辅助生殖技术与儿童癌症风险：基于人群的研究及系统评价和荟萃分析。

Assisted reproductive technology and the risk of pediatric cancer: A population based study and a systematic review and meta analysis.

机构信息

Maccabi-Kahn Research Institute, Tel Aviv, Israel; IVF Unit, Assuta Medical Center, Tel Aviv, Israel.

Maccabi-Kahn Research Institute, Tel Aviv, Israel; The Faculty of Medicine, Ariel University, Israel.

出版信息

Cancer Epidemiol. 2019 Dec;63:101613. doi: 10.1016/j.canep.2019.101613. Epub 2019 Oct 10.

DOI:10.1016/j.canep.2019.101613

PMID:31606679

Abstract

BACKGROUND

There is controversy whether exposure to assisted reproductive technology (ART) is associated with increased risk of pediatric cancer. We aimed at calculating the overall risk of pediatric cancers after ART in a large cohort of exposed women; and to conduct a systematic review and meta- analysis of cohort studies examining overall risk of pediatric cancers after ART.

METHODS

All children born in Israel who were members of Maccabi Health Services (MHS) between 1999 and 2016 after ART, were linked to the Israeli Registry of Childhood Cancer (IGS) to identify those with cancer diagnosed before 16 years of age. In parallel we conducted a systematic review and meta-analysis of observational cohort studies with more than 5000 ART- exposed cases that measured pediatric cancer after ART.

RESULTS

In the cohort study, the risk ratio for pediatric cancer after ART in general was 0.95 (95% CI, 0.76-1.19). The RR was 1.09 (95% CI, 0.79-1.48) for IVF treatments. Meta- analysis of 13 cohort studies with a total of 750,138 women exposed to ART (with 1152 pediatric cancers) and 214,008,000 unexposed controls (with 30,458 pediatric cancers) did not reveal increased risk for pediatric cancers (RR 0.99; 95% CI, 0.85-1.15).

CONCLUSIONS

Based on very large numbers, ART in general, and IVF in particular, are not associated with overall increased risk of pediatric cancer.

摘要

背景

辅助生殖技术（ART）暴露是否会增加儿童癌症风险存在争议。我们旨在计算大量暴露于 ART 的女性中 ART 后儿科癌症的总体风险；并对检查 ART 后儿科癌症总体风险的队列研究进行系统回顾和荟萃分析。

方法

在以色列，1999 年至 2016 年间在 Maccabi 健康服务（MHS）之后接受 ART 的所有儿童，均与以色列儿童癌症登记处（IGS）联系，以确定在 16 岁之前被诊断出患有癌症的儿童。同时，我们对超过 5000 例 ART 暴露病例进行了系统回顾和荟萃分析，这些病例测量了 ART 后的儿科癌症。

结果

在队列研究中，ART 后儿科癌症的风险比一般为 0.95（95%CI，0.76-1.19）。IVF 治疗的 RR 为 1.09（95%CI，0.79-1.48）。对 13 项队列研究的荟萃分析，这些研究共纳入了 750138 名接受 ART（1152 例儿科癌症）和 214008000 名未暴露于 ART 的对照组（30458 例儿科癌症），并未发现儿科癌症风险增加（RR 0.99；95%CI，0.85-1.15）。