Prenatal environmental stressors and pediatric cancer - PROJECT SUMMARY/ABSTRACT Pediatric cancer is the leading cause of disease-related deaths in children. Its environmental origins are not well understood, but there is emerging evidence that points to the etiologic importance of several environmental exposures, such as air pollution and temperature. Although a few studies provide an intriguing first look at the association between environmental stressors and pediatric cancer, they have focused on only one dimension of the environment at a time, which may not provide a complete picture. Thus, there remains a critical research gap in understanding the full impact of environmental exposures on pediatric cancers, including novel exposures which have been underexplored like radon and wildfire smoke, for which there is a strong biological basis. The objective of this K99/R00 is to fill this research gap by providing robust estimates of the association between environmental exposures (individually and jointly) and pediatric cancers using several novel assessments in large state and nationwide datasets. The K99 phase is designed to augment the candidate’s prior research experience through coursework, mentorship, and directed readings, with specific training in: (1) pediatric cancer epidemiology and etiology, (2) atmospheric and radiation exposure sciences, (3) the latest advances in environmental mixtures analyses, and (4) big data analytics. The proposed project will draw on rich data sources on pediatric cancer cases and births by linking cancer and birth registries in New Jersey and Taiwan; and high- resolution environmental exposures including particulate matter ≤2.5 µm, ozone, nitrogen dioxide, ambient temperature, humidity, wildfire smoke, fungal spores, and radon. Aim 1 (K99 phase) will provide robust estimates of the association between prenatal and early life environmental exposures and the incidence of pediatric cancers by applying novel machine learning methods for environmental mixtures to a statewide cohort of live births in New Jersey. Aim 2 (R00 phase) will identify at-risk communities by assessing child and/or neighborhood- level factors that drive heterogeneity in the association between environmental stressors and pediatric cancers in New Jersey. Aim 3 (R00 phase) will create a Taiwan-based cohort by linking several nationwide datasets (i.e., Maternal and Child Health database, Birth Registry, Cancer Registry, and Registry for Beneficiaries of the National Health Insurance Program) and repeat the analyses in Aims 1 and 2 in a different context. Because Taiwan has a centralized health system database, we can also investigate potential effect modification by parental comorbidities and medication use. This K99/R00 award, with its proposed training and mentored research, will be critical to the candidate’s long-term goal to become a leading environmental epidemiologist who conducts rigorous large-scale research that contributes to the understanding of how the environment impacts children’s health.
