Opportunities for research and research funding are likely to expand considerably over the next grant period as a result of two initiatives that will provide new resources for investigators interested in childhood cancer.

Children's Oncology Group (COG) - The two major pediatric cooperative clinical trials groups (CCG and POG), and the disease-specific groups (NWTS - Wilms' tumor and IRS - rhabdomyosarcoma) have agreed to merge to form COG. In the past, Dr. Buckley and others have taken advantage of the impressive size of CCG (in terms of patient accrual) and its infrastructure to conduct case-control studies of childhood cancer. Where needed, inter-group studies were mounted, including POG patients, but the mechanism for inter-group studies was always problematic.

With the merger of these groups, a new entity will be created that will encompass virtually every significant hospital or institution treating children with cancer in the U.S. and Canada. This will have a significant impact on the ability of investigators to rapidly accrue case series for epidemiological studies, effectively doubling the population base of CCG alone.

National Network for Research on Causes of Cancer in Childhood (NNRCCC) - The NCI has been in discussion with NIEHS, EPA and CDC to plan a national registration system for childhood cancer, based around COG. The rationale is that COG already registers almost all cases of cancer in children under age 15, and with collaborative input from the numerous state and local cancer registries, it will be possible to create a comprehensive national registry to facilitate epidemiological research. The NNRCCC will include a repository for biological samples and a database that will include selected demographic, clinical and epidemiological data.

The NNRCCC will stimulate research in a number of ways. It will provide population-based case series for case-control studies. In many ways, it will function as COG is planned to, in providing access to large case series, but the NNRCCC will be structured specifically to facilitate epidemiological research and the clinical and demographic data and biological samples will be collected with epidemiological research in mind. For the first time, national population studies will be possible: these include analysis of trends in incidence; comparisons by ethnicity; ecological and GIS correlative studies; and investigation of disease clustering.