Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Cancer. 2015 Jun 15;121(12):2072-7. doi: 10.1002/cncr.29325. Epub 2015 Mar 3.
The purpose of this study was to assess patterns of cancer occurrence during pregnancy and the postpartum period.
This was a register-based study using data from the Swedish Multi-Generation Register and the National Cancer Register from 1963 to 2007. Pregnancy-associated cancer (PAC) was defined as a malignancy detected during pregnancy or within 2 years of delivery and was assessed in 7 time windows: pregnancy, trimesters 1-3, 0-6 months, 7-12 months, and second year postpartum. Population incidence rates by 5-year age groups and periods were used to estimate the expected number of PACs for each site. The observed versus the expected (O/E) number of cases was estimated with 95% confidence intervals (CI).
The 3 most common malignancies during pregnancy were melanoma (n = 232), breast (n = 139) and cervical cancer (n = 139). With a slightly different rank order, these cancers are also the most common in women of childbearing age. The number of observed cases during pregnancy was lower than expected for all cancers, with a combined O/E ratio for all sites of 0.46 (95% CI, 0.43-0.49). The O/E ratio was close to 1 during all postpartum intervals, including 0-6 months (0.93; 95% CI, 0.88-0.98), 7-12 months (0.96; 95% CI, 0.91-1.01), and during the second year after delivery (0.95; 95% CI, 0.92-0.99).
The rate of cancer during pregnancy was lower than expected for all sites, a finding that could not be explained entirely by delayed diagnosis. A rebound in the number of observed cases after delivery was restricted to melanoma, nervous system malignancies, and breast and thyroid cancer.
本研究旨在评估怀孕期间和产后期间癌症发生的模式。
这是一项基于登记的研究，使用了瑞典多代登记处和 1963 年至 2007 年全国癌症登记处的数据。妊娠相关癌症（PAC）定义为在怀孕期间或分娩后 2 年内检测到的恶性肿瘤，并在 7 个时间窗中进行评估：怀孕、妊娠第 1-3 个三个月、0-6 个月、7-12 个月和产后第二年。使用 5 岁年龄组和时期的人群发病率来估计每个部位的 PAC 预期数量。观察到的与预期（O/E）病例数用 95%置信区间（CI）进行估计。
怀孕期间最常见的 3 种恶性肿瘤是黑色素瘤（n=232）、乳腺癌（n=139）和宫颈癌（n=139）。以略有不同的排名顺序，这些癌症也是育龄妇女中最常见的癌症。怀孕期间观察到的病例数低于所有癌症的预期，所有部位的 O/E 比值均为 0.46（95%CI，0.43-0.49）。在所有产后间隔内，O/E 比值接近 1，包括 0-6 个月（0.93；95%CI，0.88-0.98）、7-12 个月（0.96；95%CI，0.91-1.01）和分娩后第二年（0.95；95%CI，0.92-0.99）。
所有部位的怀孕期间癌症发生率均低于预期，这一发现不能完全用诊断延迟来解释。分娩后观察到的病例数增加仅限于黑色素瘤、神经系统恶性肿瘤以及乳腺癌和甲状腺癌。
