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

Abstract

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.

Childhood Leukemia and Primary Prevention

“…Recently, our research group has suggested that the time is right to develop activities focused on primary prevention of childhood leukemia. 185,186 …”

“…While the CDC has been exploring opportunities for early life prevention of child and adult cancers, there are diverse opinions about whether there is an adequate evidence base for primary prevention of cancer. 185 In a summary of expert opinion on what evidence should be necessary to support taking action, suggestions range from animal studies and toxicologic profiles to high quality systematic reviews (see Text Box 2). 185 …”

“…185 In a summary of expert opinion on what evidence should be necessary to support taking action, suggestions range from animal studies and toxicologic profiles to high quality systematic reviews (see Text Box 2). 185 …”

Foreword: Cancer Prevention Can Start Early and Last a Lifetime

“…In a series of webinars held over 1 year, we engaged experts in discussions to help clarify our understanding of the scientific literature and its application for public health. The article by Holman et al 10 summarizes the themes that emerged from those discussions. Other articles in this special supplement were contributed by participants in the webinars, and they expand on specific topics.…”

Disparities in the Context of Opportunities for Cancer Prevention in Early Life

“…In this article, we highlight factors that were selected on the basis of several criteria. The factors we examined (1) occurred in early life (in the prenatal period through age 10); (2) were identified by a group of subject matter experts consulting with the Centers for Disease Control and Prevention (CDC) 2 ; and (3) had at least 1 meta-analysis that demonstrated an empirical association with cancer occurrence. Based on these criteria, we selected the following factors: adverse childhood experiences 3 ; maternal alcohol consumption in pregnancy 4 ; assisted reproductive technology (ART) 5, 6 ; childhood obesity 7, 8 ; high or low birth weight 9–11 ; exposure to radiation, 12, 13 benzene, 14, 15 pesticides, or insecticides 16–19 ; isolated cryptorchidism 10, 20 ; early onset of puberty 21–23 ; exposure to parental tobacco smoke in utero 24, 25 and in childhood 26 ; allergies, asthma, and atopy 27–29 ; and early exposure to infection and early day care.…”