Cancer survival in women diagnosed with pregnancy- associated cancer: An overview using nationwide registry data in Sweden 1970-2018

被引:26
作者
Johansson, Anna L., V [1 ,2 ]
Fredriksson, Irma [3 ,4 ]
Mellemkjaer, Lene [5 ]
Stensheim, Hanne [6 ]
Lahteenmaki, Paivi [7 ,8 ]
Winther, Jeanette F. [9 ,10 ,11 ]
Ullenhag, Gustav J. [12 ,13 ]
Lundberg, Frida E. [1 ,14 ]
机构
[1] Karolinska Inst, Dept Med Epidemiol & Biostat, POB 281, SE-17177 Stockholm, Sweden
[2] Canc Registry Norway, Oslo, Norway
[3] Karolinska Univ Hosp, Dept Breast Endocrine Tumors & Sarcoma, D2 02, SE-16757 Oslo, Sweden
[4] Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
[5] Danish Canc Soc Res Ctr, Breast Canc Epidemiol Grp, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
[6] Canc Registry Norway, Dept Res, Box 5313, N-0304 Oslo, Norway
[7] Karolinska Inst, Swedish Childhood Canc Registry, Tomtebodav Gen 18A, SE-17165 Solna, Sweden
[8] Turku Univ Hosp, Turku, Finland
[9] Danish Canc Soc, Childhood Canc Res Grp, Res Ctr, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
[10] Aarhus Univ, Fac Hlth, Dept Clin Med, Aarhus, Denmark
[11] Univ Hosp, Aarhus, Denmark
[12] Uppsala Univ Hosp, Dept Oncol, Entrance 101, SE-75185 Uppsala, Sweden
[13] Uppsala Univ, Dept Immunol Genet & Pathol, Uppsala, Sweden
[14] Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden
基金
瑞典研究理事会;
关键词
Pregnancy; Cancer; Pregnancy-associated cancer; Mortality; Survival; BREAST-CANCER; BIOLOGICAL FEATURES; CERVICAL-CANCER; GASTRIC-CANCER; PROGNOSIS; CARCINOMA; MORTALITY; MELANOMA; MANAGEMENT; DENMARK;
D O I
10.1016/j.ejca.2021.07.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Pregnancy-associated cancer (PAC) is increasing over time in many countries. We provide a comprehensive, population-based overview of cancer survival in women with PAC across five decades. Methods: We performed a nationwide cohort study of 121,382 women diagnosed with cancer at age 15-49 between 1970 and 2018 using birth and cancer registers in Sweden. Pregnancy associated cancer was defined as diagnosed during pregnancy and within one year of delivery, while non-PAC was outside this window. Cox regression estimated adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) comparing cancer mortality for PAC versus non-PAC. Results: In total, 5079 women had a diagnosis of PAC. Cutaneous malignant melanoma, breast, cervical, thyroid and central nervous system (CNS) were the most common sites of PAC. A higher cancer mortality was observed in PAC versus non-PAC for breast (HR = 1.72, 95% CI 1.54-1.93) and uterine cancer (myometrium/unspecified) (8.62, 2.80-26.53), in which all PAC deaths were uterine sarcomas. Increased mortality was also observed in upper digestive tract cancer diagnosed during pregnancy and colon cancer diagnosed during first year after delivery. Contrary, the HR for CNS tumours was significantly decreased (0.71, 0.55-0.91). Survival after PAC improved for most sites over time, with survival after breast cancer during pregnancy in recent years being similar to that of non-pregnancy associated breast cancer. Conclusion: For the majority of sites, PAC was not associated with poorer prognosis compared to non-PAC, a finding which was stable over time. The main exceptions were breast cancer and rarer cancers, such as uterine sarcoma. (C) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
引用
收藏
页码:106 / 115
页数:10
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