Life after childhood cancer: marriage and offspring in adult long-term survivors – a population-based study in the Piedmont region, Italy

Abstract

The majority of childhood cancer cases survive to adulthood. We describe the experience of marriage and reproduction as indicators of quality of life, in a population-based cohort of adult long-term survivors after early cancer reported to the Childhood Cancer Registry of Piedmont. The study included 1237 survivors with a malignant neoplasm diagnosed during 1967-2000 when aged 0-14 years, who attained age 18 years. Vital and marital status and number of offspring were assessed through the Vital Statistics Offices. Marriage and fertility deficits were estimated by comparison with the Piedmont population. Among the individuals included in this study, 919 (74.3%) never married and never lived as married. The marriage deficit was 32% [observed/expected 0.68; 95% confidence interval (CI): 0.55-0.83] in men and 18% (observed/expected 0.82; 95% CI: 0.68-0.98) in women. A total of 179 children were born to 120 women, with a fertility deficit of 41% (observed/expected 0.59; 95% CI: 0.51-0.69). In conclusion, the observed decrements in marriage in men and women and fertility in women suggest that efforts should be made to improve the recovery from physical and psychological traumas related to diagnosis and treatment of cancer.

Marriage and parenthood among childhood cancer survivors: a report from the Italian AIEOP Off-Therapy Registry

“…These findings are in accordance with previous studies in Piedmont, 13,20 and Wales. 11 They confirm that, in some aspects, the social life of these subjects retains some significant difference, or even limitations, in comparison with that of their peers.…”

“…38 In this study, there was a significant excess of male offspring that persisted also after adjusting for birth order. This finding is consistent with those of previous studies conducted in Piedmont 13,20 (the Piedmont cohort is included in the present study and represents 9.7% of the OTR cohort) but has not been observed in other studies. [39][40][41][42][43][44] We can speculate that a wider use of assisted reproduction treatments, which are known to influence the gender ratio of children, might explain this finding.…”

“…[15][16][17][18][19] In Italy, the only attempts to assess the experience of marriage and parenthood of childhood cancer survivors have been carried out in a single region situated in the North-West of the country (representing approximately 7% of the whole Italian population) using data of the Childhood Cancer Registry of Piedmont. 13,20 In the present study, we used data from administrative sources and from the Italian Off-Therapy Registry (OTR), [21][22][23] maintained by the Italian Association of Pediatric Hematology and Oncology (AIEOP), to evaluate the experience of marriage and parenthood in a large cohort of long-term childhood cancer survivors.…”

Life beyond the disease: relationships, parenting, and quality of life among survivors of childhood cancer

“…In an earlier Italian study, there was a reported fertility deficit of 41%. 7 In Finland, only 15% of survivors parented at least one child compared to 58% of siblings. 8 The British Childhood Cancer Survivor Study reported only 31% of survivors having at least one child which is approximately two-thirds of what would be expected from British population statistics.…”

Fertility and Fecundity After Chemotherapy for Childhood Cancer

“…On average, the wedding rate of survivors of childhood cancer is 32% lower than that of the general population for men and 18% lower for women. The discrepancy is very sharply marked for survivors of brain tumors, who are affected by endocrine and neurological complications as well as emotional disorders (Dama 2009). …”