In the United States, more than 45,000 adolescent and young women are diagnosed with cancer each year. Fertility and reproductive outcomes are critical issues for young adult cancer survivors, but little is known about the effect of cancer diagnosis and treatment on the clinical course of future pregnancy.
In a newly funded study led by a faculty member at the University of North Carolina Gillings School of Global Public Health, researchers will compile an evidence base for counseling women who must make difficult decisions about their future childbearing intentions while simultaneously confronting a cancer diagnosis.
Dr. Hazel Nichols, assistant professor of epidemiology at UNC, is lead investigator of the study, titled “Clinical Pregnancy Outcomes Among Female Adolescent and Young Adult Cancer Survivors.” Dr. Nichols, who also is a member of UNC’s Lineberger Comprehensive Cancer Center, received an R01 research project grant from the National Institutes of Health to fund the study.
The project, which launched July 1, will leverage existing data sources – including health care systems information, the Society for Assisted Reproductive Technology Clinic Outcome Reporting System and an innovative linkage of the North Carolina Central Cancer Registry, public and private administrative cancer treatment claims and N.C. birth certificates – to assess clinical pregnancy outcomes among women diagnosed with the most common adolescent and young adult (AYA) cancers, which include lymphoma, breast, melanoma, thyroid and gynecologic cancers. Together, these cancers account for more than 70 percent of all diagnoses in the AYA age group (ages 15 to 39 years at diagnosis).
“Adolescents and young adults have a lot of unanswered questions about what a cancer history means for starting or growing their families in the future,” Dr. Nichols said. “We want to provide scientific evidence from real-world settings to understand the impact of cancer on future pregnancy.”
The researchers will assess pregnancy risks such as miscarriage and adverse birth outcomes (i.e., low birth weight and preterm birth). After examining factors that may contribute to these risks – including cancer type, age at diagnosis, type of cancer treatment, minority or low-income status and use of assisted reproductive technologies – the investigators will compare the risks to those found in women without a prior cancer diagnosis.
Ultimately, this population-level study will inform survivorship planning by addressing fertility and parenthood more widely across the cancer care continuum.
[Photo: In the U.S., more than 45,000 adolescent and young women are diagnosed with cancer each year, but little is known about the effect of cancer diagnosis and treatment on the clinical course of future pregnancy. UNC’s Dr. Hazel Nichols will lead a study to compile an evidence base for counseling women who must make difficult decisions about their future childbearing intentions while facing a cancer diagnosis. photo – Riccardo Battistella]