The high cancer incidence in young people in Italy: do genetic signatures reveal their environmental causes?

The increased incidence of cancer in children and adolescents registered in Italy in the last few decades is one of the highest amongst Western countries. The causes are difficult to identify, but recent daily news and some epidemiological surveys, such as the ‘Sentieri’ study, suggest that environmental pollution has an important role. In the past 20 years, epigenetic studies have described how the changes induced by the cell microenvironment on the non-coding parts of the genome can heavily influence gene function, contributing to the carcinogenesis process. Connecting links amongst the external environment, cellular microenvironment and functional epigenetic and genetic mutations promote carcinogenesis. Today, the whole genome sequencing techniques for human cancers can help to formulate a map of mutational signatures in individual tumours, and a list of mutational fingerprints showing exposure to specific environmental mutagens is being developed. Determining the ethical, legal and economic consequences of known cancer causative agents in young people will be a crucial step for a serious reconsideration of primary prevention. Ruggero Ridolfi