Environmental and Economic Strategies for Primary Prevention of Cancer in Early Life

Kriebel, David; Hoppin, Polly; Jacobs, Molly; Clapp, Richard

doi:10.1542/peds.2015-4268i

Cited by 6 publications

(6 citation statements)

References 41 publications

(44 reference statements)

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“…Without detracting from the importance of tobacco control, these findings suggest that progress in the primary prevention of cancer must include many strategies, not only those focused on healthy lifestyles but also reduction of carcinogen exposures wherever possible [17,18]. Such exposures include urban air pollution, particularly diesel exhaust, water pollution, pesticides in food, ionizing radiation and work-related chemicals [2].…”

Section: Discussionmentioning

confidence: 99%

Cancer rates not explained by smoking: a county-level analysis

et al. 2020

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Background: Debates over the importance of "lifestyle" versus "environment" contributions to cancer have been going on for over 40 years. While it is clear that cigarette smoking is the most significant cancer risk factor, the contributions of occupational and environmental carcinogens in air, water and food remain controversial. In practice, most cancer prevention messaging focuses on reducing cigarette smoking and changing other personal behaviors with little mention of environmental chemicals, despite widespread exposure to many known carcinogens. To inform decision-making on cancer prevention priorities, we evaluated the potential impact of smoking cessation on cancer rates. Methods: Using cancer incidence data from 612 counties in the SEER database, and county-level smoking prevalences, we investigated the impact of smoking cessation on incidence for 12 smoking-related cancer types, 2006-2016. A multilevel mixed-effects regression model quantified the association between county-level smoking prevalence and cancer incidence, adjusting for age, gender and variability over time and among counties. We simulated complete smoking cessation and estimated the effects on county-level cancer rates. Results: Regression models showed the expected strong association between smoking prevalence and cancer incidence. Simulating complete smoking cessation, the incidence of the 12 smoking-related cancer types fell by 39.8% (54.9% for airways cancers; 28.9% for non-airways cancers). And, while the actual rates of smoking-related cancers from 2006 to 2016 declined (annual percent change (APC) = − 0.8, 95% CI = − 1.0 to − 0.5%), under the scenario of smoking elimination, the trend in cancer incidence at these sites was not declining (APC = − 0.1, 95% CI = − 0.4 to + 0.1%). Not all counties were predicted to benefit equally from smoking elimination, and cancer rates would fall less than 10% in some counties. Conclusions: Smoking prevention has produced dramatic reductions in cancer in the US for 12 major types. However, we estimate that eliminating smoking completely would not affect about 60% of cancer cases of the 12 smoking-related types, leaving no improvement in the incidence trend from 2006 to 2016. We conclude that cancer prevention strategies should focus not only on lifestyle changes but also the likely contributions of the full range of risk factors, including environmental/occupational carcinogens.

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Section: Discussionmentioning

confidence: 99%

Cancer rates not explained by smoking: a county-level analysis

et al. 2020

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“…12,13 Children living in families with low socioeconomic conditions are more likely to be exposed to residential and outdoor pollutants as well as carcinogens at conception and during pregnancy. [14][15][16] According to the delayed infection hypothesis, which was originally formulated for childhood allergies, delayed exposure to common infections in early childhood may dysregulate the immune response and thus promote the transition to leukemic stem cells. 17,18 In addition, delays in diagnosis, low adherence to treatment, and inadequate resources to cope with the social, psychological, and economic burden of the disease may also contribute to a socioeconomic gap in survival.…”

Section: Introductionmentioning

confidence: 99%

“…Socioeconomic conditions might affect both cancer incidence and survival 12,13 . Children living in families with low socioeconomic conditions are more likely to be exposed to residential and outdoor pollutants as well as carcinogens at conception and during pregnancy 14‐16 . According to the delayed infection hypothesis, which was originally formulated for childhood allergies, delayed exposure to common infections in early childhood may dysregulate the immune response and thus promote the transition to leukemic stem cells 17,18 .…”

Section: Introductionmentioning

confidence: 99%

Parental education and cancer mortality in children, adolescents, and young adults: A case‐cohort study within the 2011 Italian census cohort

Alicandro

Bertuccio

Sebastiani

et al. 2020

Cancer

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BACKGROUND: Progress in the treatment of juvenile cancers has led to remarkable improvements in survival. However, not all families have the resources to cope with the burden that such diseases require. This study was aimed at evaluating the association between parental education and cancer mortality in children, adolescents, and young adults. METHODS: This was a case-cohort study based on 1889 cancer cases and 108,387 noncases sampled from the 2011 Italian census cohort of 10,964,837 individuals younger than 20 years and followed for 6 years. Mortality rate ratios (MRRs) were estimated for individuals with parents with high and intermediate levels of education (International Standard Classification of Education [ISCED] levels 5-8 and 3-4, respectively) in comparison with individuals with less educated parents (ISCED levels < 3) through multiple Poisson regression models. RESULTS: Over the follow-up, 684, 858, and 347 cancer cases with parents with the lowest, intermediate, and highest levels of education, respectively, were registered. In comparison with the individuals with parents with the lowest level of education, the MRR from all neoplasms was 0.92 (95% confidence interval [CI], 0.83-1.03) for those with parents with an intermediate level of education and 0.83 (95% CI, 0.72-0.95) for those with parents with the highest level of education. The MRRs from all neoplasms for individuals with parents with the highest level of education were 0.88 (95% CI, 0.69-1.11) among children, 0.87 (95% CI, 0.70-1.06) among adolescents, and 0.64 (95% CI, 0.50-0.83) among young adults. CONCLUSIONS: Children, adolescents, and young adults with highly educated parents have reduced mortality from cancer. This calls for further efforts to optimize treatment for children of less educated parents. Cancer 2020;126:4753-4760.

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“…For example, in Massachusetts, industry use of certain carcinogens declined after initiation of requirements that companies develop plans to reduce the use of toxic chemicals. 95, 96 Of note, the implementation of the plan was not required. This approach may be worth considering in other communities.…”

Section: Themes and Highlights From The Meetingsmentioning

confidence: 99%

Opportunities During Early Life for Cancer Prevention: Highlights From a Series of Virtual Meetings With Experts

Holman

Buchanan

2016

Pediatrics

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Compelling evidence suggests that early life exposures can affect lifetime cancer risk. In 2014, the Centers for Disease Control and Prevention’s (CDC’s) Cancer Prevention Across the Lifespan Workgroup hosted a series of virtual meetings with select experts to discuss the state of the evidence linking factors during the prenatal period and early childhood to subsequent risk of both pediatric and adult cancers. In this article, we present the results from a qualitative analysis of the meeting transcripts and summarize themes that emerged from our discussions with meeting participants. Themes included the state of the evidence linking early life factors to cancer risk, research gaps and challenges, the level of evidence needed to support taking public health action, and the challenges of communicating complex, and sometimes conflicting, scientific findings to the public. Opportunities for collaboration among public health agencies and other stakeholders were identified during these discussions. Potential next steps for the CDC and its partners included advancing and building upon epidemiology and surveillance work, developing and using evidence from multiple sources to inform decision-making, disseminating and communicating research findings in a clear and effective way, and expanding collaborations with grantees and other partners. As the science on early life factors and cancer risk continues to evolve, there are opportunities for collaboration to translate science into actionable public health practice.

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Environmental and Economic Strategies for Primary Prevention of Cancer in Early Life

Cited by 6 publications

References 41 publications

Cancer rates not explained by smoking: a county-level analysis

Cancer rates not explained by smoking: a county-level analysis

Parental education and cancer mortality in children, adolescents, and young adults: A case‐cohort study within the 2011 Italian census cohort

Opportunities During Early Life for Cancer Prevention: Highlights From a Series of Virtual Meetings With Experts

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