Cancer and Pregnancy: Estimates in Italy from Record-Linkage Procedures between Cancer Registries and the Hospital Discharge Database
Daniela Pierannunzio, Alice Maraschini, Tania Lopez, Serena Donati, Rosalba Amodio, Fortunato Bianconi, Rossella Bruni, Marine Castaing, Claudia Cirilli, Giovanna Fantaci, Linda Guarda, Silvia Iacovacci, Lucia Mangone, Guido Mazzoleni, Walter Mazzucco, Anna Melcarne, Elisabetta Merlo, Fabio Parazzini, Fedro Alessandro Peccatori, Massimo Rugge, Giuseppe Sampietro, Giovanni Scambia, Giovanna Scarfone, Ausilia Sferrazza, Fabrizio Stracci, Antonina Torrisi, Maria Francesca Vitale, Silvia Francisci- Cancer Research
- Oncology
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.