Cancer and Pregnancy: Update of Estimates in Italy by Linking Data from Cancer Registries and Hospital Discharge Records

<b>Background/Objectives</b>: The increasing incidence of cancer during pregnancy is a growing public health concern, driven by delayed parenthood and rising maternal age. Pregnancy-associated cancer (PAC) presents complex clinical challenges, necessitating a balance between maternal cancer treatment and fetal safety. Historically considered incompatible with favorable pregnancy outcomes, evidence now suggests that pregnancy can often proceed without affecting cancer prognosis. A 2022 study in Italy provided the first population-based PAC estimates by linking cancer registries (CRs) and hospital discharge records (HDRs). This study aimed to update PAC estimates to 2019, covering 30% of the Italian population and addressing prior data limitations. <b>Methods</b>: A retrospective longitudinal analysis was conducted on women aged 15-49 diagnosed with malignant cancers between 2003 and 2019. Data from 21 Italian CRs were linked with HDRs to identify PAC cases, defined as obstetric hospitalizations occurring for women diagnosed with cancer in our study cohort in the period spanning from one year before to two years after a cancer diagnosis. All malignant cancers, excluding non-melanoma skin cancers, were analyzed. PAC rates were calculated per 1000 pregnancies, and trends were assessed using log-linear and JoinPoint regression models. <b>Results</b>: Among 131,774 women diagnosed with cancer, 6329 PAC cases were identified, with a PAC rate of 1.43 per 1000 pregnancies, consistent with global estimates. Thyroid (24.4%) and breast cancer (23.2%) were the most common. Analyzing the PAC rate by pregnancy outcome, in the period 2015-2019, this increased for both childbirths and miscarriages but decreased for voluntary terminations. Most hospitalizations (54%) occurred pre-diagnosis, peaking at diagnosis, especially for breast cancer (69%). <b>Conclusions</b>: PAC incidence is rising, particularly for live births and miscarriages, underscoring the need for multidisciplinary care and robust epidemiological insights to guide clinical management.

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Publication Details

Journal
Cancers
Published
2025-04-05
DOI
https://doi.org/10.3390/cancers17071230
Primary Topic
Cancer Risks and Factors
Type
article
Field-Weighted Citation Impact
0.00

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article

Cancer and Pregnancy: Update of Estimates in Italy by Linking Data from Cancer Registries and Hospital Discharge Records

Manuel Zorzi, Fortunato Bianconi, Alice Maraschini, Daniela Pierannunzio et al.
Cancers
Cancer Risks and Factors
article

Cancer and Pregnancy: Update of Estimates in Italy by Linking Data from Cancer Registries and Hospital Discharge Records

Manuel Zorzi, Fortunato Bianconi, Alice Maraschini, Daniela Pierannunzio, Antonella Ippolito, Giovanni Scambia, William Mantovani, Giovanna Fantaci, Serena Donati, Silvia Francisci, Walter Mazzucco, Maria Teresa Pesce, Michael Mian, Tania López, Lucìa Mangone, Rosa De Vincenzo, Rossella Bruni, Paola Ballotari, Elisabetta Merlo, Ettore Bidoli, Edoardo Corsi Decenti, Fabrizio Stracci, Giuseppe Sampietro, Francesca Bella, Silvia Iacovacci, Claudia Cirilli, Antonina Torrisi, Maria Francesca Vitale, Giuseppe Furgiuele
article en

Abstract

<b>Background/Objectives</b>: The increasing incidence of cancer during pregnancy is a growing public health concern, driven by delayed parenthood and rising maternal age. Pregnancy-associated cancer (PAC) presents complex clinical challenges, necessitating a balance between maternal cancer treatment and fetal safety. Historically considered incompatible with favorable pregnancy outcomes, evidence now suggests that pregnancy can often proceed without affecting cancer prognosis. A 2022 study in Italy provided the first population-based PAC estimates by linking cancer registries (CRs) and hospital discharge records (HDRs). This study aimed to update PAC estimates to 2019, covering 30% of the Italian population and addressing prior data limitations. <b>Methods</b>: A retrospective longitudinal analysis was conducted on women aged 15-49 diagnosed with malignant cancers between 2003 and 2019. Data from 21 Italian CRs were linked with HDRs to identify PAC cases, defined as obstetric hospitalizations occurring for women diagnosed with cancer in our study cohort in the period spanning from one year before to two years after a cancer diagnosis. All malignant cancers, excluding non-melanoma skin cancers, were analyzed. PAC rates were calculated per 1000 pregnancies, and trends were assessed using log-linear and JoinPoint regression models. <b>Results</b>: Among 131,774 women diagnosed with cancer, 6329 PAC cases were identified, with a PAC rate of 1.43 per 1000 pregnancies, consistent with global estimates. Thyroid (24.4%) and breast cancer (23.2%) were the most common. Analyzing the PAC rate by pregnancy outcome, in the period 2015-2019, this increased for both childbirths and miscarriages but decreased for voluntary terminations. Most hospitalizations (54%) occurred pre-diagnosis, peaking at diagnosis, especially for breast cancer (69%). <b>Conclusions</b>: PAC incidence is rising, particularly for live births and miscarriages, underscoring the need for multidisciplinary care and robust epidemiological insights to guide clinical management.

CancersVol. 17(7)
Università Cattolica del Sacro Cuore (IT), University of Bergamo (IT), Istituto Nazionale di Statistica (IT), University of Perugia (IT), Istituto Superiore di Sanità (IT), Agostino Gemelli University Polyclinic (IT), Azienda Unita' Sanitaria Locale Di Modena (IT), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), National Centre for Disease Prevention and Control (IT), University of Ragusa (IT), Agenzia Regionale Sanitaria della Puglia (IT), Italian Association for Cancer Research (IT), Centro di Riferimento Oncologico (IT), Policlinico Universitario di Catania (IT), Regione del Veneto (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT)
Ministero della Salute
Openalex Percentile: Top 90%
Cancer Risks and Factors
DOIOpen Access PDFOpenAlex
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