Predictors of Marriage and Parenthood in Adult Survivors of Childhood Cancers: An Indian Perspective

Background: We analyzed the predictors of marriage and parenthood in our cohort of adult survivors of childhood cancer. Methods: We conducted a retrospective cohort analysis of adult survivors of childhood cancer aged > 25 years at a tertiary cancer center in India, evaluating marital status, parenthood, and associated predictors using multivariable logistic regression. Results: Among 844 survivors, 36.4% of males and 37.6% of females were ever married. On multivariable analysis, male sex (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.41–0.83, p = 0.003) and diagnosis of central nervous system (CNS) tumor/retinoblastoma (OR 0.42, 95% CI 0.22–0.81, p = 0.009) were associated with lower likelihood of marriage, while employment was strongly associated with higher likelihood (OR 3.75, 95% CI 2.62–5.37, p < 0.001). Among married survivors, treatment before 2000 was associated with a higher likelihood of parenthood (OR 3.94, 95% CI 2.20–7.06, p < 0.001), while other treatment-related factors were not significantly associated. Highly gonadotoxic treatment (OR 2.19, 95% CI 1.22–3.93, p = 0.01) was associated with use of assisted reproductive technology. Conclusions: Sociodemographic and temporal factors, particularly employment and treatment era, were the primary determinants of marriage and parenthood in this cohort.