A systematic review of residential proximity to upstream oil and gas development and childhood, adolescent and young adult cancer risk

Objective: Upstream oil and gas development (OGD) can release carcinogenic and radioactive agents into air and water. This review summarizes evidence on the relationship between residential proximity to upstream OGD and cancer risk among children, adolescents, and young adults (CAYA). Methods: We systematically searched PubMed and Embase through April 25, 2025, for original, peer-reviewed epidemiologic investigations of residential proximity to upstream OGD and cancer in CAYA (≤25 years). We excluded studies of downstream activity, those lacking CAYA-specific results, and non-English publications. Two reviewers independently screened records, extracted data, and assessed risk of bias with a World Health Organization tool. Results: From 3274 screened articles, 10 met inclusion criteria. Four case-control studies, all United States-based (Pennsylvania n = 3, Colorado n = 1), used individual-level proximity metrics during defined temporal windows and controlled for confounders. Six ecological studies (Ecuador n = 4, Croatia n = 1, Pennsylvania n = 1) used area-based density or binary exposure metrics with limited confounder adjustment. All studies assessed hematopoietic malignancies. All case-control studies observed positive associations between OGD proximity and cancer with three reporting elevated leukemia risk. Two studies from different states reported highly similar leukemia risk in the closest OGD buffer zones (Colorado: 3 km OR 2.07, 95 % CI 1.08-3.74; Pennsylvania: 2 km OR 1.98, 95 % CI 1.06-3.69). Ecologic study findings were mixed, including elevated risks for hematologic and central nervous system cancers. Limitations include few studies, imprecise exposure metrics, and potential residual confounding. Discussion: Despite limited evidence, the majority of studies reported positive, statistically significant associations between OGD and childhood cancer, most consistently for leukemia, supporting efforts to reduce OGD proximity to children.