Each year in the United States (U.S.), more than 15,000 children and adolescents younger than 21 years of age are diagnosed with cancer, which is the leading cause of morbidity and mortality in youth. Over 10% of these cases are diagnosed in Texas. Pediatric cancer incidence has steadily increased by an annual average of 0.6% since 1975, with acute lymphoblastic leukemia (ALL) accounting for the largest proportion of cases (23%). This steady increase suggests that pollutants in the environment may be playing a significant role in pediatric ALL risk. However, we do not understand why most children are diagnosed with ALL. Being exposed to environmental pollutants (e.g., heavy metals like arsen...

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Each year in the United States (U.S.), more than 15,000 children and adolescents younger than 21 years of age are diagnosed with cancer, which is the leading cause of morbidity and mortality in youth. Over 10% of these cases are diagnosed in Texas. Pediatric cancer incidence has steadily increased by an annual average of 0.6% since 1975, with acute lymphoblastic leukemia (ALL) accounting for the largest proportion of cases (23%). This steady increase suggests that pollutants in the environment may be playing a significant role in pediatric ALL risk. However, we do not understand why most children are diagnosed with ALL. Being exposed to environmental pollutants (e.g., heavy metals like arsenic and organic chemicals like certain pesticides) has long been suspected of contributing pediatric ALL risk. However, very few studies have been able to accurately measure these pollutants in children diagnosed with ALL. This is partly because the critical time of exposure is often in early life, long before a child is diagnosed with ALL. There is growing evidence that primary teeth (i.e., baby teeth) serve as a stable repository for exposures that occur during development and early childhood, similar to growth rings on a tree. Therefore, emerging studies are utilizing primary teeth to reconstruct multiple early-life exposures, referred to as the exposome. Our objective is to pioneer a novel approach to advance discovery of the early-life environmental exposures that cause pediatric ALL. The collection of teeth as a marker for early-life exposures has enormous translational potential for uncovering the causes of pediatric ALL and, in the future, for other cancer types. The results will provide information for a larger grant application to examine the tooth exposome from a larger group of individuals. The knowledge gained from this project and subsequent projects will profoundly impact preventative strategies for childhood cancer.

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