Survivors of Childhood Cancer Risk Premature Menopause

A woman who survives cancer as a child has a greatly increased risk of experiencing menopause before she reaches age 40. If this occurs, her risk for osteoporosis, cardiac disease, and psychosexual dysfunction increases.

Researchers working with the Childhood Cancer Survivors Study (CCSS), a retrospective longitudinal cohort study of more than 20,000 childhood cancer survivors diagnosed between 1970 and 1986, found that survivors had nonsurgical premature menopause at a rate 13 times greater than the control group. The affected women were older at time of assessment, more likely to have had Hodgkin lymphoma, less likely to have had leukemia, and had greater ovarian exposure to radiation and/or alkylating chemotherapy agents.

Dr. Charles A. Sklar of Memorial Sloan-Kettering Cancer Center and colleagues identified 2,819 CCSS subjects who were menstruating more than 5 years after their cancer diagnosis; controls were selected from among survivors' siblings, not always from the same families - in this case 1,065 age-matched women with normal menstrual patterns.

In an accompanying editorial in the July 5 Journal of the National Cancer Institute (JNCI), Drs. Wendy Y. Chen and JoAnn E. Manson of Harvard Medical School wrote, "the health consequences of premature menopause are still poorly understood," noting that some of them are controversial, and not all are negative: such women have a lower risk of breast and ovarian cancer. Nonetheless, this study helps clinicians identify women for whom counseling, prevention, screening, and treatment strategies should be considered. NCI Bulletin 7/11/2006

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