Childhood brain tumors are the most common pediatric solid tumor and include several histological subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors.

https://cebp.aacrjournals.org/content/cebp/23/12/2716.full.pdf

Childhood brain tumor epidemiology: a brain tumor epidemiology consortium review.

Tumors of the Kidney, Renal Pelvis, and Ureter

Water pollution is the presence of chemical, physical, or biological components or factors producing a condition of impairment of a given water body with respect to some beneficial use. The level of contamination necessary to render a water body impaired is highly dependent on the type of water body, its location, and the types of beneficial uses it supports. A water deemed unfit for drinking by humans may be suitable for other uses, such as habitat, irrigation, or recreation. Although certain natural events can cause water pollution, we will focus herein on the anthropogenic sources of pollution, that is, pollution arising from human activities.

Water Contamination and Pollution

Maternal exposure to dietary factors during pregnancy can influence embryonic development and may modulate the phenotype of offspring through epigenetic programming. Folate is critical for nucleotide synthesis, and preconceptional intake of dietary folic acid (FA) is credited with reduced incidences of neural tube defects in infants. While fortification of grains with FA resulted in a positive public-health outcome, concern has been raised for the need for further investigation of unintended consequences and potential health hazards arising from excessive FA intakes, especially following reports that FA may exert epigenetic effects. The objective of this article is to discuss the role of FA in human health and to review the benefits, concerns and epigenetic effects of maternal FA on the basis of recent findings that are important to design future studies.

/pdf/folic-acid-supplementation-in-pregnancy-and-implications-in-2ebw5agflc.pdf

Folic acid supplementation in pregnancy and implications in health and disease

https://stacks.cdc.gov/view/cdc/39084/cdc_39084_DS1.pdf

Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S.

Following the introduction of mandatory Canadian folic acid flour fortification in mid-1997, the incidence of selected childhood cancers that declined in Ontario prior to and subsequent to this public policy initiative was examined. A population-based cohort study of all incident cases of childhood malignancy in Ontario between the years 1985 and 2006 was conducted. Participants were identified from a database provided by the Pediatric Oncology Group of Ontario and included children 0 to 4 years of age and 5 to 9 years of age who were diagnosed with cancer. Among children aged 0 to 4 years, the incidence rate of Wilms' tumor declined from 1.94 to 1.43 per 100,000 (incidence rate ratio 0.74, 95% confidence interval, 0.57-0.95). No significant change was seen in the prefortification vs postfortification time periods for acute lymphoblastic leukemia, brain cancers, or embryonal cancers among the 0- to 4-year or 5- to 9-year age groups. There was an approximately 30% reduction in risk of Wilms' tumor following introduction of the initiative. This corroborates a recent case-control study from Germany. These data may also provide some reassurance that universal flour fortification does not heighten the risk of pediatric cancer.

Pediatric cancer rates after universal folic acid flour fortification in Ontario.

QUESTION It seems to me that cancer is occurring or being diagnosed more frequently among young women who are or might become pregnant. In the past year, I have seen several such women in my practice and I have had difficulty finding appropriate information in order to counsel them. Is there somewhere I can go for information about cancer during pregnancy so that I can better educate and inform these patients? ANSWER The Motherisk Program at the Hospital for Sick Children supports an on-line Cancer in Pregnancy Forum where physicians and other health care professionals can submit questions or details of experiences that they have had with patients who had cancer during pregnancy. Questions about the safety of chemotherapeutic drugs before and during pregnancy and about possible exacerbation of previous cancer by pregnancy are most common.

https://www.cfp.ca/content/cfp/53/11/1891.full.pdf

Sandy G. Grupp

Papers

Pediatric cancer rates after universal folic acid flour fortification in Ontario.

Cancer in pregnancy: Motherisk on-line question and answer forum