ESMO Congress 2023 | OncologyPRO

Abstract 1864P

Background

Globally, more than 1.3 mio adolescents and young adults (AYAs) are diagnosed with cancer each year. Long-term survival has increased due to improved cancer therapy; however, a potential side effect is reduced fertility. Despite development in fertility preservation uncertainty regarding future fertility is still of major concern to the AYAs. The aim of this study was to identify to what extent nulliparous, female AYAs with cancer have children after cancer treatment compared to nulliparous female AYAs without cancer.

Methods

This is a national register study based on the Danish National Assisted Reproductive Technology-Couple cohort including female AYAs diagnosed with cancer when aged 18-39 from 1978–2016. According to diagnosis onset, the female AYAs with cancer were randomly age-matched with 60 female AYAs without cancer (comparison group: CG). Study participants were followed until end of study, death, or migration (31/12-2017). Death was incorporated as a competing risk in all analyses. Hazard Ratio (HR) were calculated, comparing the female AYAs with cancer with the CG. HR was adjusted for time of diagnosis, immigration status, marital status, and educational level.

Results

33.3% of AYAs with cancer had at least one child after cancer treatment vs. 40% in the CG. Female AYAs with malignant melanoma had solely a higher HR of having children after cancer treatment compared to the CG. Female AYAs with leukaemia, breast and CNS cancer had the lowest HR of having children after cancer treatment, especially in the age interval 32-39 years. Table: 1864P

	N (%)	≥ 1 child after cancer N (%)	Adjusted HR (95% CI)*
18-25 y	26-31 y	32-39 y
All	7519 (100)	2505 (33.3)	0.77 (0.72-0.82)	0.65 (0.61-0.69)	0.59 (0.52-0.67)
Gyn cancer	1773 (23.6)	435 (24.5)	0.49 (0.42-0.58)	0.44 (0.38-0.50)	0.39 (0.29-0.52)
Breast cancer	1115 (14.8)	179 (16.1)	0.63 (0.42-0.95)	0.46 (0.37-0.56)	0.35 (0.26-0.48)
Mal melanoma	1960 (26.1)	1071 (54.6)	1.02 (0.93-1.12)	1.03 (0.93-1.13)	1.13 (0.92-1.39)
CNS cancer	303 (4.0)	65 (21.5)	0.70 (0.51-0.97)	0.40 (0.26-0.61)	0.25 (0.06-0.97)
Leukaemia	258 (3.4)	37 (14.3)	0.39 (0.26-0.57)	0.25 (0.09-0.65)	0.41 (0.13-1.26)
Lymphoma	278 (3.7)	78 (28.1)	0.63 (0.47-0.85)	0.48 (0.30-0.75)	0.76 (0.32-1.84)
CG	499,616	199,861 (40.0)	1	1	1

*Adjusted analysis is based on complete case sample, N=6275. Approximately 16% (6275/7519) is excluded in the adjusted analysis due to missing data.

Conclusions

A third of nulliparous, female AYAs with cancer had at least one child after cancer which is lower than for female AYAs without cancer. The HR for having children after cancer decrease with increased age being lowest in female AYAs with leukaemia, breast- and CNS cancer.