Research on childhood cancer survivor offspring has been limited to genetic disease occurrence, malformations or non-hereditary cancers. However, previous surveys indicated that survivors harbor fears about their (prospective) children’s overall health. Our Multicenter Offspring Study examined extensive health aspects in children born to survivors and their siblings providing comprehensive information to be used in patient counseling to elucidate and alleviate existing concerns.
Using a specifically designed questionnaire, childhood cancer survivors and their siblings were surveyed on their offspring’s health (Supplementary material). Recruitment strategies depended on local infrastructures and standards of participating centers, including registry-based and direct approaches. Group differences were tested non-parametrically and effect sizes were calculated.
In total, 1126 survivors reported on 1780 offspring and 271 siblings reported on 441 offspring. Response rates ranged from 32.1% (Czech Republic) to 85.0% (Austria). Respondents were more likely to be female (p = .007), older at time of survey (p < .001), diagnosed 1980–1999 (p < .001) and treated with chemotherapy (p < .001). Compared to siblings, survivors were younger at time of survey (35 years vs. 39 years, p < .001) and at first birth (29 years vs. 30 years, p < .001). Survivor and sibling offspring only differed in terms of age at survey (6.3 years vs. 8.9 years, p < .001).
The Multicenter Offspring Study investigates a wide variety of health aspects in offspring born to survivors and their siblings in five European countries. Our study cohorts form a solid basis for future analyses; yet, certain limitations, due to differences in approach among participating centers, must be considered when interpreting findings.
- • This study forms the basis for comprehensive analyses of survivor offspring health.
- • A total of 1126 survivors with 1780 offspring were included.
- • Characteristics of survivors and siblings, as well as their offspring, were balanced.
- • Subjective health status of offspring was highly rated by survivors and siblings.
- • Survivors reported higher anxiety regarding cancer development in offspring.
A high quality of life is an important post-therapeutic goal for childhood cancer patients. Survivors of childhood cancer are able to participate in everyday life, despite possible treatment-related physical and/or psychosocial impairment ; however, they tend to achieve milestones later in life than peers . Although a desire for prospective children is reported by the majority of survivors , birth rates are lower than in the general population . Some of this discrepancy can be explained by the higher prevalence of therapy-associated infertility among survivors . Access to fertility preserving measures still varies across Europe, resulting in an inequality of opportunity—this is especially true for female survivors . However, this discrepancy may also be due to survivors’ expressed fear that their cancer treatment might negatively impact prospective children’s health .
Previous studies showed no increased risk of genetic diseases, non-hereditary cancers or malformations in survivor offspring, including offspring born following reproductive treatment . Likewise, survivor offspring were hospitalized at the same frequency and with similar diagnoses than peers, however, more often to rule out malignancy . A survey on survivor offspring revealed that survivors consulted specialists more often than general practitioners or pediatricians 1
1 Pediatricians, in Germany, are considered the specialist doctor for regular screening check-ups, acute and chronic disease management, similar to general practitioners in adults.
for their children .
To offer adequate patient counseling and address concerns, further assessment of offspring health is crucial. We therefore conducted the Multicenter Offspring Study in Austria, Czech Republic, Germany, Poland and Switzerland to examine health aspects of childhood cancer survivor offspring within a large, European sample .