Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.
Unit of Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark.
Cancer. 2021 Oct 15;127(20):3881-3892. doi: 10.1002/cncr.33791. Epub 2021 Jul 23.
During the past 4 decades, there has been a growing focus on preserving the fertility of patients with childhood cancer; however, no large studies have been conducted of live births across treatment decades during this period. Therefore, the authors estimated the potential birth deficit in female childhood cancer survivors and the probability of live births.
In total, 8886 women were identified in the 5 Nordic cancer registries in whom a childhood cancer had been diagnosed during 1954 through 2006. A population comparison cohort of 62,903 women was randomly selected from the central population registries matched by age and country. All women were followed for live births recorded in medical birth registries. The cumulative probability and the risk ratio (RR) with 95% confidence intervals (CIs) of a live birth were calculated by maternal age across treatment decades.
The probability of a live birth increased with treatment decade, and, at age 30 years, the rate for survivors most recently diagnosed was close to the rate among the general population (1954-1969: RR, 0.65 [95% CI, 0.54-0.78]; 1970s: RR, 0.67 [95% CI, 0.60-0.74]; 1980s: RR, 0.69 [95% CI, 0.64-0.74]; 1990s: RR, 0.91 [95% CI, 0.87-0.95]; 2000s: RR, 0.94 [95% CI, 0.91-0.97]).
Female childhood cancer survivors had a lower probability of a live birth than women in the general population, although, in survivors diagnosed after 1989, the probability was close to that of the general population. Because the pattern of live births differs by cancer type, continuous efforts must be made to preserve fertility, counsel survivors, and refer them rapidly to fertility treatment if necessary.
The purpose of this study was to compare the probability of giving birth to a liveborn child in female survivors of childhood cancer with that of women in the general population. Survivors of childhood cancer had a lower probability of live births than women in the general population, although survivors diagnosed after 1989 had a probability close to that of the general population. Continuing focus on how to preserve the potential for fertility among female patients with childhood cancer during treatment is important to increase their chances of having a child.
在过去的 40 年里，人们越来越关注保护儿童癌症患者的生育能力；然而，在此期间，并没有针对这一时期不同治疗阶段的活产儿进行大型研究。因此，作者估计了女性儿童癌症幸存者的潜在生育缺陷和活产儿的概率。
在总共 5 个北欧癌症登记处中，确定了 8886 名女性，她们在 1954 年至 2006 年期间被诊断患有儿童癌症。从中央人口登记处随机选择了 62903 名年龄和国家匹配的女性作为人口对照队列。所有女性均随访医疗出生登记处记录的活产儿。根据母亲年龄计算了不同治疗阶段的活产儿累积概率和风险比（RR）及其 95%置信区间（CI）。
活产儿的概率随着治疗阶段的增加而增加，在 30 岁时，最近诊断为幸存者的活产儿率接近普通人群的活产儿率（1954-1969 年：RR，0.65[95%CI，0.54-0.78]；1970 年代：RR，0.67[95%CI，0.60-0.74]；1980 年代：RR，0.69[95%CI，0.64-0.74]；1990 年代：RR，0.91[95%CI，0.87-0.95]；2000 年代：RR，0.94[95%CI，0.91-0.97]）。
与普通人群相比，女性儿童癌症幸存者活产儿的概率较低，但在 1989 年后被诊断为癌症的幸存者中，这一概率接近普通人群。由于活产儿的模式因癌症类型而异，因此必须继续努力保护生育能力，为幸存者提供咨询，并在必要时迅速将其转介至生育治疗。
本研究的目的是比较儿童癌症幸存者女性与普通人群女性生育活产儿的概率。与普通人群相比，儿童癌症幸存者的活产儿概率较低，但在 1989 年后被诊断为癌症的幸存者中，这一概率接近普通人群。在治疗期间继续关注如何保护女性儿童癌症患者的生育能力对提高她们生育的机会非常重要。
