Study protocol for the Fex-Can Childhood project

Ljungman, Lisa; Anandavadivelan, Poorna; Jahnukainen, Kirsi; Lampic, Claudia; Wettergren, Lena

doi:10.1097/md.0000000000019919

Cited by 10 publications

(12 citation statements)

References 64 publications

(66 reference statements)

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“…This study is part of the Fex‐Can Childhood project, which is a nationwide population‐based research initiative investigating the prevalence and predictors of sexual dysfunction and fertility‐related distress in young adult survivors of childhood cancer 15 . The project included all survivors who had been diagnosed with cancer before the age of 18 years and who were 19–40 years old and residents in Sweden at the time of enrolment.…”

Section: Methodsmentioning

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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Section: Methodsmentioning

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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“…Our study is part of the national population‐based Fex‐Can Childhood project addressing the prevalence and predictors of sexual dysfunction and fertility‐related distress in young adult childhood cancer survivors 10 . It included all survivors in the National Quality Registry for Childhood Cancer in Sweden who were 19 to 40 years of age and residents in Sweden at the time of enrolment.…”

Section: Methodsmentioning

confidence: 99%

“…Sociodemographic data, medication use and information on menstruation and fertility were retrieved from a survey consisting of validated self‐report instruments and study‐specific items. The survey was sent to all eligible participants together with a letter describing the study 10 . The survey could be completed on paper, Web or by telephone interview.…”

Section: Methodsmentioning

confidence: 99%

“…The survey was sent to all eligible participants together with a letter describing the study. 10 The survey could be completed on paper, Web or by telephone interview. Two reminders were sent out to the nonresponders.…”

Section: Methodsmentioning

confidence: 99%

“…Our study is part of the national population-based Fex-Can Childhood project addressing the prevalence and predictors of sexual dysfunction and fertility-related distress in young adult childhood cancer survivors. 10 It included all survivors in the National Quality Registry for Childhood Cancer in Sweden who were 19 to 40 years of age and residents in Sweden at the time of enrolment. The registry included patients diagnosed with cancer before the age of 18 years; however, during the 1980s and part of the 1990s only patients diagnosed before the age of 16 were treated at the child oncology units and, hence, included in the registry.…”

Section: Participantsmentioning

confidence: 99%

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

Haavisto

Wettergren

Lampic

et al. 2023

Intl Journal of Cancer

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Endocrine complications are a common late effect after childhood cancer. Our study assessed the prevalence and predictors of premature ovarian insufficiency (POI) and prospects of pregnancy in young female survivors. This nationwide study combined registry and survey data for female childhood cancer survivors aged 19 to 40 years, identified through the National Quality Registry for Childhood Cancer in Sweden. Of 1989 approached young women, 1333 (67%) participated by completing a survey.Median age at diagnosis 1981 to 2017 was 6 (range 0-17) and at study 28 (19-40) years. There were two indicators of POI, induced puberty reported in 5.3% and estrogen replacement therapy (ERT) in 9.3% at assessment. In separate logistic regression analyses (P < .001), induced puberty and ERT were significantly predicted by hematopoietic stem cell transplantation (HSCT), abdominal irradiation, central nervous system irradiation and chemotherapy. ERT was also associated with older age at diagnosis. Of the 626 women (48% of responders) who had tried to become pregnant, 25% had undergone fertility investigations and 72% reported having a biological child. Treatment with HSCT was associated with 5.4 times the odds of needing fertility investigations (P < .001). Having a biological child was associated with non-HSCT treatment, but also with ever having had a partner and older age at the time of study Abbreviations: AOF, acute ovarian failure; CNS, central nervous system; ERT, estrogen replacement therapy; HSCT, hematopoietic stem cell transplantation; POI, premature ovarian insufficiency; TBI, total body irradiation.

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Body image in adolescent survivors of childhood cancer: The role of chronic health conditions

Belle

Sláma

Schindera

et al. 2022

Pediatric Blood & Cancer

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Background Cancer and its treatment may impair the body image of childhood cancer survivors during adolescence. We compared the body image between adolescent cancer survivors and their siblings, and determined whether survivors’ body image is associated with socio‐demographic characteristics, clinical characteristics and chronic health conditions. Procedure As part of the nationwide Swiss Childhood Cancer Survivor Study, we sent questionnaires to adolescents (aged 16–19 years), who survived >5 years after having been diagnosed with childhood cancer between 1989 and 2010. Siblings received the same questionnaire. We assessed the level of agreement with three body image statements referring to body satisfaction and preferences for changes. Chronic health conditions were classified into cardiovascular, pulmonary, endocrine, musculoskeletal, renal/digestive, neurological and hearing or vision impairment. We used ordered logistic regression models to identify determinants of a more negative body image. Results Our study included 504 survivors (48% female) with a median age at study of 17.7 years (interquartile range: 16.8–18.6) and 136 siblings. Survivors and siblings reported overall comparable levels of agreement with body image statements (all p > .05). Female survivors (all odds ratio [ORs] ≥1.7), survivors treated with haematopoietic stem cell transplantation (HSCT; all ORs ≥2.2), and survivors with ≥2 chronic health conditions (all ORs ≥1.4) reported a more negative body image. This was particularly pronounced for survivors suffering from musculoskeletal or endocrine conditions. Conclusion Female survivors, survivors treated with HSCT or with chronic health conditions are at risk of body image concerns during adolescence. Increased awareness among clinicians and targeted psychosocial support could mitigate such concerns.

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Study protocol for the Fex-Can Childhood project

Abstract: Supplemental Digital Content is available in the text

Cited by 10 publications

References 64 publications

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

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

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

Body image in adolescent survivors of childhood cancer: The role of chronic health conditions

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