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Incidence of Pregnancy-Associated Cancer in Denmark, 1977–2006

Eibye, Simone MD; Kjær, Susanne Krüger MD, DMSC; Mellemkjær, Lene PhD

doi: 10.1097/AOG.0b013e3182a057a2
Original Research

OBJECTIVE: To estimate the incidence of pregnancy-associated cancer during a 30-year period in Denmark on the basis of both births and abortions with and without age adjustment and age standardization.

METHODS: Using data from the nationwide Danish registries, we investigated the occurrence of pregnancy-associated cancer (defined as cancer diagnosed during pregnancy and up to 1 year after pregnancy has ended) in pregnancies resulting in a birth (live birth or stillbirth) or an abortion. We included patients with primary cancer diagnosed at ages 15–44 years during 1977–2006 according to the Danish Cancer Registry. The patients were linked to the Medical Birth Registry, the Registry for Induced Abortions, and the National Patient Registry to obtain information on pregnancies.

RESULTS: We identified 2,426 patients with pregnancy-associated cancer. The three most frequent types were melanoma, cervical cancer, and breast cancer. We found an increase in the total numbers of all pregnancy-associated cancers from 572 cases during 1977–1986 to 1,052 cases during 1997–2006. The proportions of all pregnancy-associated cancers among all cancers increased from 5.4% to 8.3% during the same periods. The overall crude incidence rate of all pregnancy-associated cancer was 89.6 out of 100,000 pregnancies. The crude incidence increased over time, with an average annual percentage change of 2.9% (95% confidence interval [CI] 2.4–3.3). After age adjustment, the increase was still statistically significant (1.6%, 95% CI 1.1–2.1).

CONCLUSION: We found a statistically significant increase in pregnancy-associated cancer during the 30-year study period. The tendency to postpone childbirth only partly explains the increase in incidence rates.

LEVEL OF EVIDENCE: III

In Denmark, the incidence of pregnancy-associated cancer increased during 1977–2006, and this cannot be explained only by an increase in maternal age.

Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, and the Department of Obstetrics and Gynecology, the Juliane Marie Center, Rigshospitalet, Copenhagen, Denmark.

Corresponding author: Lene Mellemkjær, Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark; e-mail: lene@cancer.dk.

Supported by Rigshospitalets Forskningspulje.

The authors thank Thor Schütt Svane Nielsen and Peter Bo Aarslev for assistance with the statistical analyses, Kirsten Frederiksen for statistical advice, and Christian Dehlendorff for comments on the manuscript.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.