title: Marriage and parenthood among childhood cancer survivors: a report from the Italian AIEOP Off-Therapy Registry.
abstract: BACKGROUND
  The aim of this study was to describe the patterns of marriage and parenthood in a cohort of childhood cancer survivors included in the Off-Therapy Registry maintained by the Italian Association of Pediatric Hematology and Oncology.
  
  
  METHODS
  We analyzed a cohort of 6,044 patients diagnosed with cancer between 1960 and 1998, while aged 0 to 14 years and who were 18 years old or older by December 2003. They were followed up through the regional vital statistics registers until death or the end of follow up (October 30, 2006), whichever occurred first, and their marital status and date of birth of their children were recorded. The cumulative probabilities of being married and having a first child were computed by gender and compared by tumor type within the cohort. Marriage and fertility rates (the latter defined as the number of live births per woman-year) were compared with those of the Italian population of the same age, gender, area of residence and calendar period by means of the observed to expected (O/E) ratios.
  
  
  RESULTS
  During the follow-up period, 4,633 (77%) subjects had not married. The marriage O/E ratios were 0.56 (95% CI: 0.51-0.61) and 0.70 (95% CI: 0.65-0.76) among men and women, respectively. Overall, 263 men had 367 liveborn children, and 473 women had 697 liveborn children. The female fertility O/E ratio was 0.57 (95% CI: 0.53-0.62) overall, and 1.08 (95% CI: 0.99-1.17) when analyses were restricted to married/cohabiting women
  
  
  CONCLUSIONS
  Childhood cancer survivors are less likely to marry and to have children than the general population, confirming the life-long impact of their previous disease on their social behavior and choices. The inclusion of counseling in the strategies of management and long-term surveillance of childhood cancer patients could be beneficial to survivors as they approach adulthood.
authors.affiliation: Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit – CPO Piemonte, CeRMS, S.Giovanni Hospital and University of Turin, Turin, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pivetta
authors.forename: Milena M
authors.initials: MM
authors.lastname: Maule
authors.forename: Paola
authors.initials: P
authors.lastname: Pisani
authors.forename: Daniela
authors.initials: D
authors.lastname: Zugna
authors.forename: Riccardo
authors.initials: R
authors.lastname: Haupt
authors.forename: Momcilo
authors.initials: M
authors.lastname: Jankovic
authors.forename: Maurizio
authors.initials: M
authors.lastname: Aricò
authors.forename: Fiorina
authors.initials: F
authors.lastname: Casale
authors.forename: Anna
authors.initials: A
authors.lastname: Clerico
authors.forename: Luca
authors.initials: L
authors.lastname: Cordero di Montezemolo
authors.forename: Valentina
authors.initials: V
authors.lastname: Kiren
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Giovanna
authors.initials: G
authors.lastname: Palumbo
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
authors.forename: Marta
authors.initials: M
authors.lastname: Pillon
authors.forename: Nicola
authors.initials: N
authors.lastname: Santoro
authors.forename: Monica
authors.initials: M
authors.lastname: Terenziani
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Valsecchi
authors.forename: Elisa
authors.initials: E
authors.lastname: Dama
authors.forename: Corrado
authors.initials: C
authors.lastname: Magnani
authors.forename: Franco
authors.initials: F
authors.lastname: Merletti
authors.forename: Guido
authors.initials: G
authors.lastname: Pastore
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data*; D008875:Middle Aged; D010290:Parents; D012042:Registries / Q000706:statistics & numerical data; D017741:Survivors / Q000706:statistics & numerical data*