Health status and academic performance in offspring of central nervous system tumor survivors

Projekt: Avhandling



Due to the advanced treatments, a growing number of cancer patients could survive to reproductive age and subsequently have their own children. The impact of a history of cancer and related treatments on the health of their offspring is thus raising concern. Available evidence from population-based studies suggested that cancer survivors were associated with an increased risk of damage concerning reproductive function; this indicates cancer itself or treatments play a role in the reproductive system. It is plausible that the health of children of cancer survivors might be affected due to the damage of reproductive organs of these survivors. Central nervous system (CNS) tumour is the second most common cancer in population below age of 20 years in Sweden, just behind haematopoietic malignancies. Its incidence rate is still increasing but the mortality rate has slightly decreased, which led to an increasing number of children born after their parents have been diagnosed with CNS tumour. But the potential adverse effects of CNS tumour diagnosis in early life on their offspring is still unknown. This thesis provided a comprehensive assessment of potential adverse outcomes for offspring of survivors who were ever previously diagnosed with CNS tumor under the age of 20, ranging from birth outcome, health status to academic performance. In this thesis, these children were found to have a higher risk of being born preterm and getting a poor academic performance. Although the general health status (physical and mental health) in children of survivors was comparable with that in the general population, these children were found to have an increased risk of CNS tumor, infectious diseases, and mental retardation. Furthermore, the observed associations varied by sex of survivors, sex of offspring, age at parental diagnosis, histology of parental tumor as well as the time interval between parental tumor diagnosis and childbirth.

Populärvetenskaplig beskrivning

More and more patients who were diagnosed with central nervous system tumor in childhood or adolescence were able to grow up into adulthood and have their own children. It results in increasing concerns among these survivors for their children. For example, whether their children will be affected by parental tumor and treatments, how long will be safe to have a child after treatment, whether their children will be born with problems, what kinds of diseases their children may have a higher risk of when they are growing up, and so forth. In recent years, some researchers explored the potential adverse outcomes in children of cancer survivors, which were however limited to children of overall cancer survivors. It is known that prognosis is highly different across different types of cancer. Thus, it is urgent to examine the influence of specific cancer types on their children to provide tailored recommendations for survivors with different types of cancer. In this thesis, we aimed to investigate the health status and school performance in children of survivors who were diagnosed with central nervous system tumor under age of 20.
In Paper I, we found that these survivors were more likely to have preterm-born infants, especially female survivors and childhood survivors. However, the risk declined with time, so these survivors were recommended to be concerned about the timing to have a child and to care more about the first pregnancy after tumor diagnosis. Findings from Paper II suggested that the overall physical health was similar between children of these survivors and the general population. But children, whose father had a diagnosis with CNS tumor, may be concerned over the risk of malignancy and infectious diseases. In Paper III, children of these survivors were not related to an increased incidence of general mental disorders but linked to a higher risk of mild intelligent disability. Furthermore, in Paper IV, these children tended to get poor academic performance. These findings recommend more attention should be paid to the neurodevelopment and cognitive function for children of survivors with CNS tumor.
Gällande start-/slutdatum2018/07/262021/05/26

Ämnesklassifikation (UKÄ)

  • Cancer och onkologi
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi