Congenital Abnormalities: A Legacy of Cancer Treatment?

Extract

Both childhood and adult cancer survivors are keenly interested in understanding the potential battery of long-term health effects related to their disease and treatment. Unfortunately, the potential hazards are many. For example, large numbers of cancer survivors are left permanently infertile by therapy-induced gonadal failure ( 1 ), heart disease is among the serious sequelae of anthracycline treatment and mediastinal radiotherapy ( 2 ), and subsequent malignancies related to chemotherapy and radiotherapy can arise in several organ systems ( 3 ). In this issue of the Journal, Stahl et al. ( 4 ) tackle another pressing health question for cancer survivors—might they somehow pass along genetic damage capable of causing adverse outcomes in their children? Among the outcomes studied in this investigation, including preterm birth, low birth weight, and size for gestational age, only major congenital abnormalities emerged as a potential outcome associated with a paternal cancer diagnosis. With a prevalence of 3.7% among the children of male cancer survivors and 3.2% for men without a history of cancer, the children of cancer survivors had a modest 17% relative increase in major congenital abnormalities (adjusted relative risk 1.17, 95% confidence interval 1.05 to 1.31).