Department of Paediatric Haematology and Oncology, Royal Hospital for Children and Young People and University of Edinburgh, Edinburgh, UK.
School of Computer Science, University of St. Andrews, North Haugh, St. Andrews, UK.
Br J Cancer. 2024 Nov;131(8):1309-1319. doi: 10.1038/s41416-024-02818-0. Epub 2024 Sep 12.
Survival from childhood and adolescent cancer has increased, but the chance of a livebirth in female survivors under 18 years at diagnosis may be reduced.
We performed a national population-based analysis, including all female cancer survivors diagnosed in Scotland before the age of 18 years between 1981 and 2012. Scottish Cancer Registry records were linked to Scottish maternity records. Females from the exposed group with no pregnancies before cancer diagnosis (n = 2118) were compared with three general population controls matched for age and year of diagnosis.
The cumulative incidence of a livebirth for all diagnoses was reduced to 37% (95% CI 33-40%) for cancer survivors at 30 years of age vs 58% (57-60%) for controls. The deficit varying by diagnosis: for lymphoid leukaemia, the cumulative incidence at 30 years was 29% (23-36%) vs 57% (52-61%) for controls with similar deficits in CNS tumours and retinoblastoma. There was a steady improvement in the chance of livebirth in those diagnosed more recently.
We have shown a reduced chance of livebirth in female survivors of cancer diagnosed before age 18. The deficit is present for all diagnoses.
儿童和青少年癌症患者的生存率有所提高，但在诊断时未满 18 岁的女性幸存者生育活产儿的机会可能会降低。
我们进行了一项全国性的基于人群的分析，包括 1981 年至 2012 年间在苏格兰诊断为癌症前未满 18 岁的所有女性癌症幸存者。苏格兰癌症登记处的记录与苏格兰产妇记录相链接。在癌症诊断前没有怀孕的暴露组女性（n=2118 人）与年龄和诊断年份相匹配的 3 名普通人群对照进行比较。
所有诊断的活产儿累积发生率在 30 岁时降至癌症幸存者的 37%（95%CI 33-40%），而对照组为 58%（57-60%）。诊断结果不同，累积发生率也不同：在淋巴样白血病中，30 岁时的累积发生率为 29%（23-36%），对照组为 57%（52-61%），中枢神经系统肿瘤和视网膜母细胞瘤的累积发生率也相似。最近诊断的患者生育活产儿的机会稳步提高。
我们已经证明，在 18 岁之前被诊断患有癌症的女性幸存者生育活产儿的机会降低。所有诊断的患者都存在这种缺陷。
