Assisted Reproductive Technology & Risk of Childhood Cancer

辅助生殖技术

• 批准号: 8613468
• 负责人: BARBARA Joan LUKE
• 金额: $ 57.59万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2016-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8613468
• 关键词: Affect; Angelman Syndrome; Assisted Reproductive Technology; Beckwith-Wiedemann Syndrome; Birth; California; Case Series; Certification; Child; Clinic; Conceptions; Congenital Abnormality; Data; Databases; Disease; Disease Outcome; Embryonal Cancers; Fertility; General Population; Germ Cells; Germ-Line Mutation; Hepatoblastoma; Illinois; Incidence; Infant; Infertility; Insurance Coverage; Link; Low Birth Weight Infant; Malignant Childhood Neoplasm; Malignant Neoplasms; Massachusetts; Maternal Age; Medical; New Jersey; New York; New York City; Outcome; Perinatal; Population; Pregnancy; Prevalence; Procedures; Reporting; Resources; Risk; Sample Size; Services; Societies; Time; United States; assisted reproduction; cancer risk; cancer type; case control; child bearing; cohort; disorder risk; early childhood; high risk; imprint; in utero; neoplasm registry; premature; prenatal; programs; success

DESCRIPTION (provided by applicant): Use of assisted reproductive technology (ART) has risen steadily in the United States during the past two decades due to several reasons, including childbearing at older maternal ages and increasing insurance coverage. Studies have reported significantly higher risks of adverse perinatal outcomes in assisted- versus spontaneous-conception pregnancies, including an excess of prematurity, low birthweight, and birth defects. ART and/or infertility may influence the incidence of other conditions with prenatal origins, such as childhood cancer. In addition, the prevalence of imprinting disorders such as Beckwith-Wiedemann and Angelman syndromes is elevated among children conceived by ART; some of these disorders, in turn, drastically raise the risk of several embryonal cancers that occur in early childhood. Several cohort, case-control, and case- series studies of assisted reproduction and childhood cancer have reported null results, although all were limited by small sample size and could not differentiate specific cancer types. One study that focused specifically on hepatoblastoma found that use of infertility treatment or assisted reproduction was associated with a nine-fold increased risk of disease. Using the resources of the Society for Assisted Reproductive Technology (SART) and the birth and cancer registries in 20 States and New York City, we propose to conduct the largest study to date of ART and childhood cancer risk. SART maintains an ongoing national database of programs that provide ART services in the United States as mandated by the federal Fertility Success Rate and Certification Act of 1992 [PL 102-493]. As of 2006, the latest year of data available, this included comprehensive data (including identifiers sufficient for linkage) on 138,198 ART cycles from 483 clinics resulting in 41,343 pregnancies and 54,656 infants for a single year. We propose to link the data from the SART database from 2004-2013 to the birth and cancer registries of 20 states and New York City, including the five states with the highest numbers of ART births (California, New York, Illinois, New Jersey, and Massachusetts), to create a cohort of approximately 30 million children, including over 467,000 conceived by ART to evaluate the association between assisted reproduction and the risk for childhood cancer. The specific aim of this study is to compare the incidence of childhood cancer in children with assisted conception to that in the general population.

描述（由申请人提供）：过去二十年来，美国辅助生殖技术（ART）的使用稳步增长，原因有多种，包括高龄生育和保险覆盖范围的增加。研究报告称，与自然受孕相比，辅助受孕的围产期不良结局的风险明显更高，包括早产率过高、出生体重过低和出生缺陷。 ART 和/或不孕症可能会影响其他产前疾病的发病率，例如儿童癌症。此外，在通过 ART 受孕的孩子中，贝克威斯-维德曼综合征和安格曼综合征等印记疾病的患病率有所升高；其中一些疾病反过来又大大增加了儿童早期发生几种胚胎癌的风险。一些关于辅助生殖和儿童癌症的队列、病例对照和病例系列研究报告了无效结果，尽管所有这些研究都受到小样本量的限制并且无法区分特定的癌症类型。一项专门针对肝母细胞瘤的研究发现，使用不孕不育治疗或辅助生殖与患病风险增加九倍相关。我们建议利用辅助生殖技术协会 (SART) 以及 20 个州和纽约市的出生和癌症登记处的资源，开展迄今为止最大规模的 ART 与儿童癌症风险研究。 SART 维护着一个持续的国家项目数据库，这些项目按照 1992 年联邦生育成功率和认证法案 [PL 102-493] 的规定在美国提供 ART 服务。截至 2006 年（可获得的最新数据），这包括来自 483 个诊所的 138,198 个 ART 周期的综合数据（包括足以链接的标识符），一年内导致 41,343 例怀孕和 54,656 例婴儿。我们建议将 2004 年至 2013 年 SART 数据库的数据与 20 个州和纽约市的出生和癌症登记处联系起来，其中包括 ART 出生人数最多的五个州（加利福尼亚州、纽约州、伊利诺伊州、新泽西州、和马萨诸塞州）创建了一个由大约 3000 万儿童组成的队列，其中包括超过 467,000 名通过 ART 受孕的儿童，以评估辅助生殖与儿童癌症风险之间的关联。本研究的具体目的是比较辅助受孕儿童与普通人群的儿童癌症发病率。