Marriage and parenthood among subjects cured of childhood cancer: a report from the Italian AIEOP Off-Therapy Registry

Background. The aim of this work was to describe the patterns of marriage and parenthood in a cohort of individuals cured of childhood cancer included in the Off-Therapy Registry maintained by the Italian Association of Pediatric Hematology and Oncology. Design and Methods. We analyzed a cohort of 6,044 patients diagnosed with cancer while aged 15 years or less, between 1960 and 1998, and who were 18 years old or older by December 2003. They were followed up through the regional vital statistics registers until marriage/birth of 1st child, death, or the end of follow-up (October 30, 2006), whichever occurred first. The cumulative probabilities of being married and having children were computed by gender and tumor type. Marriage and fertility rates were compared with those of the Italian population (of the same age, gender, area of residence and time period) by means of the observed to expected ratios. Results. During the follow-up period, 4,633 (77%) subjects had not married. The marriage observed/expected ratios were 0.56 (95% CI: 0.51-0.61) and 0.70 (95% CI: 0.65-0.76) among men and women, respectively. Overall, 263 men had 367 children, and 473 women had 697 children. The women fertility O/E ratio was 0.45 (95% CI: 0.42-0.49). Conclusions. Subjects cured of childhood cancer are less likely to marry and to have children than the general population, confirming the life-long impact of their previous disease on their social behaviors and choices. These information should contribute to direct the current strategies for the treatment of childhood cancer.