Ji Jianguang, Sundquist Jan, Sundquist Kristina
Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Eur J Cancer Prev. 2018 May;27(3):274-278. doi: 10.1097/CEJ.0000000000000396.
Current evidence on congenital malformations in the offspring of cancer survivors is largely inconsistent. Therefore, through this study we aimed to explore the prevalence of congenital malformations in the offspring of cancer survivors. To this end, female cancer survivors were identified from the Swedish Cancer Register and were further linked to the Swedish Medical Birth Register and Hospital Discharge Register to identify congenital malformation in their children at birth or during adulthood between 1987 and 2010. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between congenital malformation and maternal cancer diagnosis. A total of 816 congenital malformations were noted among 9266 children of maternal cancer survivors, and the rate was 8.8%, whereas the rate in the general population was 7.7%. After adjusting for some confounding factors, we found that the risk for congenital malformation in children of cancer survivors was significantly increased with an odds ratio of 1.11 and 95% confidence interval of 1.04-1.20 as compared with that in controls. The increased risk was largely consistent irrespective of maternal age at diagnosis of cancer. The risk for congenital malformation was increased among offspring of female cancer survivors, which calls for further attention directed toward those cancer survivors who plan to have children.
目前关于癌症幸存者后代先天性畸形的证据在很大程度上并不一致。因此,通过本研究,我们旨在探讨癌症幸存者后代先天性畸形的患病率。为此,从瑞典癌症登记处识别出女性癌症幸存者,并将其进一步与瑞典医疗出生登记处和医院出院登记处相联系,以确定其子女在1987年至2010年期间出生时或成年期的先天性畸形情况。采用多因素逻辑回归来估计先天性畸形与母亲癌症诊断之间关联的比值比和95%置信区间。在9266名母亲为癌症幸存者的子女中,共记录到816例先天性畸形,发生率为8.8%,而一般人群中的发生率为7.7%。在对一些混杂因素进行调整后,我们发现,与对照组相比,癌症幸存者子女先天性畸形的风险显著增加,比值比为1.11,95%置信区间为1.04 - 1.20。无论母亲诊断癌症时的年龄如何,增加的风险在很大程度上是一致的。女性癌症幸存者后代先天性畸形的风险增加,这需要对那些计划生育的癌症幸存者给予进一步关注。