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Desai A, Sutradhar R, Lau C, Widger K, Lee DS, Nathan PC, Gupta S. Morbidity and healthcare use among mothers of children with cancer: A population-based study. Pediatr Blood Cancer 2023; 70:e30612. [PMID: 37543725 DOI: 10.1002/pbc.30612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND The impact of a child's cancer diagnosis on subsequent maternal physical health is unclear. METHODS We identified all Ontario children diagnosed less than 18 years with cancer between 1992 and 2017. Linkage to administrative databases identified mothers who were matched to population controls. We identified physical health conditions, acute healthcare use, and preventive healthcare use through validated algorithms using healthcare data, and compared them between exposed (child with cancer) and unexposed mothers. Predictors of health outcomes were assessed among exposed mothers. RESULTS We identified 5311 exposed mothers and 19,516 matched unexposed mothers. For exposed mothers, median age at last follow-up was 48 years, (interquartile range: 42-53). Exposed mothers had an increased risk of cancer (hazard ratio [HR] 1.2, 95% confidence interval [95% CI]: 1.0-1.5, p = .03), but not of any other adverse physical outcomes or of increased acute healthcare use. Exposed mothers were more likely to receive influenza vaccinations (odds ratio 1.4, 95% CI: 1.3-1.5, p < .0001), and underwent cancer screening at the same rate as unexposed mothers. Among exposed mothers, bereavement was associated with a subsequent increased risk of cancer (HR 1.7, 95% CI: 1.2-2.5, p = .004) and death (HR 2.2, 95% CI: 1.2-4.1, p = .01). CONCLUSION Mothers of children with cancer are at increased risk of developing cancer, but not of other adverse physical health outcomes, and were equally or more likely to be adherent to preventive healthcare practices. Bereaved mothers were at increased risk of subsequent cancer and death. Interventions targeting specific subpopulations of mothers of children with cancer or focused on screening for specific cancers may be warranted.
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Affiliation(s)
- Aditi Desai
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Cancer Research Program, ICES, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Cindy Lau
- Cancer Research Program, ICES, Toronto, Ontario, Canada
| | - Kim Widger
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Douglas S Lee
- Cancer Research Program, ICES, Toronto, Ontario, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Paul C Nathan
- Cancer Research Program, ICES, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Ontario, Canada
| | - Sumit Gupta
- Cancer Research Program, ICES, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Ontario, Canada
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von Stedingk K, Stjernfelt KJ, Kvist A, Wahlström C, Kristoffersson U, Stenmark-Askmalm M, Wiebe T, Hjorth L, Koster J, Olsson H, Øra I. Prevalence of germline pathogenic variants in 22 cancer susceptibility genes in Swedish pediatric cancer patients. Sci Rep 2021; 11:5307. [PMID: 33674644 PMCID: PMC7935871 DOI: 10.1038/s41598-021-84502-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/12/2021] [Indexed: 11/30/2022] Open
Abstract
Up to 10% of pediatric cancer patients harbor pathogenic germline variants in one or more cancer susceptibility genes. A recent study from the US reported pathogenic variants in 22 out of 60 analyzed autosomal dominant cancer susceptibility genes, implicating 8.5% of pediatric cancer patients. Here we aimed to assess the prevalence of germline pathogenic variants in these 22 genes in a population-based Swedish cohort and to compare the results to those described in other populations. We found pathogenic variants in 10 of the 22 genes covering 3.8% of these patients. The prevalence of TP53 mutations was significantly lower than described in previous studies, which can largely be attributed to differences in tumor diagnosis distributions across the three cohorts. Matched family history for relatives allowed assessment of familial cancer incidence, however, no significant difference in cancer incidence was found in families of children carrying pathogenic variants compared to those who did not.
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Affiliation(s)
- Kristoffer von Stedingk
- Department of Pediatrics, Clinical Sciences, Lund University, Lasarettsgatan 40, 22185, Lund, Sweden. .,Department of Oncogenomics, University Medical Center, AMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Karl-Johan Stjernfelt
- Department of Pediatrics, Clinical Sciences, Lund University, Lasarettsgatan 40, 22185, Lund, Sweden.,Pediatric Oncology and Hematology, Children's Hospital, Skåne University Hospital, Lund, Sweden
| | - Anders Kvist
- Department of Oncology and Pathology, Clinical Sciences, Lund University, Lund, Sweden
| | - Cecilia Wahlström
- Department of Oncology and Pathology, Clinical Sciences, Lund University, Lund, Sweden
| | - Ulf Kristoffersson
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Marie Stenmark-Askmalm
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Thomas Wiebe
- Department of Pediatrics, Clinical Sciences, Lund University, Lasarettsgatan 40, 22185, Lund, Sweden.,Pediatric Oncology and Hematology, Children's Hospital, Skåne University Hospital, Lund, Sweden
| | - Lars Hjorth
- Department of Pediatrics, Clinical Sciences, Lund University, Lasarettsgatan 40, 22185, Lund, Sweden.,Pediatric Oncology and Hematology, Children's Hospital, Skåne University Hospital, Lund, Sweden
| | - Jan Koster
- Department of Oncogenomics, University Medical Center, AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Håkan Olsson
- Department of Oncology, Clinical Sciences, Lund University, Lund, Sweden.,Department of Cancer Epidemiology, Clinical Sciences, Lund, University, Lund, Sweden
| | - Ingrid Øra
- Department of Pediatrics, Clinical Sciences, Lund University, Lasarettsgatan 40, 22185, Lund, Sweden.,Pediatric Oncology and Hematology, Children's Hospital, Skåne University Hospital, Lund, Sweden
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