University of Texas Health Science Center at Houston, School of Public Health, Dallas, Texas, USA.
Center for Pediatric Population Health, Dallas, Texas, USA.
Cancer. 2024 Sep 1;130(17):2928-2937. doi: 10.1002/cncr.35341. Epub 2024 May 2.
Fertility after cancer is a top concern for adolescents and young adults with cancer (AYAs) (15-39 years old at diagnosis). The authors characterized live births after cancer by race and ethnicity ("race/ethnicity") in a population-based sample of female AYAs.
This study used Texas Cancer Registry data linked to birth certificates (1995-2016) to estimate cumulative incidence of live birth, based on first live birth after cancer, and compared differences by race/ethnicity. Proportional subdistribution hazards models were used to estimate associations between race/ethnicity and live birth, adjusted for diagnosis age, cancer type, stage, year, and prior live birth, overall and for each cancer type.
Among 65,804 AYAs, 10-year cumulative incidence of live birth was lower among non-Hispanic Black AYAs than other racial/ethnic groups: 10.2% (95% confidence interval [CI], 9.4-10.9) compared to 15.9% (95% CI, 14.1-17.9) among Asian or Pacific Islander, 14.7% (95% CI, 14.2-15.3) among Hispanic, and 15.2% (95% CI, 14.8-15.6) among non-Hispanic White AYAs (p < .01). In the adjusted overall model, Black AYAs were less likely to have a live birth after cancer than all other groups. In adjusted models for each cancer type, live birth was significantly less likely for Black AYAs with gynecologic cancers or lymphomas (compared to White AYAs) or thyroid cancers (compared to Hispanic AYAs).
Black AYAs are less likely than AYAs of other races/ethnicities to have a live birth after cancer, in contrast to patterns of live birth in the general population. Research and action to promote childbearing equity after cancer are imperative.
癌症后的生育能力是癌症青少年和年轻人（15-39 岁诊断时）最关心的问题。作者在基于人群的女性青少年和年轻人样本中，按种族和民族（“种族/民族”）描述了癌症后的活产。
本研究使用德克萨斯癌症登记处的数据与出生证明（1995-2016 年）相关联，根据癌症后首次活产来估计活产的累积发生率，并按种族/民族进行比较。使用比例亚分布风险模型估计种族/民族与活产之间的关联，调整了诊断年龄、癌症类型、分期、年份和既往活产，总体和每种癌症类型。
在 65804 名青少年和年轻人中，非西班牙裔黑人青少年和年轻人的活产 10 年累积发生率低于其他种族/民族群体：10.2%（95%置信区间 [CI]，9.4-10.9），而亚洲或太平洋岛民为 15.9%（95% CI，14.1-17.9），西班牙裔为 14.7%（95% CI，14.2-15.3），非西班牙裔白人为 15.2%（95% CI，14.8-15.6）（p<0.01）。在调整后的总体模型中，黑人青少年和年轻人癌症后活产的可能性低于其他所有群体。在每种癌症类型的调整模型中，黑人青少年和年轻人的妇科癌症或淋巴瘤（与白人青少年和年轻人相比）或甲状腺癌（与西班牙裔青少年和年轻人相比）活产的可能性明显较低。
与一般人群的活产模式相反，黑人青少年和年轻人癌症后活产的可能性低于其他种族/民族的青少年和年轻人。迫切需要开展研究和采取行动，促进癌症后生育公平。
