EARLY MENOPAUSE IN LONG-TERM SURVIVORS OF CANCER DURING ADOLESCENCE

被引:294
作者
BYRNE, J
FEARS, TR
GAIL, MH
PEE, D
CONNELLY, RR
AUSTIN, DF
HOLMES, GF
HOLMES, FF
LATOURETTE, HB
MEIGS, JW
STRONG, LC
MYERS, MH
MULVIHILL, JJ
机构
[1] INFORMAT MANAGEMENT SERV INC, ROCKVILLE, MD USA
[2] CALIF DEPT HLTH SERV, EMERYVILLE, CA USA
[3] UNIV KANSAS, MED CTR, KANSAS CITY, KS 66103 USA
[4] UNIV IOWA, IOWA CITY, IA 52242 USA
[5] YALE UNIV, NEW HAVEN, CT 06520 USA
[6] UNIV TEXAS, MD ANDERSON CANCER CTR, HOUSTON, TX 77030 USA
[7] UNIV PITTSBURGH, DEPT HUMAN GENET, PITTSBURGH, PA 15260 USA
关键词
MENOPAUSE; CHILDHOOD CANCER; RADIATION; ALKYLATING AGENT; OVARIAN FAILURE; FOLLOW-UP STUDIES;
D O I
10.1016/0002-9378(92)91335-8
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: We attempted to investigate the risk of early menopause after treatment for cancer during childhood or adolescence. STUDY DESIGN: We interviewed 1067 women in whom cancer was diagnosed before age 20, who were at least 5-year survivors, and who were still menstruating at age 21. Self-reported menopause status in survivors was compared with that in 1599 control women. RESULTS: Cancer survivors, with disease diagnosed between ages 13 and 19, had a risk of menopause four times greater than that of controls during the ages 21 to 25; the risk relative to controls declined thereafter. Significantly increased relative risks of menopause during the early 20s occurred after treatment with either radiotherapy alone (relative risk 3.7) or alkylating agents alone (relative risk 9.2). During ages 21 to 25 the risk of menopause increased 27-fold for women treated with both radiation below the diaphragm and alkylating agent chemotherapy. By age 31, 42% of these women had reached menopause compared with 5% for controls. CONCLUSION: Treatment for cancer during adolescence carries a substantial risk for early menopause among women still menstruating at age 21. Increasing use of radiation and chemotherapy, together with the continued trend toward delayed childbearing, suggests that these women should be made aware of their smaller window of fertility so that they can plan their families accordingly.
引用
收藏
页码:788 / 793
页数:6
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