Pregnancy-Associated Cancer: A U.S. Population-Based Study

Abstract

Background: The incidence of pregnancy-associated cancer (PAC) is expected to increase as more women delay childbearing until later ages. However, information on frequency and incidence of PAC is scarce in the United States. Methods: We identified pregnancies among women aged 10-54 years during 2001-2013 from five U.S. health plans participating in the Cancer Research Network (CRN) and the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). We extracted information from the health plans' administrative claims and electronic health record databases, tumor registries, and infants' birth certificate files to estimate the frequency and incidence of PAC, defined as cancer diagnosed during pregnancy and up to 1 year postpartum. Results: We identified 846 PAC events among 775,709 pregnancies from 2001 to 2013. The overall incidence estimate was 109.1 (95% confidence interval [CI] = 101.8-116.7) per 100,000 pregnancies. There was an increase in the incidence between 2002 and 2012 (the period during which complete data were available), from 75.0 (95% CI = 54.9-100.0) per 100,000 pregnancies in 2002 to 138.5 (95% CI = 109.1-173.3) per 100,000 pregnancies in 2012. The most common invasive cancers diagnosed were breast (n = 208, 24.6%), thyroid (n = 168, 19.9%), melanoma (n = 93, 11.0%), hematologic (n = 87, 10.3%), and cervix/uterus (n = 74, 8.7%). Conclusions: Our study provides contemporary incidence estimates of PAC from a population-based cohort of U.S. women. These estimates provide the data needed to help develop clinical and public health policies aimed at diagnosing PAC at an early stage and initiating appropriate therapeutic interventions in a timely manner.

Frequency of Pregnancy-Associated Cancer: A Systematic Review of Population-Based Studies

“…The majority of the studies were based on national registries. Five studies relied on a database covering 20% of country community hospital inpatient stays [12,13,[15][16][17], and one used data from two multicentric studies [14]. Among the registry-based studies, ten used data from a linkage between a hospital discharge registry, a maternal/birth registry and a cancer registry [2][3][4][6][7][8][9][10]25,26].…”

“…Most of the studies on PACs reported the most frequent types of tumor [2][3][4][5]14,18,[20][21][22][23][24] (Table S1). In a Swedish study, the most common tumors were breast, melanoma and cervical cancer.…”

“…Italian studies reported breast and thyroid as the most common cancer types, followed by skin cancer [23] or lymphoma [24]. In the studies for the USA, the two most frequent tumors were breast and thyroid cancer, followed by cervical cancer [4,5] or melanoma [14]. In the Australian ones, the most common cancer was melanoma, followed by breast and thyroid/endocrine tumors.…”

Real-World Data Analysis of Pregnancy-Associated Breast Cancer at a Tertiary-Level Hospital in Romania

“…Breast cancer (BC) is the most frequent female cancer worldwide, and the leading cause of cancer-related death among women [ 1 ]. It is also one of the most common types of cancer encountered during pregnancy [ 2 , 3 ]. Data regarding the global burden of disease between 1990–2017 among Romanian women of fertile age (15–49 years) reveal that although the number of BC-related deaths has decreased, the importance of BC as a cause of mortality has increased by 38.51%.…”

Identification of core genes and clinical roles in pregnancy-associated breast cancer based on integrated analysis of different microarray profile datasets

“…Pregnancy-related disease occurs in 0.2-3.8% of all breast cancer patients, comprising 1:10000 to 1:3000 pregnancies. The prevalence is much higher in pre-menopausal women, with 10-25% of breast cancers estimated to be pregnancy-associated [4][5][6][7][8][9].…”