Starting date: March 2023
Work Programme
The Childhood Cancer Awareness and Research Evidence Team (CCARE) was set up to highlight childhood cancer research across IARC and to support the WHO Global Initiative for Childhood Cancer (GICC). The GICC strives for the goal of increasing the survival rate of children with cancer globally to at least 60% by 2030 while reducing their suffering and improving their quality of life.
The objectives of CCARE are:
- to improve communication within IARC and seek synergies in research on childhood cancer;
- to streamline the dissemination of knowledge on childhood cancer generated at IARC; and
- to support the GICC by providing scientific evidence for global action.
To achieve these goals, the team members meet regularly within IARC and communicate with WHO partners. IARC’s expertise in research on childhood cancer is built through the following projects.
- International Incidence of Childhood Cancer (IICC): Childhood cancer data, collected by population-based cancer registries around the world, are processed, analysed, and periodically disseminated through the IICC series, which is a unique resource on childhood cancer incidence. The latest volume (IICC-3) was supported by the Union for International Cancer Control (UICC).
- International Classification of Childhood Cancer (ICCC): This is a standardized system that categorizes paediatric cancer types according to the WHO Classification of Paediatric Tumours and the International Classification of Diseases for Oncology (ICD-O) into three-level categories. The ICCC facilitates consistent reporting of cancer statistics in childhood populations on an international level.
- Targeting Childhood Cancer through the Global Initiative for Cancer Registry Development (ChildGICR): The development of childhood cancer registration in low- and middle-income countries is supported through implementation in target countries, an educational programme, and implementation research. This project is conducted in collaboration with St. Jude Children’s Research Hospital (USA), which also supports the project financially.
- Cancer Risk in Childhood Cancer Survivors (CRICCS): This project leverages international quality-assured data collected by population-based cancer registries. The objectives of CRICCS are to estimate the number of childhood cancer survivors in a population, to understand the risk of development of second cancers among childhood cancer survivors, and to develop guidelines for population-based cancer registries to study childhood cancer survivorship. This project is supported by Children with Cancer UK.
- Cancer in Children – Epidemiology, Registration, Omics (CICERO): This new multidisciplinary project examines several complementary aspects of childhood cancer research. One part of the project is dedicated to studies of childhood cancer in Africa, in particular completeness of ascertainment, understanding referral patterns, survival, and treatment completion. This will be complemented by defining molecular profiles of childhood cancer cases in Africa using epigenomics methodology. Another part of CICERO is dedicated to the development and dissemination of indicators of the burden of childhood cancer and encompasses incidence, survival, prevalence, mortality, and financial impact. The CICERO project is supported by the Ministry of Health, Welfare and Sport of the Government of the Netherlands.
- Childhood Cancer and Leukemia International Consortium (CLIC): Founded in 2007 with a focus on leukaemia and expanding to include other childhood cancers, this consortium facilitates collaboration among more than 30 case–control studies and has led to more than 25 publications. IARC hosts the Data Coordination Center, where data from most participating studies are stored, facilitating pooled analyses, and leads investigations of environmental causes, in particular parental occupational exposures before conception or during pregnancy and domestic exposures such as pesticides and paint.
- Global Acute Leukaemia/Lymphoma network (GALnet): This is a research consortium in which expertise acquired in high-income countries is transferred to paediatric oncology units based in low- and middle-income countries to increase their participation in international research projects. The consortium has contributed to the understanding of childhood cancer and improved awareness, detection, diagnosis, and treatment in different parts of the world.
- Childhood cancer in relation to radiofrequency electromagnetic fields from television and radio broadcast transmitters (CIRE-RF): This is a registry-based case–control study in France in which residential information from previous case–control studies is linked with estimates of environmental exposure to radiofrequency electromagnetic fields obtained from official sources. This is the newest in the portfolio of studies investigating the unresolved question of whether exposure to electric, magnetic, or electromagnetic fields increases the risk of certain childhood cancers.
- Childhood Leukaemia and Environmental Risk Factors (CLERF): In this pilot study, conducted in Germany, IARC explored the feasibility of recruiting patients with leukaemia, enrolled in European clinical trials, for etiological research on gene–environment interactions. On the basis of these findings, a standardized protocol of recruitment, applicable to most European countries, can be developed.
- COVID-19 and Childhood Cancer: This project looks at the impact of the COVID-19 pandemic on the occurrence of childhood cancer, using data from the German Childhood Cancer Registry. The pandemic may have had an impact on risk, referral, delayed diagnosis, and/or treatment.
- The Environment and Child Health International Consortium (ECHIG) has been established to strengthen the collaboration and coordinate the activities of the birth cohorts from China, Denmark, France, Japan, and Norway, among others. ECHIG actively works on harmonization of study methods and data, including infant health outcomes, biomarkers, and environmental measurements.
- The Environmental Hazards and Prevention of Acute Lymphoblastic Leukaemia in Children (ENV-ALL) project aims to investigate the associations between maternal exposure to various persistent chemicals (per- and polyfluoroalkyl substances; PFAS) during pregnancy and the presence of pre-leukaemic clones at birth, which could lead to a higher risk of developing acute lymphoblastic leukaemia during childhood. The ultimate goal is to produce new scientific evidence for primary prevention strategies so that fewer children in France, in Europe, and around the globe develop this most common childhood cancer.
- EpiChildCan: This project aims to identify epigenetic markers of early-life factors and precursors of childhood cancer and its predisposing phenotypes. With a focus on leukaemia/lymphoma and brain cancer, the project spans critical stages of childhood cancer development while backtracking its origin to the birth period. Epigenetic mechanisms are then integrated with genomics and transcriptomics to derive multi-omics cancer driver genes affecting the course of the disease. Such an innovative approach, including follow-up from birth to the clinic, cannot be implemented without international collaboration. Resources amassed in large, unique, and complementary networks of prospective and retrospective studies are combined to tackle this challenge with a scale, design, and uniqueness beyond the reach of any single country. The derived evidence is then triangulated from multiple angles, including epidemiology, clinical, organoid, and animal models. This work is supported by the French National Cancer Institute, the World Cancer Research Fund International, the IARC Postdoctoral Fellowship Programme, the Marie Curie Actions-People-COFUND, and Children with Cancer UK. This project benefits from access to the rich resources of the International Childhood Cancer Cohort Consortium (I4C).
- DiaLCT: This project aims to establish a molecular diary of use of tobacco and of alternative nicotine delivery systems to map mechanisms of cancer in early and adult life. The project currently focuses on vaping and cigarette and waterpipe smoking while setting a research framework that can be expanded to other tobacco/nicotine exposure forms. This framework triangulates evidence from state-of-the-art molecular and data science (including AI) tools applied in birth studies, adult cohorts, clinical samples, and cell and animal models, as well as bioengineered smoking robots that mimic the smoking operandi in humans. This work is supported by the French National Cancer Institute and the French Institute for Public Health Research, the IARC Postdoctoral Fellowship Programme, the Medical Practice Plan (American University of Beirut) in Lebanon, and King Abdullah International Medical Research Center in Saudi Arabia.
- International Lifestyle Behaviour and Biobanking Programme in Paediatric Oncology: This project is a collaboration between IARC and the International Initiative for Pediatrics and Nutrition (IIPAN) that aims to develop an information resource for studying the impact of nutrition and other lifestyle factors on health outcomes in children and adolescents with cancer. The two studies under the IIPAN–IARC collaboration are the InterNatIonal CHildhood Leukemia Microbiome/MEtabolome Cohort (NICHE) and the Southern European Prospective Investigation into Childhood Cancer and Nutrition (EPICkids). Understanding the role of nutrition status will help improve survival of children and adolescents with cancer. Recruitment of patients and data collection are under way by personnel trained at collaborating IIPAN sites in several countries, using standard operating procedures.
- Determinants of Late Diagnosis and Delayed Treatment of Cancer (DEDICA): This study aims to evaluate the determinants of late diagnosis and delayed treatment of childhood cancers and how the elimination of these challenges can contribute towards the improvement of cancer control strategy. On the basis of the perceptions of patients with cancer, the study will investigate which determinants of socioeconomic status and the health system affect the time to diagnosis and the time to treatment initiation and completion.
- The IARC Monographs programme identifies the causes of human cancer. Agents that are known or suspected to cause different types of cancer (including childhood cancers) are identified in the list of classifications by cancer site. Agents accorded priority for evaluation are listed in the report of the Advisory Group to Recommend Priorities for the IARC Monographs and include agents linked to the risk of childhood cancer. The Advisory Group to Recommend Priorities for the IARC Monographs during 2025–2029 recommended several agents to be evaluated with high priority that are relevant for childhood cancer etiology (i.e. some pesticides, infectious, lifestyle, and physical agents, and pharmaceuticals). Chemotherapeutic agents that are commonly used to treat childhood cancers (platinum-based anthracyclines) are also on the high-priority list because their use may elucidate the risk of second cancer in childhood cancer survivors.
- South-ROCK: In this project, the current paediatric oncology research consortia active in southern regions of France, centred around Lyon and Marseille, have set up an integrated centre of excellence in paediatric oncology research, called Research on Cancer for Kids (ROCK), in which IARC participates. The main themes of this large consortium are the therapeutic exploitation of alterations in developmental pathways in paediatric tumours, adapting care approaches to the developing bodies of children and adolescents with cancer, and implications of characterizing the role of environmental factors for the prevention of paediatric cancers.
- The Childhood Cancer Quality of Care, Financial Protection, and Health System Readiness (DECAN-CHILD) project started in 2022 to evaluate delays to diagnosis and care, and their determinants, for children with cancer in Nepal. The project is being implemented in five major tertiary hospitals in Nepal and includes assessment of the health system capacity to diagnose and treat children with cancer, as well as the financial burden of childhood cancer treatment for the family and for the health system. This project was supported by IARC/WHO during 2022–2025 and is currently funded by the Canadian Institutes of Health Research (CIHR) during 2026–2028. Through interdisciplinary and cross-sectoral global partnerships, this study generates evidence relevant for health system policy and practice.
- EpiBEAM is a research project investigating how food contaminants (mycotoxins) and viral infections alter epigenetic marks on DNA and influence the development of endemic Burkitt lymphoma, the most common childhood cancer in sub-Saharan Africa. Using unique biospecimen cohorts from sub-Saharan African regions, combined with multi-omics approaches and in vitro modelling, EpiBEAM seeks to strengthen evidence-based cancer prevention strategies in the context of climate change in Africa and worldwide.
Team Composition
Team Leaders:
Dr Eva Steliarova-Foucher, Cancer Surveillance Branch (CSU)
Dr Akram Ghantous, Environment and Lifestyle Epidemiology Branch (ENV)
Emails: steliarovae@iarc.who.int; ghantousa@iarc.who.int
Secretary: Dr Indira Adhikari (Postdoctoral Scientist, CSU)
Team members:
Dr Andre Carvalho (Scientist, EPR)
Dr Inge Huybrechts (Scientist, NME)
Dr Rita Khoueiry (Scientist, ENV)
Dr Joanne Kim (Scientist, ENV)
Dr Zisis Kozlakidis (Head, LSB)
Dr Michele Matta (Scientist, ENV)
Dr Farah Nassar (Scientist, ENV)
Dr Elisa Pasqual (Scientist, ESC)
Dr Sergey Senkin (Scientist, ENV)
Dr Ljubica Zupunski (Scientist, ENV)
Visiting scientist:
Dr Miroslava Makohusova (IARC Visiting Scientist, CSU)
Early-career scientists:
Dr Blanchard Conombo (IARC Postdoctoral Fellow, CSU)
Dr Shiny Manohar (IARC Postdoctoral Fellow, NME)
Dr Deependra Singh (IARC Postdoctoral Fellow, EPR)
Director’s representatives:
Dr Véronique Chajès (Programme Officer, DIR)
Mr Clément Chauvet (Strategic Engagement and Resource Mobilization Officer, DIR)
Senior advisors:
Dr Freddie Bray (Branch Head, CSU)
Dr Joachim Schüz (Branch Head, ENV)
Dr Mary Schubauer-Berigan (Branch Head, ESC)
Key publications
- Piñeros M, Lam CG, Mery L, Znaor A, Steliarova-Foucher E, Abraham N, et al. (2026). Building local capacity for childhood cancer registration: real-world examples. JCO Glob Oncol. 12(12):e2500471. https://doi.org/10.1200/GO-25-00471 PMID:41494142
- Steliarova-Foucher E, Colombet M, Ries LAG, Moreno F, Dolya A, Shin HY, et al., editors (2025). International Incidence of Childhood Cancer, Volume III (IARC Scientific Publication No. 170). Lyon, France: International Agency for Research on Cancer. https://publications.iarc.who.int/658
- Daltveit DS, Morgan E, Bardot A, Steliarova-Foucher E, Damie A, Hagenimana M, et al. (2025). Childhood cancer survival in Africa, Asia, Latin America and the Caribbean, during 2008-2017 (SURVCAN-3): a population-based benchmarking study of 16 821 children. J Natl Cancer Inst. djaf321. https://doi.org/10.1093/jnci/djaf321 PMID:41391483
- Mallon B, Dial C, Akonde FB, Ahouidi MJD, Diouf N, Anne M, et al. (2025). The path towards a population-based childhood cancer registry in the region of Dakar in Senegal: a feasibility study of the Franco-African Paediatric Oncology Group (GFAOP). EJC Paediatr Oncol. https://doi.org/10.1016/j.ejcped.2025.100420 PMID:41368026
- Blanco-Lopez J, Kintossou AK, Manohar S, Iguacel I, Pisanu S, Almeida CCB, et al. (2025). Role of the perinatal experience on the risk of acute leukemia in childhood or adolescence: systematic review and meta-analysis. Int J Cancer. ijc.70256. https://doi.org/10.1002/ijc.70256 PMID:41277016
- Khoshakhlagh AH, Ghobakhloo S, Ghantous A, Carlsen L (2025). A global systematic evaluation of the impact of air pollution on pediatric cancer development. Ecotoxicol Environ Saf. 305:119231. https://doi.org/10.1016/j.ecoenv.2025.119231 PMID:41115344
- Ducreux B, Firmin J, Ferreux L, Patrat C, Clavel J, Ghantous A, et al. (2025). DNA methylation profiles and cancer in children conceived after assisted reproductive technology. Clin Epigenetics. 17(1):174. https://doi.org/10.1186/s13148-025-01982-1 PMID:41121288
- Michailidis TM, Corveleyn L, Almey R, Bader Y, Odongo GA, Herceg Z, et al. (2025). Aflatoxin B1 induces subtle but coordinated histone modifications in Epstein-Barr virus infected and non-infected Burkitt lymphoma cells. Environ Int. 204:109813. https://doi.org/10.1016/j.envint.2025.109813 PMID:41016387
- Karagas MR, Kaldor J, Michaelis M, Muchengeti MM, Alfaiate D, Argirion I, et al. (2025). Carcinogenicity of hepatitis D virus, human cytomegalovirus, and Merkel cell polyomavirus. Lancet Oncol. 26(8):994–5. https://doi.org/10.1016/S1470-2045(25)00403-6 PMID:40587985
- Bosch de Basea M, Thierry-Chef I, Harbron R, Hauptmann M, Byrnes G, Bernier MO, et al. (2025). Author correction: risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults. Nat Med. 31(7):2452. https://doi.org/10.1038/s41591-025-03689-5 PMID:40217080
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