Fosså Sophie D, Magelssen Henriette, Melve Kari, Jacobsen Anne B, Langmark Frøydis, Skjaerven Rolv
The Norwegian Radiumhospital, Department of Clinical Cancer Research, Montebello 0310 Oslo, Norway.
J Natl Cancer Inst Monogr. 2005(34):77-82. doi: 10.1093/jncimonographs/lgi019.
Cancer survivors may fear infertility, obstetric problems, and genetic alterations in their offspring. After linkage of three registries the probability of post-treatment parenthood and the risk of obstetric and perinatal problems were estimated in cancer survivors compared to individuals without a cancer diagnosis. A total of 1531 of 13,817 patients had 2307 children after one parent's cancer diagnosis: 972 males had 1479 children and 559 females had 828. A total of 1217 patients (784 males and 433 females) became parents > or =9 months after the diagnosis (1899 births: 1221 to male cancer patients and 678 to female patients). The post-diagnosis parenthood probability was 8% at 5 years, and 14% at 10 years without further increase. Female cancer survivors gave birth to post-diagnosis infants with on average 130 grams lower birth weight and 6 days shorter gestations compared with infants in the non-cancer population. Infants fathered by male cancer survivors did not differ from control infants with respect to birth weight or gestational age. There was no increase in the prevalence of major congenital malformations in the offspring of cancer survivors as compared with the offspring of the non-cancer population. Multiple births and deliveries by cesarean sections were increased. Parenthood after cancer is possible in a significant number of patients, more so for males than females. The risk of major congenital malformations was not increased relative to the non-cancer population, nor was perinatal mortality increased. However, female cancer survivors delivered more preterm births and low-birth-weight infants than what was found in the non-cancer population.
癌症幸存者可能担心自己会不孕、出现产科问题以及子女发生基因改变。在合并三个登记处的数据后,对癌症幸存者与未患癌症者相比的治疗后为人父母的概率以及产科和围产期问题的风险进行了评估。在13817名患者中,共有1531名在一方被诊断患有癌症后育有2307名子女:972名男性育有1479名子女,559名女性育有828名子女。共有1217名患者(784名男性和433名女性)在诊断后≥9个月成为父母(1899例出生:男性癌症患者1221例,女性患者678例)。诊断后为人父母的概率在5年时为8%,10年时为14%,之后不再进一步上升。与非癌症人群中的婴儿相比,女性癌症幸存者所生的诊断后婴儿平均出生体重低130克,妊娠期短6天。男性癌症幸存者所育子女的出生体重或胎龄与对照婴儿无差异。与非癌症人群的后代相比,癌症幸存者后代中主要先天性畸形的患病率没有增加。多胞胎和剖宫产的比例有所增加。相当数量的癌症患者在患癌后仍有可能为人父母,男性比女性的可能性更大。相对于非癌症人群,主要先天性畸形的风险没有增加,围产期死亡率也没有增加。然而,女性癌症幸存者所分娩的早产和低体重婴儿比非癌症人群中发现的更多。