The Mutational Epidemiology of Childhood Cancer

The diversity of childhood cancers and their molecular subtypes suggest etiologic heterogeneity. Detection of mutSig in childhood cancers has promoted hypothesis generation; e.g., the enrichment of UV-related signatures in aneuploid B-acute lymphoblastic leukemia has inspired new studies. Although the Mutographs projects were developed to investigate geographical variation in incidence, mutational epidemiology studies should also be employed to understand why certain mutSig are enriched in particular childhood cancers or subtypes. As pediatric cancers have lower mutational burdens than adult cancers, studying childhood cancer may also help determine the causes of mutSig with unknown etiologies. Given persistent differences in pediatric cancer risk by ancestry and socioeconomics, as well as the shifting global burden of childhood cancer, there is a need for studies with patients from diverse populations.