TABLE 2.
Examples of Early Life Factors Associated With Risk or Prevention of Pediatric and Adult Cancers
| Associated Cancers | |
|---|---|
| Risk factors | |
| Adverse childhood events (eg, child abuse) | Adult cancers 17 |
| Maternal alcohol consumption during pregnancy | Leukemia 18 |
| Assisted reproductive technology | Pediatric cancers 19 |
| Body weight | |
| Maternal prepregnancy weight | Pediatric cancers (eg, acute myeloid leukemia) 20 |
| Childhood obesity | Adult cancers (eg, esophageal adenocarcinoma) 21 |
| High birth weight | Pediatric (eg, leukemia) 22–24 and adult (eg, breast cancer,25 testicular cancer26) cancers |
| Chemical agents | |
| Benzene | Childhood acute lymphoblastic leukemia 27 |
| BPA | Adult cancers 28,29 |
| Carbon tetrachloride | Neuroblastoma 30 |
| Diethylstilbestrol (prenatal exposure) | Adult cancers (eg, clear cell adenocarcinoma of the vagina and cervix) 31–33 |
| Occupational exposures (paints, metals, hydrocarbons) | Pediatric cancers (eg, leukemia, brain and central nervous system tumors) 34–37 |
| Pesticides, herbicides, and insecticides | Pediatric cancers (eg, leukemia, lymphoma, and brain cancer) 38–41 |
| Polybrominated diphenyl ethers | Leukemia 42 |
| Polychlorinated biphenyl | Leukemia 43 |
| Polycyclic aromatic hydrocarbons | Leukemia, 44 neuroblastoma 30 |
| Tobacco exposure | Pediatric (eg, leukemia, 45 hepatoblastoma, 46 non-Hodgkin lymphoma 47) and adult (eg, lung cancer 48) cancers |
| Traffic-related air pollution | Pediatric cancers (eg, leukemia) 49–51 |
| Chromosomal abnormalities (eg, Down syndrome) | Leukemia 52 |
| Genetic syndromes | |
| Ataxia telangiectasia | Pediatric (eg, leukemia) 53 and adult (eg, breast cancer) 54 cancers |
| Li-Fraumeni syndrome | Pediatric (eg, leukemia) and adult (eg, premenopausal breast cancer) 55 cancers |
| Lynch syndrome | Colorectal cancer 56 |
| Multiple endocrine neoplasia syndrome | Endocrine gland tumors, 57 pediatric cancers |
| Isolated cryptorchidism | Testicular cancer 58 |
| Older parental age | Pediatric (eg, leukemia, lymphoma, neuroblastoma) 59 and adult (eg, breast cancer) 60 cancers |
| Placental phenotype (eg, extremely large or small) | Adult cancers 61 |
| Pubertal events | |
| Early menarche | Adult cancers 62 |
| Age at peak height velocity | Adult cancers 62 |
| Radiation | |
| Ionizing radiation | Pediatric (eg, leukemia) and adult (eg, thyroid and breast cancers) 63 cancers |
| Nonionizing radiation | Pediatric (eg, leukemia) 64 and adult (eg, breast cancer) 65 cancers |
| UV radiation | Skin cancers, ocular melanoma 66 |
| Viruses and bacteria | |
| Epstein-Barr virus | Burkitt lymphoma, nasopharyngeal carcinoma 67 |
| Herpesvirus | Kaposi sarcoma 67 |
| Helicobacter pylori | Gastric cancer 68 |
| Human papillomavirus | Adult cancers (eg, cervical cancer) 67,69 |
| Protective and moderating factors | |
| Allergies, asthma, and atopy | Childhood (eg, leukemia, 70,71 neuroblastoma, 72 non-Hodgkin lymphoma 73) and adult (eg, gliomas, 74 pancreatic cancer 75) cancers |
| Childhood obesity | Breast cancer 21, 76 |
| Dietary factors | |
| Breastfeeding | Childhood (leukemia, lymphoma, Wilms tumor) 77,78 and adult (eg, premenopausal breast cancer) 79 cancers |
| Maternal prenatal folic acid consumption | Pediatric cancers (eg, leukemia) 80–82 |
| Early stimulation of the immune system (eg, day care attendance at younger age) | Acute lymphoblastic leukemia 83,84 |
| Physical activity during childhood | Breast cancer 85 |
Note: This list is not exhaustive, and although some research findings suggest that these factors may be associated with subsequent cancer risk, the strength and consistency of the evidence varies. In addition, the types, sources, and quality of evidence (eg, animal models, observational studies, case-control studies, prospective cohort studies) vary as well.