Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Int J Cancer. 2021 May 1;148(9):2184-2192. doi: 10.1002/ijc.33394. Epub 2020 Nov 23.
With the improvement of treatments, a growing number of survivors with childhood or adolescent central nervous system (CNS) tumor are parenting their own children. We aimed to explore the risk of somatic diseases among children of these survivors compared to population controls. Children of survivors with CNS tumor below age of 20 were identified between 1973 and 2014 by combining the several Swedish registers. Five children without parental CNS tumor were matched randomly to generate the population comparisons. Relative risk (RR) and absolute excess risk (AER) were calculated for overall somatic diseases, and hazard ratio (HR) was calculated for specific type of somatic diseases. A total of 2231 somatic disease diagnoses were identified in children of survivors with a cumulative incidence rate of 94.77 per 1000 person-years, whereas the rate was 92.79 in matched comparisons thus resulting in an overall RR of 1.02 (95% CI = 0.98-1.07) and AER of 1.98 (95% CI = -2.06, 6.13). Specifically, five of 1364 children of survivors had CNS tumor with an incidence rate of 0.21 per 1000 person-year, whereas the rate was 0.04 in children of matched children, generating a HR of 4.91 (95% CI = 1.42-16.96). Children of male survivors were at a statistically increased risk of malignancy, as well as infectious and parasitic diseases. In conclusion, no significantly higher risk of overall somatic diseases was found in children of survivors with CNS tumor before the age of 20, but children with a paternal diagnosis of CNS tumor had significantly increased risk of malignancies and infectious and parasitic diseases.
随着治疗方法的改进,越来越多的患有儿童或青少年中枢神经系统 (CNS) 肿瘤的幸存者开始养育自己的孩子。我们旨在探讨与人群对照相比,这些幸存者的子女患躯体疾病的风险。通过结合瑞典的多个登记处,我们于 1973 年至 2014 年期间确定了年龄在 20 岁以下的 CNS 肿瘤幸存者的子女。为了生成人群比较,我们随机匹配了 5 名没有父母 CNS 肿瘤的儿童。我们计算了总体躯体疾病的相对风险 (RR) 和绝对超额风险 (AER),以及特定类型躯体疾病的风险比 (HR)。共确定了 2231 例儿童幸存者的躯体疾病诊断,累积发病率为每 1000 人年 94.77 例,而匹配对照的发病率为 92.79 例,因此总体 RR 为 1.02 (95%CI = 0.98-1.07),AER 为 1.98 (95%CI = -2.06, 6.13)。具体来说,1364 名幸存者的子女中有 5 名患有 CNS 肿瘤,发病率为每 1000 人年 0.21 例,而匹配对照的子女发病率为 0.04 例,HR 为 4.91 (95%CI = 1.42-16.96)。男性幸存者的子女患恶性肿瘤以及传染病和寄生虫病的风险统计学上增加。总之,在 20 岁之前,CNS 肿瘤幸存者的子女总体躯体疾病风险没有显著增加,但患有父亲 CNS 肿瘤诊断的子女患恶性肿瘤以及传染病和寄生虫病的风险显著增加。