Maraschini Alice, Corsi Decenti Edoardo, Donati Serena, Francisci Silvia, Lopez Tania, Amodio Rosalba, Bianconi Fortunato, Bovo Emanuela, Bruni Rossella, Castaing Marine, Cirilli Claudia, De Vincenzo Rosa Pasqualina, Furgiuele Giuseppe, Guarda Linda, Iacovacci Silvia, Mangone Lucia, Mazzucco Walter, Melcarne Anna, Merlo Elisabetta, Mian Michael, Sampietro Giuseppe, Scambia Giovanni, Scuderi Tiziana, Sferrazza Ausilia, Stracci Fabrizio, Torrisi Antonina, Trojano Vito, Vitale Maria Francesca, Pierannunzio Daniela
Technical-Scientific Statistical Service, Italian National Institute of Health, Rome, Italy.
National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy.
Tumori. 2025 Feb;111(1):71-78. doi: 10.1177/03008916241298810. Epub 2024 Dec 2.
Concurrence of pregnancy and cancer diagnosis is increasingly frequent in Italy. The study aimed to compare women with pregnancy-associated cancers (PACs) to those of childbearing age, focusing on fertility, induced abortion, and miscarriage.
The population-based study included women aged 15-49 years, both with and without PAC, who were residents in the area covered by the 19 participating Cancer Registries between 2003 and 2015 and identified by individual deterministic linkage with the Hospital Discharge Database.
Overall, 2,218,139 obstetrics hospitalizations occurred, covering delivery (75%), induced abortion (14%), and miscarriage (11%). Among 2409 women with PAC, 69% gave birth, 16% had an induced abortion and 15% a miscarriage. Compared with the reference population, the fertility rate in women with PACs was steadily lower (mean values 25.7/1000 vs 37.7/1000), while induced abortion (from 359/1000 - SRR 1.99, 95%CI 1.32-3.00 - in 2003 to 147/1000 - SRR 1.11, 95%CI 0.59-2.09 - in 2015) and miscarriage ratios exhibited a decreasing trend.
These results are consistent with international literature and are probably due to advancements in diagnostic and therapeutic opportunities. This is the first Italian population-based study analysing fertility and pregnancy outcomes among women with PAC based on a reliable information on cancer diagnosis.
在意大利，妊娠与癌症诊断同时发生的情况越来越常见。本研究旨在比较妊娠相关癌症（PAC）患者与育龄女性，重点关注生育力、人工流产和自然流产。
这项基于人群的研究纳入了15至49岁的女性，包括患有和未患有PAC的女性，她们是2003年至2015年间19个参与癌症登记处覆盖地区的居民，并通过与医院出院数据库的个体确定性链接进行识别。
总体而言，共发生了2218139例产科住院病例，其中分娩占75%，人工流产占14%，自然流产占11%。在2409例患有PAC的女性中，69%分娩，16%进行了人工流产，15%发生了自然流产。与参照人群相比，患有PAC的女性生育率持续较低（平均值分别为25.7/1000和37.7/1000），而人工流产率（从2003年的359/1000 - 标准化发病比1.99，95%置信区间1.32 - 3.00降至2015年的147/1000 - 标准化发病比1.11，95%置信区间0.59 - 2.09）和自然流产率呈下降趋势。
这些结果与国际文献一致，可能归因于诊断和治疗机会的进步。这是意大利第一项基于人群的研究，基于癌症诊断的可靠信息分析患有PAC的女性的生育力和妊娠结局。
