Background/Objectives: The increasing incidence of cancer during pregnancy is a growing public health concern, driven by delayed parenthood and rising maternal age. Pregnancy-associated cancer (PAC) presents complex clinical challenges, necessitating a balance between maternal cancer treatment and fetal safety. Historically considered incompatible with favorable pregnancy outcomes, evidence now suggests that pregnancy can often proceed without affecting cancer prognosis. A 2022 study in Italy provided the first population-based PAC estimates by linking cancer registries (CRs) and hospital discharge records (HDRs). This study aimed to update PAC estimates to 2019, covering 30% of the Italian population and addressing prior data limitations.Methods: A retrospective longitudinal analysis was conducted on women aged 15–49 diagnosed with malignant cancers between 2003 and 2019. Data from 21 Italian CRs were linked with HDRs to identify PAC cases, defined as obstetric hospitalizations occurring for women diagnosed with cancer in our study cohort in the period spanning from one year before to two years after a cancer diagnosis. All malignant cancers, excluding non-melanoma skin cancers, were analyzed. PAC rates were calculated per 1000 pregnancies, and trends were assessed using log-linear and JoinPoint regression models.Results: Among 131,774 women diagnosed with cancer, 6329 PAC cases were identified, with a PAC rate of 1.43 per 1000 pregnancies, consistent with global estimates. Thyroid (24.4%) and breast cancer (23.2%) were the most common. Analyzing the PAC rate by pregnancy outcome, in the period 2015–2019, this increased for both childbirths and miscarriages but decreased for voluntary terminations. Most hospitalizations (54%) occurred pre-diagnosis, peaking at diagnosis, especially for breast cancer (69%).Conclusions: PAC incidence is rising, particularly for live births and miscarriages, underscoring the need for multidisciplinary care and robust epidemiological insights to guide clinical management.
**背景/目的：** 随着生育年龄推迟和产妇高龄化趋势，妊娠期癌症发病率不断上升，已成为日益严峻的公共卫生问题。妊娠相关癌症（PAC）带来了复杂的临床挑战，需要在母体癌症治疗与胎儿安全之间取得平衡。尽管历史上认为PAC难以获得良好的妊娠结局，但现有证据表明，妊娠通常可以继续而不影响癌症预后。意大利2022年的一项研究通过关联癌症登记处（CRs）和医院出院记录（HDRs），首次提供了基于人群的PAC估计数据。本研究旨在将PAC估计数据更新至2019年，覆盖意大利30%的人口，并解决先前数据存在的局限性。 **方法：** 对2003年至2019年间诊断为恶性肿瘤的15-49岁女性进行回顾性纵向分析。将来自意大利21个CRs的数据与HDRs关联，以识别PAC病例。PAC定义为研究队列中在癌症诊断前后一年至两年期间发生产科住院的癌症确诊女性。分析了所有恶性肿瘤（非黑色素瘤皮肤癌除外）。计算每1000次妊娠的PAC发生率，并使用对数线性和JoinPoint回归模型评估趋势。 **结果：** 在131,774名确诊癌症的女性中，共识别出6329例PAC病例，PAC发生率为每1000次妊娠1.43例，与全球估计值一致。甲状腺癌（24.4%）和乳腺癌（23.2%）最为常见。按妊娠结局分析PAC发生率，在2015-2019年期间，分娩和流产相关的PAC发生率均有所上升，但自愿终止妊娠相关的发生率下降。大多数住院（54%）发生在诊断前，并在诊断时达到高峰，尤其是乳腺癌（69%）。 **结论：** PAC发病率正在上升，尤其是在活产和流产病例中，这凸显了需要多学科护理和强有力的流行病学见解来指导临床管理。
肿瘤(癌症)患者之家