Childhood cancer survivors are more likely to go through early menopause

Women who survive childhood cancer are more likely to suffer premature menopause, according to a study in the July 5 issue of the Journal of the National Cancer Institute. Risk factors include radiation to the ovaries and certain forms of chemotherapy.

Over 70% of children or adolescents diagnosed with cancer will survive long-term. Survivors have an increased risk of premature menopause, defined as menopause before age 40.

Charles A. Sklar, M.D., of Memorial Sloan-Kettering Cancer Center in New York, and colleagues examined the incidence of and risk factors for premature menopause in 2,819 childhood cancer survivors over age 18 as identified in the Childhood Cancer Survivor Study and 1,065 female siblings of survivors.

The authors observed that premature menopause occurred in 126 childhood cancer survivors and 33 siblings. Non-surgical premature menopause occurred more frequently in childhood cancer survivors. For cancer patients treated with both abdominal-pelvic radiation and the class of chemotherapy known as alkylating drugs, the cumulative incidence of premature menopause was nearly 30%. Age, radiation to the ovaries, a diagnosis of Hodgkin lymphoma, and treatment with alkylating chemotherapy increased a cancer survivor's risk of premature menopause.

The authors write, "The results of this study will facilitate counseling current survivors about their future risk of premature menopause and will aid in designing new regimens that seek to diminish late ovarian toxicity."

In an accompanying editorial, Wendy Y. Chen, M.D., and JoAnn E. Manson, M.D., Dr.P.H., from Brigham and Women's Hospital in Boston, discuss the health effects of premature menopause. They write, "The current study helps clinicians to identify women at increased risk of [premature menopause], so that prevention, screening, and treatment strategies can be implemented at an earlier stage."

Contacts:

• Article: Joanne Nichols, 212-639-3573, nicholaj@mskcc.org

• Editorial: Lori Shanks, 617-534-1604

Citations:

• Article: Sklar CA, Mertenz AC, Mitby P, Whitton J, Stovall M, Kaspar C, et al. Premature Menopause in Survivors of Childhood Cancer: A Report from From the Childhood Cancer Survivor Study. J Natl Cancer Inst 2006; 98: 890-896.

• Editorial: Chen WY, Manson JE. Premature Ovarian Failure in Cancer Survivors: New Insights, Looming Concern. J Natl Cancer Inst. 2006; 98: 880-881.

Note:
The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.

---

---