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. 2023 Aug 28;15(17):4305.
doi: 10.3390/cancers15174305.

Cancer and Pregnancy: Estimates in Italy from Record-Linkage Procedures between Cancer Registries and the Hospital Discharge Database

Daniela Pierannunzio  1 , Alice Maraschini  2 , Tania Lopez  1 , Serena Donati  1 , Rosalba Amodio  3 , Fortunato Bianconi  4 , Rossella Bruni  5 , Marine Castaing  6 , Claudia Cirilli  7 , Giovanna Fantaci  8 , Linda Guarda  9 , Silvia Iacovacci  10 , Lucia Mangone  11 , Guido Mazzoleni  12 , Walter Mazzucco  3 , Anna Melcarne  13 , Elisabetta Merlo  14 , Fabio Parazzini  15 , Fedro Alessandro Peccatori  16 , Massimo Rugge  17   18 , Giuseppe Sampietro  19 , Giovanni Scambia  20 , Giovanna Scarfone  21 , Ausilia Sferrazza  22 , Fabrizio Stracci  23 , Antonina Torrisi  24 , Maria Francesca Vitale  25 , Silvia Francisci  1
Affiliations

Cancer and Pregnancy: Estimates in Italy from Record-Linkage Procedures between Cancer Registries and the Hospital Discharge Database

Daniela Pierannunzio et al. Cancers (Basel). .

Abstract

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.

Keywords: cancer; cancer registry records; childbearing age; cohort study; hospital discharge data; population-based data; pregnancy; pregnancy outcome; record linkage; reproductive health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of obstetric hospitalizations (N) of women aged 15–49 by distance (in months) from cancer diagnosis: 2003–2015, Italy.
Figure 2
Figure 2
Time trend 2003–2015 of the rate of PAC (per 1000 pregnancies) among women aged 15–49 by pregnancy outcome: all cancers, Italy, (annual percentage change in box, linear trend in dots). ‘*’ stands for statistically significant APC values (p < 0.05).
Figure 3
Figure 3
Age trend of PAC (%) by pregnancy outcome: all cancers, 2003–2015, Italy.
See this image and copyright information in PMC

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