Premature ovarian insufficiency and chance of pregnancy after childhood cancer: A population‐based study (the <scp>Fex‐Can</scp> study)

Haavisto, Anu; Wettergren, Lena; Lampic, Claudia; Lähteenmäki, Päivi; Jahnukainen, Kirsi

doi:10.1002/ijc.34541

Cited by 12 publications

(4 citation statements)

References 23 publications

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“…Patients with hematopoietic stem cell transplantation had an OR of 18.5 (95% CI 10.8 to 31.8) for estrogen replacement therapy. 29 During our follow‐up period, there have been no drastic changes in treatment protocols in the most common cancer groups. In hematological malignancies, for example myeloid leukemia, most of the adults and a majority of the childhood cancer patients had received a stem cell transplant during our follow‐up period.…”

Section: Discussionmentioning

confidence: 92%

Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

Silvén,

Savukoski,

Pesonen

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionTo investigate the occurrence of previous cancer diagnoses in women suffering from premature ovarian insufficiency (POI) and compare it with the general population, shedding light on the association between cancer, cancer treatments, and POI.Material and methodsWe conducted a nationwide case–control study based on registry data from various sources, including the Social Insurance Institution, Finnish Population Information System, and Finnish Cancer Registry spanning from 1953 to 2018. Our subjects comprised all women in Finland who, between 1988 and 2017, received hormone replacement therapy reimbursement for ovarian insufficiency before the age of 40 years (n = 5221). Controls, matched in terms of age and municipality of residence, were selected from the Finnish Population Information System (n = 20 822). Our main exposure variable was a history of cancer diagnosis preceding the diagnosis of POI. We analyzed odds ratios (OR) to compare the prevalence of previous cancers in women with POI with that in controls, stratifying results based on cancer type, age at cancer diagnosis, and the time interval between cancer diagnosis and POI. We also assessed changes in OR for previous cancer diagnoses over the follow‐up period.ResultsOut of the women diagnosed with POI, 21.9% had previously been diagnosed with cancer, resulting in an elevated OR of 36.5 (95% confidence interval [CI] 30.9 to 43.3) compared with 0.8% of the controls. The risk of developing POI was most pronounced during the first 2 years following a cancer diagnosis, with an OR of 103 (95% CI 74.1 to 144). Importantly, this risk remained elevated even when the time interval between cancer and POI exceeded 10 years, with an OR of 5.40 (95% CI 3.54 to 8.23).ConclusionsThis study reveals that 21.9% of women with POI have a history of cancer, making the prevalence of cancer among these women 27.5 times higher than age‐matched controls in the Finnish population. The risk of developing POI is most substantial in the first 2 years following a cancer diagnosis. These findings underscore the role of cancer treatments as an etiological factor for POI and emphasize the importance of recognizing the risk of POI in cancer survivors for early diagnosis and intervention.

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Section: Discussionmentioning

confidence: 92%

Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

Silvén,

Savukoski,

Pesonen

et al. 2024

Acta Obstet Gynecol Scand

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“…21 Abdominal irradiation was not associated with these endocrine or offspring-related outcomes, which is contrary to our observation in a recently reported population-based female cohort. 28 Since only 20 survivors had abdominal irradiation, this analysis may have been underpowered. We also lacked information about scatter doses to the testes.…”

Section: Discussionmentioning

confidence: 99%

Reproductive late effects and testosterone replacement therapy in male childhood cancer survivors: A population‐based study (the Fex‐Can study)

Haavisto,

Lampic,

Wettergren

et al. 2024

Intl Journal of Cancer

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Childhood cancer survivors are at risk of various endocrine late effects affecting their quality of life. The aim of this study was to assess the prevalence and predictors of endocrine and reproductive outcomes in young adult survivors. A secondary aim was to assess possible associations between testosterone replacement therapy (TRT) and other endocrine, cardiovascular and psychosocial late effects. This nationwide study comprised 1212 male childhood cancer survivors aged 19–40 years, identified through the National Quality Registry for Childhood Cancer in Sweden. Median age at diagnosis during 1981–2017 was 7 (range 0–17) and at study 29 (19–40) years. The study combined self‐report survey data with cancer treatment data from the national registry. Hormone‐induced puberty was self‐reported by 3.8% of the survivors and ongoing TRT by 6.0%. In separate logistic regression analyses, these treatments were associated with hematopoietic stem cell transplantation and cranial radiotherapy. Hormone‐induced puberty was additionally associated with younger age at diagnosis. Men with TRT had a higher prevalence of other endocrine deficiencies, cholesterol medication, depressive symptoms and fatigue as well as a lower probability of living with a partner, having a biological child or current occupation. In the total male cohort, 28.2% reported having a biological child. Reassuring reproductive outcomes after less intensive therapies and low frequency of TRT were observed in young adult male childhood cancer survivors treated in the most recent treatment era. However, men with TRT suffered from several other endocrine, cardiovascular and psychosocial late effects, indicating a need for long‐term monitoring of this high‐risk group.

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“…Эти результаты подчеркивают важность своевременного выполнения криоконсервации тканей яичника. Вследствие временной или перманентной недостаточности яичников у девушек постпубертатного возраста репродуктивная функция нарушается, а у девочек, не достигших полового созревания, оно откладывается или не наступает вовсе [11].…”

Section: г и н е к о л о г и я | G Y N E C O L O G Yunclassified

Methods for preserving fertility in childhood cancer patients

Adamyan,

Sibirskaya,

Pivazyan

et al. 2024

Opuholi ženskoj reproduktivnoj sistemy

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Each year, more than 400,000 children and adolescents under the age of 18 are diagnosed with cancer. The most common nosologies in childhood are leukemia, lymphoma and brain tumors. The use of chemoradiotherapy as an antitumor treatment in these cases is associated with a high risk of gonadotoxicity. The preservation of fertility in children and adolescents during malignant tumor therapy is one of the key aspects of treatment. To date, there are many unresolved issues in this problem, affecting the preservation of both physical and psychological health of patients in adulthood. The main methods of maintaining the reproductive function in girls are cryopreservation of ovarian tissue or oocytes, ovarian autotransplantation, the use of assisted reproductive technologies, including the techniques of in vitro fertilization and in vitro oocyte maturation, oophoropexy and neoadjuvant cytoprotective pharmacotherapy. The choice of fertility preservation method depends on many factors: the overall condition of the child, the type of malignant disease, the age and sexual status of the patient, the capabilities of the medical center, as well as legal and financial aspects. Due to the lack of information on pediatric oncofertility, large-scale multicenter clinical trials involving children and adolescents are needed.

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Premature ovarian insufficiency and chance of pregnancy after childhood cancer: A population‐based study (the Fex‐Can study)

Cited by 12 publications

References 23 publications

Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

Reproductive late effects and testosterone replacement therapy in male childhood cancer survivors: A population‐based study (the Fex‐Can study)

Methods for preserving fertility in childhood cancer patients

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