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Hoefgen HR, Benoit J, Chan S, Jayasinghe Y, Lustberg M, Pohl V, Saraf A, Schmidt D, Appiah LC. Female reproductive health in pediatric, adolescent, and young adult cancer survivors. Pediatr Blood Cancer 2023; 70 Suppl 5:e29170. [PMID: 37381166 DOI: 10.1002/pbc.29170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 06/30/2023]
Abstract
An estimated 500,000 cancer survivors of reproductive age in the United States will live to experience the long-term consequences of cancer treatment. Therefore, a focused aspect of cancer care has appropriately shifted to include quality of life in survivorship. Infertility is a late effect of therapy that affects 12% of female survivors of childhood cancer receiving any cancer treatment in large cohort studies and results in a 40% decreased likelihood of pregnancy in young adults of ages 18-39 years. Nonfertility gynecologic late effects such as hypoestrogenism, radiation-induced uterine and vaginal injury, genital graft-versus-host disease after hematopoietic stem cell transplant, and sexual dysfunction also significantly affect quality of life in survivorship but are underdiagnosed and require consideration. Several articles in the special edition "Reproductive Health in Adolescent and Young Adult Cancer Survivorship" address infertility, genital graft-versus-host disease, and psychosexual functioning in survivorship. This review article focuses on other adverse gynecologic outcomes of cancer therapies including hypogonadism and hormone replacement therapy, radiation-induced uterovaginal injury, vaccination and contraception, breast and cervical cancer screening, and pregnancy considerations in survivorship.
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Affiliation(s)
- Holly R Hoefgen
- Division of Pediatric and Adolescent Gynecology, Department of Obstet Gynecol, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Janie Benoit
- Gynecology & Reproductive Sciences, CHU Ste-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Serena Chan
- Division of Pediatric and Adolescent Gynecology, Department of Obstetrics, Gynecology & Reproductive Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yasmin Jayasinghe
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Maryam Lustberg
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Victoria Pohl
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Amanda Saraf
- Division Pediatric Hematology Oncology, Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
| | - Deb Schmidt
- MACC Fund Center for Cancer and Blood Disorders, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Leslie Coker Appiah
- Division of Pediatric and Adolescent Gynecology, Department of Obstet Gynecol, Children's Hospital Colorado, University of Colorado Denver, Denver, Colorado, USA
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Association of Cytokine Gene Polymorphisms with Prostate Cancer Risk from a Study in Central China. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:1259009. [PMID: 36034203 PMCID: PMC9392598 DOI: 10.1155/2022/1259009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022]
Abstract
Our study intended to investigate five cytokine gene single nucleotide polymorphisms (SNPs) and their associations with prostate cancer risk. Genotypes of five cytokine gene SNPs were detected by MassARRAY for blood samples from a group of patients with prostate cancer (n = 90) and a control group (n = 140) in central China. The differences in tumor clinical stages, Gleason scores, and PSA values in patients with prostate cancer were also investigated. The frequencies of the five cytokine gene SNPs (L-1β rs16944, IL-4 rs2070874, IL-4rs2227284, IL-16 rs7175701, and IL-16 rs11556218) genotypes were not found to be significantly mutated in prostate cancer patients compared with the control group. In addition, for five cytokine gene SNPs genotypic comparisons, patients with different Gleason scores, clinical stages, and PSA values were grouped into two subgroups. There was also no statistically significant association in all these subgroups. Our study suggests that cytokine gene polymorphisms may not be a risk factor for prostate cancer in a central Chinese population. Nevertheless, more large-scale studies on the Chinese population are necessary to examine our conclusions. The discovery of cytokine gene polymorphisms related to prostate cancer could update our understanding of the etiology and improve our knowledge of the early detection, diagnosis, and treatment of prostate cancer.
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Hessels AC, Langendijk JA, Gawryszuk A, A.A.M. Heersters M, van der Salm NL, Tissing WJ, van der Weide HL, Maduro JH. Review – late toxicity of abdominal and pelvic radiotherapy for childhood cancer. Radiother Oncol 2022; 170:27-36. [DOI: 10.1016/j.radonc.2022.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 11/15/2022]
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Petersen JM, Ranker LR, Barnard-Mayers R, MacLehose RF, Fox MP. A systematic review of quantitative bias analysis applied to epidemiological research. Int J Epidemiol 2021; 50:1708-1730. [PMID: 33880532 DOI: 10.1093/ije/dyab061] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Quantitative bias analysis (QBA) measures study errors in terms of direction, magnitude and uncertainty. This systematic review aimed to describe how QBA has been applied in epidemiological research in 2006-19. METHODS We searched PubMed for English peer-reviewed studies applying QBA to real-data applications. We also included studies citing selected sources or which were identified in a previous QBA review in pharmacoepidemiology. For each study, we extracted the rationale, methodology, bias-adjusted results and interpretation and assessed factors associated with reproducibility. RESULTS Of the 238 studies, the majority were embedded within papers whose main inferences were drawn from conventional approaches as secondary (sensitivity) analyses to quantity-specific biases (52%) or to assess the extent of bias required to shift the point estimate to the null (25%); 10% were standalone papers. The most common approach was probabilistic (57%). Misclassification was modelled in 57%, uncontrolled confounder(s) in 40% and selection bias in 17%. Most did not consider multiple biases or correlations between errors. When specified, bias parameters came from the literature (48%) more often than internal validation studies (29%). The majority (60%) of analyses resulted in >10% change from the conventional point estimate; however, most investigators (63%) did not alter their original interpretation. Degree of reproducibility related to inclusion of code, formulas, sensitivity analyses and supplementary materials, as well as the QBA rationale. CONCLUSIONS QBA applications were rare though increased over time. Future investigators should reference good practices and include details to promote transparency and to serve as a reference for other researchers.
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Affiliation(s)
- Julie M Petersen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lynsie R Ranker
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Ruby Barnard-Mayers
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN, USA
| | - Matthew P Fox
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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Schulte F, Forbes C, Wurz A, Patton M, Russell KB, Pluijm S, Krull KR. Childhood Cancer Survivorship: Daily Challenges. Pediatr Clin North Am 2020; 67:1083-1101. [PMID: 33131536 DOI: 10.1016/j.pcl.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survivors of childhood cancer are at risk of experiencing fatigue, pain, lower levels of physical activity, increased engagement in risky health behavior, and poor social adjustment, after finishing treatment. Risks are more pronounced for survivors of specific diagnoses or receiving specific treatment protocols. Interventions to address these outcomes are in their infancy. Future research should focus on exploring the antecedents and consequences of these outcomes. In the meantime, researchers and cancer centers should attempt to provide high-quality and accessible health information to survivors through various media outlets to encourage healthy behaviors.
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Affiliation(s)
- Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.
| | - Caitlin Forbes
- University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Amanda Wurz
- University of Calgary, Calgary, Alberta, Canada
| | | | | | - Saskia Pluijm
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Kevin R Krull
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Howell RM, Smith SA, Weathers RE, Kry SF, Stovall M. Adaptations to a Generalized Radiation Dose Reconstruction Methodology for Use in Epidemiologic Studies: An Update from the MD Anderson Late Effect Group. Radiat Res 2019; 192:169-188. [PMID: 31211642 PMCID: PMC8041091 DOI: 10.1667/rr15201.1] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Epidemiologic studies that include patients who underwent radiation therapy for the treatment of cancer aim to quantify the relationship between radiotherapy and the risk of subsequent late effects. Because of the long follow-up period required to observe late effects, these studies are conducted retrospectively. The studies routinely include patients treated across numerous institutions using a wide range of technologies and represent treatments over several decades. As a result, determining the dose throughout the patient's body is uniquely challenging. Therefore, estimating doses throughout the patient's body for epidemiologic studies requires special methodologies that are generally applied to a wide range of radiotherapy techniques. Over ten years ago, the MD Anderson Late Effects Group described various dose reconstruction methods for therapeutic and diagnostic radiation exposure for epidemiologic studies. Here we provide an update to the most widely used dose reconstruction methodology for epidemiologic studies, analytical model calculations combined with a 3D age-specific computational phantom. In particular, we describe the various adaptations (and enhancements) of that methodology, as well as how they have been used in radiation epidemiology studies and may be used in future studies.
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Affiliation(s)
- Rebecca M. Howell
- Department of Radiation Physics, The University of Texas at MD Anderson Cancer Center, Houston, Texas
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Gerstl B, Sullivan E, Chong S, Chia D, Wand H, Anazodo A. Reproductive Outcomes After a Childhood and Adolescent Young Adult Cancer Diagnosis in Female Cancer Survivors: A Systematic Review and Meta-analysis. J Adolesc Young Adult Oncol 2018; 7:627-642. [PMID: 30452301 DOI: 10.1089/jayao.2018.0036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Improvements in cancer therapy for childhood and adolescent and young adult (AYA) survivors have increased in excess of 80% among pediatric patients and in excess of 85% among AYA cancer patients. Our research group explored the late effects consequences of cancer treatment on pregnancy and birth outcomes subsequent to a childhood (0-14 years) or AYA (15-25 years) diagnosis of cancer in female cancer survivors. Embase and Medline databases were searched. There were 17 review (n = 10 matched and n = 7 unmatched) studies that met the inclusion criteria. Subanalyses were conducted on 10 matched studies. The median age for all studies for patients at diagnosis and birth was 11 and 27 years, respectively. In matched cohort studies, female childhood and AYA cancer patients, who received chemotherapy alone, had a pooled estimated rate of 18% of experiencing a live birth compared with 10% of females who received radiotherapy alone and subsequently had a live birth. Females who received surgery alone reported higher pooled estimated rates of 44% for a live birth. For matched retrospective review studies, 79% (n = 973) of women experienced a live birth, of which 22% of these babies were born preterm. This meta-analysis found lower birth rates for survivors. Access to fertility-related information and discussions around fertility preservation options and oncofertility psychosocial support should be offered to all cancer patients and their families before starting cancer treatment.
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Affiliation(s)
- Brigitte Gerstl
- 1 Department of Biostatistics, The Kirby Institute, University of New South Wales , Kensington, Australia
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
- 3 Nulune Comprehensive Cancer Centre, Prince of Wales Hospital , Sydney, Australia
| | - Elizabeth Sullivan
- 4 Australian Centre for Public Health and Population Health Research, Faculty of Health, University of Technology, Sydney, Australia
| | - Serena Chong
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
| | - Debbie Chia
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
| | - Handan Wand
- 1 Department of Biostatistics, The Kirby Institute, University of New South Wales , Kensington, Australia
| | - Antoinette Anazodo
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
- 3 Nulune Comprehensive Cancer Centre, Prince of Wales Hospital , Sydney, Australia
- 5 Women's and Children's, School of Medical Sciences, University of New South Wales , Sydney, Australia
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van der Kooi ALLF, Brewster DH, Wood R, Nowell S, Fischbacher C, van den Heuvel-Eibrink MM, Laven JSE, Wallace WHB, Anderson RA. Perinatal risks in female cancer survivors: A population-based analysis. PLoS One 2018; 13:e0202805. [PMID: 30138451 PMCID: PMC6107257 DOI: 10.1371/journal.pone.0202805] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
Background/objectives Advances in cancer management have resulted in improved survival rates, particularly in children and young adults. However, treatment may adversely affect reproductive outcomes among female cancer survivors. The objective of this study was to investigate their risk of adverse perinatal outcomes compared to the general population. Design/methods We performed a population-based analysis, including all female cancer survivors diagnosed before the age of 40 years between 1981 and 2012. Pregnancy and perinatal complications were identified through linkage of the Scottish Cancer Registry with hospital discharge records based on the Community Health Index (CHI) database. We compared 1,629 female cancer survivors with a first ever singleton pregnancy after diagnosis, with controls matched on age, deprivation quintile, and year of cancer diagnosis selected from the general population (n = 8,899). Relative risks and 95%-confidence intervals of perinatal risks were calculated using log-binomial regression. Results Survivors were more likely to give birth before 37 weeks of gestation (relative risk (RR]) 1.32, 95%-CI 1.10–1.59), but did not show an increased risk of low birth weight (<2.5kg: RR 1.15, 95%-CI 0.94–1.39), and were less likely to give birth to offspring small for gestational age (RR 0.81, 95%-CI 0.68–0.98). Operative delivery and postpartum haemorrhage were more common but approached rates in controls with more recent diagnosis. The risk of congenital abnormalities was not increased (RR 1.01, 95%-CI 0.85–1.20). Conclusion Cancer survivors have an increased risk of premature delivery and postpartum haemorrhage, but their offspring are not at increased risk for low birth weight or congenital abnormalities. In recent decades there has been a normalisation of delivery method in cancer survivors, nevertheless careful management remains appropriate particularly for those diagnosed in childhood.
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Affiliation(s)
- Anne-Lotte L. F. van der Kooi
- Department of Obstetrics and Gynecology, Erasmus MC–Sophia Children’s Hospital, Rotterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - David H. Brewster
- Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | - Rachael Wood
- Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | - Sian Nowell
- eData Research & Innovation Service (eDRIS), Information Services Division, NHS National Services Scotland and Farr Institute Scotland, Edinburgh, Scotland
| | - Colin Fischbacher
- Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | | | - Joop S. E. Laven
- Department of Obstetrics and Gynecology, Erasmus MC–Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - W. Hamish B. Wallace
- Department of Oncology and Haematology, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, Scotland
| | - Richard A. Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
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Medica ACO, Stark SS, Hadnott TN, Dietz AC, Romero SAD, Natarajan L, Martinez E, Whitcomb BW, Su HI. Use of emergency contraception among female young adult cancer survivors. Fertil Steril 2018; 109:1114-1120.e1. [PMID: 29935646 PMCID: PMC6020163 DOI: 10.1016/j.fertnstert.2018.02.136] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/23/2018] [Accepted: 02/26/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To test whether emergency contraception use in reproductive-aged cancer survivors is higher than in the general U.S. population and evaluate factors associated with use among survivors. DESIGN A retrospective cohort study compared emergency contraception use between cancer survivors in the Reproductive Window Study on ovarian function after cancer and in the general population in the 2006-2010 National Survey for Family Growth. In a cross-sectional analysis of survivors, multivariable models were used to test associations between participant characteristics and emergency contraception use. SETTING Not applicable. PATIENT(S) A total of 616 female cancer survivors aged 18-40. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Self-reported emergency contraception use. RESULT(S) The mean age of survivors was 33.4 ± 4.7, at a mean 7.5 years since diagnosis. Breast cancer (22%), Hodgkin lymphoma (18%), and leukemia (8%) were the most common cancers. Since diagnosis, 156 (25.3%) used emergency contraception, 60% because of not otherwise using contraception. Age-adjusted prevalence of use was higher in survivors than in the general population (28.3% [95% confidence interval (CI) 24.7-31.9] vs. 12.0% [95% CI 11.1-12.9]). In multivariable analysis among survivors, nonwhite race (prevalence ratio [PR] 1.3, 95% CI 1.0-1.8), breast cancer (PR 0.6, 95% CI 0.4-1.0), partnered relationship (PR 0.6, 95% CI 0.5-0.9), and older age (age 36-40 vs. 31-35; PR 0.7, 95% CI 0.5-1.0) were associated with emergency contraception. CONCLUSION(S) Female young adult cancer survivors were significantly more likely to use emergency contraception compared with the general population. Populations including nonwhite survivors have a higher risk, suggesting differences in family planning care. Strategies to improve contraception and decrease the need for emergency contraception are needed.
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Affiliation(s)
- Alexa C O Medica
- Department of Obstetrics, Gynecology and Reproductive Science, University of California-San Diego, La Jolla, California
| | - Shaylyn S Stark
- Moores Cancer Center, University of California-San Diego, La Jolla, California
| | - Tracy N Hadnott
- Department of Obstetrics, Gynecology and Reproductive Science, University of California-San Diego, La Jolla, California
| | - Andrew C Dietz
- Moores Cancer Center, University of California-San Diego, La Jolla, California
| | - Sally A D Romero
- Division of Integrative Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Loki Natarajan
- Moores Cancer Center, University of California-San Diego, La Jolla, California; Department of Family and Preventive Medicine and Moores Cancer Center, University of California-San Diego, La Jolla, California
| | - Elena Martinez
- Moores Cancer Center, University of California-San Diego, La Jolla, California; Department of Family and Preventive Medicine and Moores Cancer Center, University of California-San Diego, La Jolla, California
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | - H Irene Su
- Department of Obstetrics, Gynecology and Reproductive Science, University of California-San Diego, La Jolla, California; Moores Cancer Center, University of California-San Diego, La Jolla, California.
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p27-V109G Polymorphism Is Not Associated with the Risk of Prostate Cancer: A Case-Control Study of Han Chinese Men in Central China. DISEASE MARKERS 2018; 2018:1418609. [PMID: 29750086 PMCID: PMC5884233 DOI: 10.1155/2018/1418609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/28/2018] [Indexed: 12/16/2022]
Abstract
Objective We conducted an update meta-analysis aiming to verify the association between p27-V109G polymorphism and cancer risk, particular for prostate cancer (PCa). Then, we conducted a case-control study of Han Chinese in central China to verify the evidence-based results. Methods Relevant studies were collected from diverse databases up to March 2017. In addition, a hospital-based (H-B) case-control study enrolling 90 PCa patients and 140 healthy controls was included to verify these evidence-based findings. Genetic risk was calculated by odds ratio (OR) with its corresponding 95% confidence interval (CI). The p27-V109G polymorphism was determined by MassARRAY genotyping method. Results Finally, twenty-four published studies comprising 9627 cases and 12,102 controls were enrolled for the current meta-analysis. Overall analysis suggested that p27-V109G polymorphism decreased overall cancer risk in allelic contrast, heterozygote, and dominant models. When stratified analysis was conducted by ethnicity, data revealed that p27-V109G polymorphism was associated with a decreased cancer risk in Caucasians. Highlighted in the subgroup analysis by cancer type, we uncovered a significantly decreased risk of PCa in allelic contrast, dominant, homogeneous, and recessive models. However, in the validation case-control study, we failed to uncover a positive association between p27-V109G polymorphism and PCa risk. In addition, negative results were also identified when subgroup analyses were stratified by age, tumor grade, tumor stage, PSA levels, and other measurements. Conclusion Although evidence-based results suggest that p27-V109G polymorphism plays a protective role in overall cancer risk, particularly for PCa, our case-control study failed to validate any association between this particular polymorphism and PCa risk.
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Shliakhtsitsava K, Suresh D, Hadnott T, Su HI. Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health. Semin Reprod Med 2017; 35:378-389. [PMID: 29036745 DOI: 10.1055/s-0037-1603770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.
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Affiliation(s)
- Ksenya Shliakhtsitsava
- Department of Pediatric Hematology and Oncology, University of California, San Diego, La Jolla, California
| | - Deepika Suresh
- Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Tracy Hadnott
- Department of Reproductive Medicine, University of California, San Diego, La Jolla, California
| | - H Irene Su
- Moores Cancer Center, University of California, San Diego, La Jolla, California.,Department of Reproductive Medicine, University of California, San Diego, La Jolla, California
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Alıcı Davutoğlu E, Madazlı R, Yılmaz N, Ozel A, Uludag S, Sozen I. Pregnancy in cancer patients and survivors; experience of a university hospital in Turkey. J OBSTET GYNAECOL 2017. [PMID: 28650696 DOI: 10.1080/01443615.2017.1318265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to assess the obstetrical and neonatal outcomes of pregnancies in cancer patients and survivors. A retrospective analysis of 68 pregnancies with a history of cancer and 31 newly diagnosed pregnant cancer patients were included in the study. The mean birth weight and the mean gestational age at delivery were significantly lower in the pregnant cancer patients (p < .001). The incidences of delivery less than 34 weeks were 8.8% and 29.1% in the cancer survivors and cancer diagnosed during pregnancy groups respectively (p < .01). In 23 (76.4%) pregnant cancer patients, a single or a combination of treatment modalities was initiated. There were four (12.9%) maternal deaths in pregnant cancer patients. There were no early neonatal death and any congenital anomaly detected in the newborns. Pregnancy in cancer patients and cancer survivors has completely different clinical outcome. Pregnancy in cancer patients has increased the risk of pregnancy complication.
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Affiliation(s)
- Ebru Alıcı Davutoğlu
- a Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty , University of Istanbul , Istanbul , Turkey
| | - Riza Madazlı
- a Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty , University of Istanbul , Istanbul , Turkey
| | - Nevin Yılmaz
- a Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty , University of Istanbul , Istanbul , Turkey
| | - Ayşegül Ozel
- a Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty , University of Istanbul , Istanbul , Turkey
| | - Sezin Uludag
- a Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty , University of Istanbul , Istanbul , Turkey
| | - Işık Sozen
- a Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty , University of Istanbul , Istanbul , Turkey
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13
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Cheng XK, Wang XJ, Li XD, Ren XQ. Genetic association between the cyclin-dependent kinase inhibitor gene p27/Kip1 polymorphism (rs34330) and cancer susceptibility: a meta-analysis. Sci Rep 2017; 7:44871. [PMID: 28317869 PMCID: PMC5357887 DOI: 10.1038/srep44871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 02/15/2017] [Indexed: 12/19/2022] Open
Abstract
The p27 rs34330 (-79C/T) polymorphism has been widely studied for human cancer susceptibility. The current findings, however, still remained controversial. Therefore, we performed the meta-analysis to provide a more accurate result. Eligible studies were identified from PubMed database up to June 2015. The association of p27 rs34330 polymorphism and cancer susceptibility was estimated with odds ratios and corresponding 95% confidence intervals. The meta-analysis was performed with Stata 12. A total of ten studies with 11,214 cases and more than 8,776 controls were included in the meta-analysis (including breast, lung, thyroid, endometrial, and hepatocellular cancer). In pooled analysis, p27 gene rs34330 polymorphism significantly increased the cancer susceptibility. Subgroup analysis indicated that the elevated risk was observed under all the genetic models for Asians and under three genetic models for Caucasians. Results of sensitivity analysis were similar to the overall results. The results suggested that the p27 rs34330 polymorphism increased the cancer susceptibility, especially in Asians. Further well-designed and large sample size studies are warranted to verify the conclusion.
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Affiliation(s)
- Xiao-Ke Cheng
- Center for Evidence-Based Medicine, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China
| | - Xue-Jun Wang
- Department of Emergency, Beijing Electric Power Hospital, Taipingxili Jia 1, Beijing, 100073, China
| | - Xiao-Dong Li
- Center for Evidence-Based Medicine, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China.,Department of Urology, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China
| | - Xue-Qun Ren
- Center for Evidence-Based Medicine, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China.,Department of Urology, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China.,Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China
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Margerison-Zilko CE, Strutz KL, Li Y, Holzman C. Stressors Across the Life-Course and Preterm Delivery: Evidence From a Pregnancy Cohort. Matern Child Health J 2017; 21:648-658. [PMID: 27443654 PMCID: PMC5253130 DOI: 10.1007/s10995-016-2151-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives Growing evidence suggests that pre-conception stressors are associated with increased risk of preterm delivery (PTD). Our study assesses stressors in multiple domains at multiple points in the life course (i.e., childhood, adulthood, within 6 months of pregnancy) and their relation to PTD. We also examine heterogeneity of associations by race/ethnicity, PTD timing, and PTD clinical circumstance. Methods We assessed stressors retrospectively via mid-pregnancy questionnaires in the Pregnancy Outcomes and Community Health Study (1998-2004), a Michigan pregnancy cohort (n = 2559). Stressor domains included abuse/witnessing violence (hereafter "abuse"), loss, economic stress, and substance use. We used logistic and multinomial regression for the following outcomes: PTD (<37 weeks' gestation), PTD by timing (≤34 weeks, 35-36 weeks) and PTD by clinical circumstance (medically indicated, spontaneous). Covariates included race/ethnicity, education, parity, and marital status. Results Stressors in the previous 6 months were not associated with PTD. Experiencing abuse during both childhood and adulthood increased adjusted odds of PTD among women of white or other race/ethnicity only (aOR 1.6, 95 % CI 1.1, 2.5). Among all women, abuse in childhood increased odds of late PTD (aOR 1.5, 95 % CI 1.0, 2.2) while abuse in both childhood and adulthood non-significantly increased odds of early PTD (aOR 1.6, 95 % CI 0.9, 2.7). Sexual, but not physical, abuse in both childhood and adulthood increased odds of PTD (aOR 1.9, 95 % CI 1.0, 3.5). Conclusions Experiences of abuse-particularly sexual abuse-across the life-course may be important considerations when assessing PTD risk. Our results motivate future studies of pathways linking abuse and PTD.
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Affiliation(s)
- Claire E Margerison-Zilko
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 West Fee Rd. Rm 601B, East Lansing, MI, 48823, USA.
| | - Kelly L Strutz
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 West Fee Rd. Rm 601B, East Lansing, MI, 48823, USA
- Department of Public Health, Grand Valley State University, 545 Michigan St NE, Suite 300, Grand Rapids, MI, 49503, USA
| | - Yu Li
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 West Fee Rd. Rm 601B, East Lansing, MI, 48823, USA
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 West Fee Rd. Rm 601B, East Lansing, MI, 48823, USA
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Muñoz M, Santaballa A, Seguí MA, Beato C, de la Cruz S, Espinosa J, Fonseca PJ, Perez J, Quintanar T, Blasco A. SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016). Clin Transl Oncol 2016; 18:1229-1236. [PMID: 27896641 PMCID: PMC5138251 DOI: 10.1007/s12094-016-1587-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/30/2022]
Abstract
Chemotherapy and radiotherapy often result in reduced fertility in cancer patients. With increasing survival rates, fertility is an important quality-of-life concern for many young cancer patients. Around 70–75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior to treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to cancer treatment.
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Affiliation(s)
- M Muñoz
- Servicio de Oncología Médica, Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Hospital Clínic de Barcelona, Villarroel, 170-08036, Barcelona, Spain.
| | - A Santaballa
- Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - M A Seguí
- Corporació Sanitària Parc Taulì, Sabadell, Spain
| | - C Beato
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S de la Cruz
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J Espinosa
- Hospital General de Ciudad Real, Ciudad Real, Spain
| | - P J Fonseca
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Perez
- Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - T Quintanar
- Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - A Blasco
- Hospital General Universitario de Valencia, Valencia, Spain
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