Female reproductive health in pediatric, adolescent, and young adult cancer survivors.
Holly R HoefgenJanie BenoitSerena ChanYasmin JayasingheMaryam LustbergVictoria PohlAmanda June SarafDeb SchmidtLeslie Coker AppiahPublished in: Pediatric blood & cancer (2023)
An estimated 500,000 cancer survivors of reproductive age in the United States will live to experience the long-term consequences of cancer treatment. Therefore, a focused aspect of cancer care has appropriately shifted to include quality of life in survivorship. Infertility is a late effect of therapy that affects 12% of female survivors of childhood cancer receiving any cancer treatment in large cohort studies and results in a 40% decreased likelihood of pregnancy in young adults of ages 18-39 years. Nonfertility gynecologic late effects such as hypoestrogenism, radiation-induced uterine and vaginal injury, genital graft-versus-host disease after hematopoietic stem cell transplant, and sexual dysfunction also significantly affect quality of life in survivorship but are underdiagnosed and require consideration. Several articles in the special edition "Reproductive Health in Adolescent and Young Adult Cancer Survivorship" address infertility, genital graft-versus-host disease, and psychosexual functioning in survivorship. This review article focuses on other adverse gynecologic outcomes of cancer therapies including hypogonadism and hormone replacement therapy, radiation-induced uterovaginal injury, vaccination and contraception, breast and cervical cancer screening, and pregnancy considerations in survivorship.
Keyphrases
- childhood cancer
- young adults
- radiation induced
- replacement therapy
- radiation therapy
- hematopoietic stem cell
- preterm birth
- cervical cancer screening
- smoking cessation
- polycystic ovary syndrome
- squamous cell carcinoma
- papillary thyroid
- pregnancy outcomes
- oxidative stress
- endometrial cancer
- pregnant women
- skeletal muscle
- drug induced
- electronic health record
- squamous cell