There are currently over 50 known genetic syndromes associated with a high risk of cancer in children and adolescents. Identifying children at high risk of cancer is based on physical features, family history, and often is confirmed by genetic testing. Although there is much known about the application of follow-up screening guidelines for the common adult cancers such as breast or colon cancer in individuals wit genetic risks, there is much less known about screening for cancer in children determined to have a high risk of cancer.

Moreover, published evidence for surveillance for cancer in high-risk children is largely from studies at large academic centers and there is much less informat...

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There are currently over 50 known genetic syndromes associated with a high risk of cancer in children and adolescents. Identifying children at high risk of cancer is based on physical features, family history, and often is confirmed by genetic testing. Although there is much known about the application of follow-up screening guidelines for the common adult cancers such as breast or colon cancer in individuals wit genetic risks, there is much less known about screening for cancer in children determined to have a high risk of cancer.

Moreover, published evidence for surveillance for cancer in high-risk children is largely from studies at large academic centers and there is much less information as to how recommended guidelines can be successfully applied in smaller centers in real-world settings. In addition, there is little information on screening for cancer in children in minority populations, or in families with limited access to care because of distance from a major facility, limited financial resources, or a limited understanding of genetic risks and potential benefits of early detection.

Using a framework of expert recommended cancer screening guidelines for children at highest risk of cancer, we will determine the feasibility of screening for cancer in children in some of the most underserved areas of Texas including the southern and western border areas. We will define barriers to screening and devise and test interventions to enhance screening. We will address healthcare system limitations to screening.

This project is highly significant as cancers in children with a cancer genetic risk factor account for 10-15% of all childhood cancer and in many cases early detection can improves survival. This project addresses three CPRIT priorities: 1) devising strategies for early detection, 2) using implementation research strategies to increase surveillance use, and 3) decreasing cancer morbidity and mortality in children and adolescents.

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