects.
No disclosures to add.
Lupo PJ, Schraw JM, Desrosiers TA, et al. Association Between Birth Defects and Cancer Risk Among Children and Adolescents in a Population-Based Assessment of 10 Million Live Births. JAMA Oncol. Published online June 20, 2019. doi:10.1001/jamaoncol.2019.1215
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