Childhood Cancer Survivors at Risk for Early Menopause
Incidence nearly 30 percent in women treated with alkylating agents and abdominal/pelvic radiation
WEDNESDAY, July 5 (HealthDay News) -- Women treated for cancer in childhood are 13 times as likely to undergo non-surgical premature menopause as their female siblings without cancer, according to a report in the July 5 issue of the Journal of the National Cancer Institute. Almost one-third of childhood cancer survivors treated with alkylating agents plus radiation to the abdomen or pelvis undergo menopause by age 40.
Charles A. Sklar, M.D., of Memorial Sloan-Kettering Cancer Center in New York City, and colleagues compared the age of menopause among 2,819 women who had been treated for childhood cancer with that of 1,065 of their healthy sisters.
Overall, 126 childhood cancer survivors underwent early menopause, including 61 with surgically induced menopause. Thirty-three controls underwent early menopause, including 31 with surgical menopause. The cumulative incidence of menopause by age 40 was 8 percent in cancer patients versus 0.8 percent in their siblings, for a 13-fold higher risk. Childhood cancer patients treated with radiation to the pelvis/abdomen and alkylating agents had a cumulative incidence of nearly 30 percent by age 40.
"The results of this study will facilitate counseling current survivors about their future risk of premature menopause and aid in designing new regimens that seek to diminish late ovarian toxicity," the authors write.
In an accompanying editorial, JoAnn Manson, M.D., of Brigham and Women's Hospital in Boston, and a colleague write that "this study highlights the important issue of premature menopause, which has a public health impact beyond that attributable to survivors of childhood cancer."