Cancer hazard Evaluations for Contemporary Needs: What’s New at NIEHS

Background and Aims Primary prevention is an effective strategy for reducing the global cancer burden. To inform public health decisions and communicate hazards, the U.S. National Toxicology Program conducts cancer hazard evaluations for possible listing in the congressionally mandated Report on Carcinogens (RoC). The scientific community recognizes challenges with traditional cancer hazard evaluations that do not always address real-world experiences like exposure to complex mixtures that disproportionally affect certain racial and ethnic communities. To increase the relevance and usefulness of our cancer hazard evaluations, we have enhanced our assessment methods and communication strategy. Methods and Results We highlight advancements from recent and ongoing cancer hazard evaluations, encompassing the entire lifecycle of our review process – from substance selection to systematic review methods and hazard communication. We have selected real-world exposures such as mixtures (e.g., wood smoke), non-traditional agents (e.g., light at night), complex exposure scenarios (e.g., night shift work), and chemical classes (e.g., polycyclic aromatic hydrocarbons) for review. Systematic review methodology improvements include (1) using evidence maps to inform the review approach, (2) implementing more structured approaches to identify and organize mechanistic data, (3) exploring read-across approaches to evaluate substances without human and animal cancer data, and (4) incorporating triangulation approaches for evidence integration. To improve hazard communication, we are contextualizing hazards (e.g., persistent night shift work), providing information on prevention (e.g., Helicobacter pylori), and presenting information in an interactive format. For example, our online platform allows the public to explore substance uses and specific human cancers associated with RoC listings. We are also exploring ways to emphasize and communicate environmental health disparities. Conclusion The RoC has a legacy of providing highly impactful information that significantly enables cancer prevention efforts. We are actively evolving our approaches to meet contemporary challenges. Keywords Cancer Hazard Assessments, Policy, Systematic Review