Pediatric Cancer Epidemiology and Survival
Epidemiological Analysis of Pediatric Cancer Based on Spatio-Temporal Clustering of Incidence and Mortality for Survival Improvement within the Long-Term Post-Chernobyl Period
Tech Area / Field
- MED-DIS/Disease Surveillance/Medicine
- INF-SOF/Software/Information and Communications
8 Project completed
Senior Project Manager
Savinova N V
Belarusian Research Center for Pediatric Oncology and Hematology, Belarus, Minsk
- Belarussian State University / Research Institute for Applied Problems of Mathematics and Informatics, Belarus, Minsk
- University of Ulsan College of Medicine & Asian Medical Center, Korea, Seoul\nHiroshima University / Research Institute for Radiation Biology and Medicine, Japan, Hiroshima
Project summaryThe project goal is to work out the means and guidelines for cancer prevention and population survival improvement in children and adolescents with malignancies on the base of the incidence and mortality spatio-temporal cluster analysis within the long-term post-Chernobyl period.
The current situation at research field. Because of high medical treatment expenditures and high mortality childhood cancer turns out to be a complicated socially-economic challenge. The 10-years population survival in all childhood malignancies in Belarus is about 70%. One third of the cases are leukemia and thyroid carcinoma. The groups of special interest are multiple primary tumors, second malignant neoplasms, as well as genetically-determined ones, including cases in infants. The total population survival from cancer is poorer than survival results showed in clinical trials. The survival of leukemia and thyroid carcinoma as second tumors is unsatisfactory. The evaluation of primary and iatrogenic cancer incidence, survival and mortality will allow revealing negative factors as well as peculiarities of the treatment results and, consequently, improving survival.
A special part is dedicated to the evaluation of the long-term effects of the ionizing radiation after Chernobyl accident. The standardized incidence rate of thyroid carcinoma at the age group under 15 years old varies from 0 to 2.2 per 1 million. The same rates took place in Belarus before Chernobyl disaster. Since 1990 the increase of incidence had been registered. Since 1996 the number of thyroid carcinoma cases has been decreasing in children and adolescents. But up to now the incidence in the age group under 15 is still one of the highest in the international statistics. The reasons why thyroid carcinoma incidence is higher in Belarusian children comparing to those in European countries within such a long term period after radioiodine exposure is still not clear.
There are various external and internal factors in the etiology of malignant neoplasms. These factors may determine not only the cancer epidemiology, but its clinical, pathologic and molecular-genetic subtype. In the current situation epidemiology cluster analysis may give important information relating to geographical variability of incidence, mortality, timorous characteristics, treatment, survival and even socially-economic factors influencing the cancer promotion at certain population.
The influence of the presented project on the progress at the given sphere. The research results will allow advances in the understanding of the nature of cancer in children and will help to substantiate the prophylaxis measures as well as to decrease mortality and improve population survival. By our knowledge, this will be the first population-based study of incidence, mortality and survival of cancer (including primary, second, genetically determined, etc.) in long-term post-Chernobyl period in children and adolescents of Belarus. Space-time cluster analysis will be optimized for the cases of malignant neoplasms.
The competence of the project participants in the given sphere. The specialists from the Public Institution “Belarusian Research Centre for Pediatric Oncology and Hematology“ (BRCPOH) of the Ministry of Healthcare of Belarus (the leading organization) as well as the specialists from the Institution of the Belarusian State University “Research Institute for Applied Problems of Mathematics and Informatics” (RIAPMI) will be invited to participate in this project.
Since 1999 the epidemiological studies of childhood cancer have been carried out at population-based national-wide Childhood Cancer Register of Belarus locating at the BRCPOH. In the course of data collection, case recording, and data analysis Childhood Cancer Register of Belarus takes to the guidelines of International Agency of Cancer Research and is considered to be its associate member. The specialists from Belarusian Thyroid Carcinoma Centre dealing with this problem since the moment of Chernobyl disaster will be involved into work.
The Research Institute for Applied Problems of Mathematics and Informatics is famous for its theoretical and applied developments in the sphere of mathematical statistics and software-algorithmic data analysis. Recently the team from this Research Institute has developed foundation of robust statistical data processing theory, and in particular of cluster analysis. Important results in the sphere of rendering and processing of multidimensional data have been obtained.
The expected results and their application. The results of the project are relevant for prevention, diagnostics and treatment of primary and secondary cancer in children and adolescents in Belarus as they take the third place in structure of total pediatric mortality. The strategy for population survival improvement will be developed based on results of the spatio-temporal cluster analysis of cancer incidence and mortality in children and adolescents.
The following results will be obtained within the seven project’s tasks:
- the epidemiology of cancer time-trends will be analyzed in children and adolescents for the 25-year period after Chernobyl accident, including the ones taking into consideration molecular-genetic peculiarities.
- the statistical methods and algorithms of spatio-temporal analysis for pediatric cancer cluster detection and monitoring will be developed;
- the methods for statistical analysis and prediction of cluster structure dynamics, taking into consideration the factors of radiation and/or industrial pollution will be developed;
- the algorithms and software of the spatio-temporal cluster analysis, monitoring and estimation of cluster dynamics will be developed;
- the geoinformation system for epidemiological spatio-temporal cluster analysis and visualization will be developed.
The fields of results applications are epidemiology, oncology, hematology, pediatrics, information technologies (IT).
Meeting the International Science Technical Centre (ISTC) goals and objectives. This project meets the ISTC goals and objectives as involves scientists that deal with biological weapons and missile technologies development, their implementation into the scientific-technical activity for peaceful uses as the project itself pursues peaceful application. Moreover, mass involvement of the scientists from the participant organizations into the international scientific community via presenting the project information at the international conferences and seminars is planed.
Scope of activities. The aim of the project will be attained within 36 months. During this time the works on 7 project task will be carried out. The labor intensiveness will make up 5738 person-days. All the tasks include epidemiological research on the basis of Childhood Cancer Register (BRCPOH), and research in the sphere of methods, algorithms and software developments in RIAPMI. Geoinformation system’s algorithms and software will be developed jointly.
The role of foreign collaborators. In the course of project implementation the roles of foreign collaborators will be the following: information exchange, commenting on the technical reports (quarter, annual, finish) presented to the project participants at the International Science Technical Centre, the organization of common symposia and workshops.
Technical approach and methodology. The epidemiologic analysis of the 25 years period after Chernobyl disaster will be carried out on the basis of the Childhood Cancer Register of the Republic of Belarus involving the methods recommended by International Agency of Cancer Researches and USA National Cancer Institution.. RET and BRAF genes as well as germ-line mutations in genes involved in DNA repair, such as RAD51 and CHEK2, will be evaluated in thyroid cancer; main himeric oncogenes in leukemia and AML1 point mutations will be evaluated in nonM3 acute myeloid leukemia. Polymerase chain reaction and sequencing will be used for molecular genetic analysis and mutation detection. The samples from the tissue/samples bank will be used. Geoinformation system, developed within the bounds of the project, and supercomputer will be used to analyze the epidemiology of cancer clusters. Robust data analysis methods will be invented to develop arbitrary shape incidence clusters. Temporal incidence cluster monitoring will be carried out using successive criteria hypothesis test. Spatio-temporal cluster analysis of the incidence on the basis of the geoinformation system will be performed depending on the radioiodine/radiocesium and industrial factors.