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Area of Science:

  • Reproductive Health
  • Oncology
  • Population Health

Background:

  • Parenthood after cancer diagnosis and treatment is a growing concern, yet population-based studies are scarce.
  • Previous research primarily focused on reproductive cancers, leaving a gap in understanding the broader impact on fertility.

Purpose of the Study:

  • To investigate the effects of various cancer forms on fertility at a population level.
  • To analyze fertility rates among cancer survivors compared to the general population.

Main Methods:

  • Utilized discrete-time hazard regression models.
  • Analyzed complete Norwegian birth cohort data (1965-2001) including men and women aged 17-44.
  • Estimated models for first- and higher-order birth rates for both sexes.

Main Results:

  • First-birth rates for cancer survivors were reduced by approximately 25% compared to the general population.
  • Male cancer survivors showed similar reductions in second- and third-birth rates.
  • Female cancer survivors experienced a 36% reduction in higher-order birth rates.
  • A significant decrease in the fertility disadvantage for cancer survivors was observed from 1965 to 2001.
  • Fertility reductions were most pronounced for reproductive cancers, but also occurred for non-reproductive cancers, suggesting social factors.

Conclusions:

  • Cancer diagnosis and treatment lead to a notable, though not prohibitive, reduction in fertility.
  • The fertility disadvantage for cancer survivors has decreased over time.
  • Both direct (subfecundity) and indirect (social) mechanisms likely contribute to reduced fertility post-cancer.