The aim of this study is to describe the frequency and trend of pregnancy-associated cancer (PAC) in Italy, an increasingly relevant phenomenon due to postponing age at childbirth. To this purpose, a population-based retrospective longitudinal study design based on cohorts of women aged 15–49 diagnosed with cancer and concomitant pregnancy is proposed. The study uses 19 population-based Cancer Registries, covering about 22% of Italy, and linked at an individual level with Hospital Discharge Records. A total of 2,861,437 pregnancies and 3559 PAC are identified from 74,165 women of the cohort with a rate of 1.24 PAC per 1000 pregnancies. The most frequent cancer site is breast (24.3%), followed by thyroid (23.9%) and melanoma (14.3%). The most frequent outcome is delivery (53.1%), followed by voluntary termination of pregnancy and spontaneous abortion (both 12.0%). The trend of PAC increased from 2003 to 2015, especially when the outcome is delivery, thus confirming a new attitude of clinicians to manage cancer throughout pregnancy. This represents the first attempt in Italy to describe PAC from Cancer Registries data; the methodology is applicable to other areas with the same data availability. Evidence from this study is addressed to clinicians for improving clinical management of women with PAC.
本研究旨在描述意大利妊娠相关癌症（PAC）的发生频率与趋势，这一现象因生育年龄推迟而日益凸显。为此，我们基于人口队列设计了一项回顾性纵向研究，研究对象为15-49岁确诊癌症且同时处于妊娠期的女性群体。研究整合了覆盖意大利约22%人口的19个基于人群的癌症登记处数据，并与个体层级的住院记录进行关联匹配。从74,165名队列女性中，共识别出2,861,437例妊娠事件及3,559例PAC病例，相当于每1000例妊娠中发生1.24例PAC。最常见的癌症部位为乳腺（24.3%），其次为甲状腺（23.9%）和黑色素瘤（14.3%）。最常见的妊娠结局是分娩（53.1%），随后是自愿终止妊娠和自然流产（均为12.0%）。2003年至2015年间PAC呈上升趋势，尤其在分娩结局组中更为明显，这证实了临床医生在妊娠期全程管理癌症的新诊疗倾向。本研究是意大利首次基于癌症登记数据描述PAC的尝试，该方法同样适用于具备相同数据条件的其他地区。研究证据可为临床医生优化PAC患者的诊疗管理提供参考。
肿瘤(癌症)患者之家