DREAM: Discovering cancer Risks from Environmental contaminants And Maternal/child health

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Project Summary/Abstract The UCSF Discovering cancer Risks from Environmental contaminants And Maternal/child health (DREAM) cohort will enhance our understanding of how multiple exposures to environmental chemicals and pollutants across a diverse population of pregnant women and their offspring are linked to cancer risks. We will enroll and follow an economically, geographically, ethnically, and racially diverse participant pool of pregnant women and their children in the San Francisco Bay Area and California’s Central Valley. Because pregnancy induces multiple maternal hormonal and physiological changes that can increase cancer susceptibility to environmental chemical exposures, we will focus on pregnancy as a period of particular vulnerability to toxic agents. We will collect questionnaire data and biospecimen samples starting at the second trimester of pregnancy up until the child reaches four years of age. We will also establish a Cohort Ambassador Program to invite participants across our three sites to provide continuous feedback which we will integrate into our research priorities. Our specific aims are designed to address the hypothesis that exposures to environmental chemicals that disrupt endocrine and other systems during this important life phase predispose women and children to cancer, as identified via intermediate cancer risk biomarkers. Our environmental exposures will focus on two major components: Consumer product related chemicals (including per- and polyfluoroalkyl substances [PFAS], phthalates and plasticizers, phenolic compounds, pesticides, and aromatic amines) measured via biomonitoring and prioritized based on widespread public exposure; and environmental pollutants in air and water, evaluated via geographic information system analyses of participants’ residential histories. Our outcomes will focus on biomarkers of risk for future cancer incidence including: short-term outcomes focusing on associations with key characteristics that are intermediate cancer risk biomarkers (immune response and chronic inflammation, oxidative stress and DNA damage, hormone disruption/receptor mediated effects, and cell immortalization). For longer term outcomes we will link cohort participants to California’s statewide population-based cancer registry, hospital discharge data, vital records, and Medi-Cal files in later years of the project to identify diagnoses of cancer and related conditions. Our multidisciplinary collaboration is built on our extensive knowledge and experience conducting large-scale research on environmental exposures during pregnancy and environmental risk factors for cancer. Our proposed cohort development and research plan will advance our understanding of multiple pollutant exposures in a young geographically and demographically diverse cohort, thus substantially advancing our knowledge on enhanced susceptibility to carcinogens linked to specific outcomes during these critical and understudied periods, combined with a platform that will allow flexibility and future collaboration to enhance our study as new science emerges.