Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
Int J Cancer. 2010 Mar 1;126(5):1196-205. doi: 10.1002/ijc.24856.
Cancer treatments have the potential to cause germline mutations that might increase the risk of cancer in the offspring of former cancer patients. This risk was evaluated in a population-based study of early onset cancer patients in Finland. Using the nationwide registry data, 26,331 children of pediatric and early onset cancer patients (diagnosed under age 35 between 1953 and 2004) were compared to 58,155 children of siblings. Cancer occurrence among the children was determined by linkage with the cancer registry, and the standardized incidence ratios (SIRs) were calculated comparing the observed number of cancers with that expected, based on rates in the general population of Finland. Among the 9,877 children born after their parent's diagnosis, cancer risk was increased (SIR 1.67; 95% CI 1.29-2.12). However, after removing those with hereditary cancer syndromes, this increase disappeared (SIR 1.03; 95% CI 0.74-1.40). The overall risk of cancer among the offspring of siblings (SIR 1.07; 95% CI 0.94-1.21) was the same as among the offspring of the patients with non hereditary cancer. Risk of cancer in offspring, born before their parents cancer diagnosis, was elevated (SIR 1.37, 95% CI 1.20-1.54), but removing hereditary syndromes resulted in a diminished and nonsignificant association (SIR 1.08, 95% CI 0.93-1.25). This study shows that offspring of cancer patients are not at an increased risk of cancer except when the patient has a cancer-predisposing syndrome. These findings are directly relevant to counseling cancer survivors with regard to family planning.
癌症治疗有可能导致种系突变，从而增加前癌症患者的后代患癌症的风险。本研究在芬兰进行了一项基于人群的早发性癌症患者的研究，评估了这种风险。利用全国范围内的登记数据，将 26331 名儿科和早发性癌症患者（1953 年至 2004 年期间 35 岁以下确诊）的子女与 58155 名同胞子女进行了比较。通过与癌症登记处的链接确定了儿童的癌症发生情况，并根据芬兰一般人群的比率计算了观察到的癌症数量与预期数量的标准化发病比（SIR）。在其父母确诊后出生的 9877 名儿童中，癌症风险增加（SIR 1.67；95%CI 1.29-2.12）。然而，去除遗传性癌症综合征后，这种增加消失了（SIR 1.03；95%CI 0.74-1.40）。同胞子女的总体癌症风险（SIR 1.07；95%CI 0.94-1.21）与非遗传性癌症患者的子女相同。在父母癌症诊断前出生的子女患癌症的风险增加（SIR 1.37，95%CI 1.20-1.54），但去除遗传性综合征后，相关性降低且无统计学意义（SIR 1.08，95%CI 0.93-1.25）。本研究表明，除患者患有癌症易感综合征外，癌症患者的子女患癌症的风险并未增加。这些发现与癌症幸存者的生育计划咨询直接相关。
