Obstetrical and perinatal complications in survivors of childhood, adolescent, and young adult cancer: A population-based study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 10529-10529
Author(s):  
Alina Zgardau ◽  
Paul C. Nathan ◽  
Sumit Gupta ◽  
Joel G. Ray ◽  
Nancy N. Baxter ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cancer Survivors ◽  
Brain Tumour ◽  
Young Adulthood ◽  
Cancer Diagnosis ◽  
Alkylating Agent ◽  
Adolescent And Young Adult ◽  
Perinatal Complications ◽  
Hematopoietic Stem ◽  
Cancer Group

10529 Background: Women who survive cancer diagnosed in childhood, adolescence or young adulthood may develop long-term health issues. Data are lacking on adverse reproductive outcomes such as infertility and obstetrical and perinatal complications. Methods: Using linked Ontario provincial cancer and obstetrical registries, we assembled a cohort of female cancer survivors diagnosed before age 21 years from 1985-2012. We matched survivors by age and geographic region to females without a prior cancer diagnosis. Outcomes included i) any recognized and past 20 weeks’ gestation pregnancy; ii) perinatal complications; and iii) obstetrical complications (including a broad composite of severe maternal morbidity [SMM]). Multivariable Cox proportional hazard and modified Poisson models compared survivors to a non-cancer group and assessed demographic, diagnostic and treatment risk factors in survivors. Results: 3,486 survivors were matched to 17,428 women without prior cancer. Median age at cancer diagnosis was 12 years (IQR 5-16) and median follow-up was 26 years (IQR 21-32). 599 (17.2%) survivors had at least one recognized pregnancy compared to 3,885 (22.3%) women without prior cancer (Hazard Ratio [HR] 0.79, 95% Confidence Interval [CI] 0.7-0.9, p < .0001). Among those who had a recognized pregnancy, 581 (97.0%) survivors carried a pregnancy > 20 weeks’ gestation vs. 3791 (97.6%) in the non-cancer group (Relative Risk [RR] 1.0, CI 0.98-1.04). Factors significantly associated with a decreased likelihood of achieving at least one recognized pregnancy among survivors included brain tumour, cranial radiation, exposure to an alkylating agent or hematopoietic stem cell transplantation (HSCT). Among women who had a livebirth or stillbirth, survivors had a RR of 2.3 (CI 1.5-3.6) for SMM and 3.2 (CI 1.6-6.6) for cardiac morbidity. Factors associated with SMM among survivors included brain tumour and pre-existing kidney disease. Among livebirth pregnancies, cancer survivors were at higher risk of preterm birth (RR 1.6, CI 1.2-2.0), especially those who received an alkylating agent or HSCT. Conclusions: Survivors of childhood, adolescence or young adulthood cancer are less likely to achieve a recognized pregnancy compared to women without prior cancer. Those who carry a pregnancy >20 weeks’ gestation are at higher risk for SMM and preterm birth. Fertility planning and counseling can be informed by cancer diagnosis and treatment, and high-risk obstetrical care is recommended for survivors at elevated risk of an adverse pregnancy outcome.

scholarly journals Psychiatric comorbidities among cancer survivors in South Korea: A nationwide, population-based, longitudinal study

2020 ◽  
Author(s):  
Jaesung Heo ◽  
O Kyu Noh
Keyword(s):  
Prostate Cancer ◽  
Substance Abuse ◽  
Longitudinal Study ◽  
Mental Disorders ◽  
South Korea ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Stress Reaction ◽  
Adjustment Disorders ◽  
Cancer Group

Abstract Background: This longitudinal study aimed to analyze the incidence of mental disorders in cancer survivors using claims data in South Korea. Methods: We confirmed the presence of mental disorders in a nationwide cohort of 555,776 patients diagnosed with stomach, breast, colorectal, or prostate cancer between January 1, 2010 and December 31, 2016. We analyzed the incidence of mental disorders based on age and time of diagnosis. Results: Analysis of the data revealed 36,526 (6.5%) cancer survivors were diagnosed with a mental disorder 1 year prior to cancer diagnosis. Of these patients with mental disorders, 16,035 were diagnosed with anxiety (43.9%), 13,848 with depression (37.9%), 3,998 with stress reaction/adjustment disorders (10.9%), and 2,645 (7.2%) with substance abuse during their first visit. The incidence of depression was relatively high in the breast-cancer group and that of anxiety was high in the prostate-cancer group. The incidence of anxiety was high in females and that of substance abuse was high in males. Further, the incidence of depression was relatively high in the young age group and that of anxiety was high in the elderly group. The overall frequency of mental disorders peaked 2 months after cancer diagnosis. The highest rate of increase after diagnosis was noted among those with stress reaction/adjustment disorders. Conclusion: Mental disorders in cancer survivors showed different patterns of incidence depending on the nature of the disease, sex, age, and primary cancer. Considering individual factors, timely diagnosis and intervention for psychological distress may increase these patients’ quality of life.

scholarly journals Perspectives Regarding Fertility in Female Adolescent and Young Adult Childhood Cancer Survivors

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1271-1271
Author(s):  
Pooja Rao ◽  
Priya Hirway ◽  
Jennifer JG Welch ◽  
Cindy L Schwartz
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Fertility Preservation ◽  
Cancer Diagnosis ◽  
Childhood Cancer Survivors ◽  
Female Adolescent ◽  
Life Goals ◽  
Adolescent And Young Adult

Abstract Introduction: Reproductive system injury, particularly ovarian failure, can be a devastating consequence of cancer treatment for female childhood cancer survivors. Recent advances in reproductive technology offer new fertility preservation techniques such as oocyte and ovarian tissue cryopreservation in addition to ovarian transposition and embryo cryopreservation. With rapid expansion of these reproductive technologies, it is imperative that we understand the personal perspectives regarding fertility of young female cancer patients. Better understanding of their attitudes will enable care providers to better counsel patients and families about options. We designed our study to evaluate the perspectives of female adolescent and young adult childhood cancer survivors regarding (a) fertility preservation procedures at the time of cancer diagnosis and (b) their prioritization of life goals, including fertility and motherhood. Methods: This study was a cross-sectional survey of female adolescent and young adult cancer survivors between 15-25 years of age at Hasbro Children's Hospital. Surveys were mailed to participants and followed with a reminder postcard and $5 incentive for participation. Written informed consent and assent were obtained. The primary study outcomes were responses to: (1) potential interest in fertility-sparing surgery at cancer diagnosis and (2) whether they would have waited to start cancer treatment if it increased future chances of becoming pregnant. Covariates included demographics (age at diagnosis, current age, race, ethnicity, education level) as well as prioritization of life goals, including fertility and motherhood, on a Likert scale from 0-5. Stata 12.0 (College Station, TX) was used to conduct chi-squared or t-tests for bivariate analysis. Logistic regression was used to calculate crude and adjusted odds ratios. Results: Sixty-five completed surveys were returned, with a 42% response rate. The mean age of subjects was 20.1 years (SD, 2.8). The majority (83.1%) were White, and non-Hispanic (92%). The most common participant cancer diagnoses were acute lymphoblastic leukemia, brain tumors, sarcomas and neuroblastoma. After adjusting for confounders including age at diagnosis and race, the odds of wanting surgery was higher (OR 2.41, 95% CI 1.42-4.09) for those who ranked pregnancy highly (> 4) and for those who ranked being a mother highly (OR 2.62, 95% CI 1.46-4.69) vs. those who did not. The adjusted odds of being willing to postpone cancer treatment for those who ranked pregnancy and motherhood highly (> 4) also remained statistically significant (OR 2.81, 95% CI 1.15-6.90; OR 3.73, 95% CI 1.14-12.6), respectively. Conclusion: Fertility and motherhood are important to female adolescent and young adult childhood cancer survivors. This study shows these young women would be interested in pursuing fertility preservation procedures at the time of cancer diagnosis, even if it meant a delay in starting cancer treatment. Pediatric oncologists should use this information to advise patients and families regarding fertility preservation options. A caveat remains however that patients would need to be counseled regarding the risks of such decisions in consideration of their specific illness. Disclosures No relevant conflicts of interest to declare.

Abstract PO-207: Cancer diagnosis in young adulthood as a risk factor for financial hardship among African American cancer survivors

2020 ◽  
Author(s):  
Theresa A. Hastert ◽  
Julie J. Ruterbusch ◽  
Mrudula Nair ◽  
Angie S. Wenzlaff ◽  
Jennifer L. Beebe-Dimmer ◽  
...  
Keyword(s):  
African American ◽  
Risk Factor ◽  
Cancer Survivors ◽  
Young Adulthood ◽  
Cancer Diagnosis ◽  
Financial Hardship

Prevention of Preterm Birth

2018 ◽  
Vol 11 (2) ◽  
pp. 95-104
Author(s):  
Ivan D. Ivanov ◽  
Stefan A. Buzalov ◽  
Nadezhda H. Hinkova
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
High Risk ◽  
Medical Science ◽  
Secondary Prophylaxis ◽  
High Risk Group ◽  
Screening Methods ◽  
Perinatal Complications ◽  
Social Significance ◽  
Neonatal Deaths

Summary Preterm birth (PTB) is a worldwide problem with great social significance because it is a leading cause of perinatal complications and perinatal mortality. PTB is responsible for more than a half of neonatal deaths. The rate of preterm delivery varies between 5-18% worldwide and has not decreased in recent years, regardless of the development of medical science. One of the leading causes for that is the failure to identify the high-risk group in prenatal care. PTB is a heterogeneous syndrome in which many different factors interfere at different levels of the pathogenesis of the initiation of delivery, finally resulting in delivery before 37 weeks of gestation (wg). The various specificities of risk factors and the unclear mechanism of initiation of labour make it difficult to elaborate standard, unified and effective screening to diagnose pregnant women at high-risk for PTB correctly. Furthermore, they make primary and secondary prophylaxis less effective and render diagnostic and therapeutic measures ineffective and inappropriate. Reliable and accessible screening methods are necessary for antenatal care, and risk factors for PTB should be studied and clarified in search of useful tools to solve issues of risk pregnancies to decrease PTB rates and associated complications.

scholarly journals Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors

Cancer ◽  
2019 ◽  
Vol 125 (11) ◽  
pp. 1908-1917 ◽  
Author(s):  
Tyler G. Ketterl ◽  
Karen L. Syrjala ◽  
Jacqueline Casillas ◽  
Linda A. Jacobs ◽  
Steven C. Palmer ◽  
...  
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Adolescent And Young Adult ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

scholarly journals Survivors’ Dilemma: Young Adult Cancer Survivors’ Perspectives of Work-Related Goals

2021 ◽  
pp. 216507992110126
Author(s):  
Lauren Victoria Ghazal ◽  
John Merriman ◽  
Sheila Judge Santacroce ◽  
Victoria Vaughan Dickson
Keyword(s):  
Content Analysis ◽  
Young Adult ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Financial Toxicity ◽  
Self Identity ◽  
Work Related ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

Background: Young adult cancer survivors have significant work-related challenges, including interruptions to education and employment milestones, which may affect work-related goals (WRGs). The study purpose was to explore posttreatment perspectives of WRGs in a sample of young adult hematologic cancer survivors. Methods: This qualitative descriptive study used social media to recruit eligible cancer survivors (young adults working or in school at the time of cancer diagnosis). Data were collected through telephone semi-structured interviews and analyzed using directed content analysis, followed by thematic content analysis to identify themes. Findings: The sample ( N = 40) were mostly female (63.5%), White (75%), and diagnosed with Hodgkin lymphoma (57.5%); most worked in professional (40%) or health care (23%) roles. The overarching theme, “Survivors’ Dilemma,” highlights a changed perspective on work-related fulfillment and financial obligations, capturing survivors’ decision-making process regarding work. Three subthemes illustrated questions that participants contemplated as they examined how their WRGs had changed: (a) Self-identity: Do I want to do this work? (b) Perceived health and work ability: Can I do this work? and (c) Financial toxicity: Can I afford to/not to do this work? Conclusions/Application to Practice: Participants experienced a state of dilemma around their WRGs, weighing areas around self-identity, perceived health and work ability, and financial toxicity. Findings suggest occupational health nurses should be aware of challenges surrounding WRGs, including how goals may change following a cancer diagnosis and treatment, and the potential stressors involved in the Survivors’ Dilemma. Occupational health nurses should assess for these issues and refer young survivors to employee and financial assistance programs, as necessary.

scholarly journals Physical Comorbidities and Depression in Recent and Long-Term Adult Cancer Survivors: NHANES 2007–2018

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3368
Author(s):  
Dafina Petrova ◽  
Andrés Catena ◽  
Miguel Rodríguez-Barranco ◽  
Daniel Redondo-Sánchez ◽  
Eloísa Bayo-Lozano ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Depression Symptoms ◽  
Depression Risk ◽  
Adult Cancer Survivors ◽  
Before And After ◽  
Nationally Representative ◽  
Risk Of Cancer

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

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