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 International Involvement

International Childhood Cancer Cohort Consortium

Around the world, several large infant/child prospective studies have been launched to examine environmental and biological determinants of common diseases. A workshop was held on September 28–29, 2005 in Rockville, MD, USA, to discuss the development of an international alliance of longitudinal studies of children to enable investigations of the role of various environmental exposures in the etiology of childhood cancer. This meeting was a result of deliberations at a prior workshop on May 20, 2004 to examine what, if any, role the National Children’s Study might have in studying childhood cancer. The 2004 workshop concluded that the rarity of virtually all forms of childhood cancer prevent even individual large cohort studies from examining the possible relationship of common exposures with common types of childhood cancer due to inadequate sample size.

The 2005 workshop was organized to discuss whether a consortium of multiple large children’s cohorts could join together to examine possible associations between exposures and childhood cancer. Representatives of 11 infant/child cohorts from four continents, representing approximately 700,000 children, agreed to establish an International Childhood Cancer Cohort Consortium (I4C) to evaluate the potential of these cohorts for this type of research. Several hypotheses in relation to childhood leukemia are proposed to test the feasibility and utility of the I4C. They include birth weight and associated determinants such as insulin-like growth factors 1 and 2; maternal folate intake from diet, folic acid supplementation, and polymorphisms in genes controlling the enzyme methylene tetrahydrofolate reductase; maternal prenatal and/or paternal preconception cigarette smoking, and specific genetic polymorphisms within CYP1A1, GSTM1, or RAS; and exposure of the mother to specific pesticides during pregnancy (with validation of questionnaire responses of the mother by measurement of the specific pesticides or metabolites in serum from biological specimens obtained from the mother during pregnancy). This cohort consortium may provide valuable insights on the causes of childhood leukemia, and may be helpful for studying other rare childhood diseases.

The Second International Childhood Cancer Cohort Consortium Workshop was held on August 29–30, 2007 at the World Health Organization in Copenhagen, Denmark. Thirty-five participants representing 10 countries discussed the progress of the I4C.

The third workshop of the International Childhood Cancer Cohort Consortium (I4C) was held in Lyon, France on November 16–17, 2009. The purpose of the workshop was to share progress across cohort studies and identify next steps. Nearly 80 individuals from over a dozen countries were represented at the meeting. The program featured preliminary results of data pooling from several of the international cohorts’ datasets. Core variables and the crosswalk of their values among the cohorts participating in the Data Pooling Project were described. New research hypotheses and methods to study environmental, genetic, epigenetic, and gene-environment interaction in relation to pediatric cancer were shared. The potential for examining postulated risk factors for other rare and/or serious disease outcomes using the cohort and case-control approach was also discussed.