Abstract：
BACKGROUND: Fertility after cancer is a top concern for adolescents and young adults with cancer (AYAs) (15-39 years old at diagnosis). The authors characterized live births after cancer by race and ethnicity (\"race/ethnicity\") in a population-based sample of female AYAs.
METHODS: This study used Texas Cancer Registry data linked to birth certificates (1995-2016) to estimate cumulative incidence of live birth, based on first live birth after cancer, and compared differences by race/ethnicity. Proportional subdistribution hazards models were used to estimate associations between race/ethnicity and live birth, adjusted for diagnosis age, cancer type, stage, year, and prior live birth, overall and for each cancer type.
RESULTS: Among 65,804 AYAs, 10-year cumulative incidence of live birth was lower among non-Hispanic Black AYAs than other racial/ethnic groups: 10.2% (95% confidence interval [CI], 9.4-10.9) compared to 15.9% (95% CI, 14.1-17.9) among Asian or Pacific Islander, 14.7% (95% CI, 14.2-15.3) among Hispanic, and 15.2% (95% CI, 14.8-15.6) among non-Hispanic White AYAs (p < .01). In the adjusted overall model, Black AYAs were less likely to have a live birth after cancer than all other groups. In adjusted models for each cancer type, live birth was significantly less likely for Black AYAs with gynecologic cancers or lymphomas (compared to White AYAs) or thyroid cancers (compared to Hispanic AYAs).
CONCLUSIONS: Black AYAs are less likely than AYAs of other races/ethnicities to have a live birth after cancer, in contrast to patterns of live birth in the general population. Research and action to promote childbearing equity after cancer are imperative.
METHODS: This study used Texas Cancer Registry data linked to birth certificates (1995-2016) to estimate cumulative incidence of live birth, based on first live birth after cancer, and compared differences by race/ethnicity. Proportional subdistribution hazards models were used to estimate associations between race/ethnicity and live birth, adjusted for diagnosis age, cancer type, stage, year, and prior live birth, overall and for each cancer type.
RESULTS: Among 65,804 AYAs, 10-year cumulative incidence of live birth was lower among non-Hispanic Black AYAs than other racial/ethnic groups: 10.2% (95% confidence interval [CI], 9.4-10.9) compared to 15.9% (95% CI, 14.1-17.9) among Asian or Pacific Islander, 14.7% (95% CI, 14.2-15.3) among Hispanic, and 15.2% (95% CI, 14.8-15.6) among non-Hispanic White AYAs (p < .01). In the adjusted overall model, Black AYAs were less likely to have a live birth after cancer than all other groups. In adjusted models for each cancer type, live birth was significantly less likely for Black AYAs with gynecologic cancers or lymphomas (compared to White AYAs) or thyroid cancers (compared to Hispanic AYAs).
CONCLUSIONS: Black AYAs are less likely than AYAs of other races/ethnicities to have a live birth after cancer, in contrast to patterns of live birth in the general population. Research and action to promote childbearing equity after cancer are imperative.
摘要：
背景：癌症后的生育力是青少年和患有癌症（AYAs）的年轻人（诊断时15-39岁）的首要问题。作者在基于人群的女性AYAs样本中，通过种族和种族（“种族/种族”）对癌症后的活产进行了表征。
方法：本研究使用与出生证明（1995-2016年）相关的德克萨斯州癌症登记数据来估计活产的累积发生率，基于癌症后的第一次活产，并按种族/民族比较差异。比例分布风险模型用于估计种族/民族和活产之间的关联。调整诊断年龄，癌症类型,舞台,Year,和之前的活产，总体和每种癌症类型。
结果：在65,804个AYAs中，非西班牙裔黑人AYAs的活产10年累积发生率低于其他种族/族裔群体：10.2％（95％置信区间[CI]，9.4-10.9）与亚洲或太平洋岛民的15.9％（95％CI，14.1-17.9）相比，西班牙裔中14.7%（95%CI，14.2-15.3），和15.2%（95%CI，14.8-15.6）在非西班牙裔白人AYAs（p<0.01）中。在调整后的总体模型中，与所有其他组相比，黑人AYAs在癌症后活产的可能性较小。在每种癌症类型的调整模型中，对于患有妇科癌症或淋巴瘤（与白色AYAs相比）或甲状腺癌（与西班牙裔AYAs相比）的黑色AYAs，活产的可能性显着降低。
结论：与其他种族/种族的AYA相比，黑人AYA在癌症后活产的可能性较小，与普通人群的活产模式相反。研究和行动促进癌症后生育公平势在必行。
方法：本研究使用与出生证明（1995-2016年）相关的德克萨斯州癌症登记数据来估计活产的累积发生率，基于癌症后的第一次活产，并按种族/民族比较差异。比例分布风险模型用于估计种族/民族和活产之间的关联。调整诊断年龄，癌症类型,舞台,Year,和之前的活产，总体和每种癌症类型。
结果：在65,804个AYAs中，非西班牙裔黑人AYAs的活产10年累积发生率低于其他种族/族裔群体：10.2％（95％置信区间[CI]，9.4-10.9）与亚洲或太平洋岛民的15.9％（95％CI，14.1-17.9）相比，西班牙裔中14.7%（95%CI，14.2-15.3），和15.2%（95%CI，14.8-15.6）在非西班牙裔白人AYAs（p<0.01）中。在调整后的总体模型中，与所有其他组相比，黑人AYAs在癌症后活产的可能性较小。在每种癌症类型的调整模型中，对于患有妇科癌症或淋巴瘤（与白色AYAs相比）或甲状腺癌（与西班牙裔AYAs相比）的黑色AYAs，活产的可能性显着降低。
结论：与其他种族/种族的AYA相比，黑人AYA在癌症后活产的可能性较小，与普通人群的活产模式相反。研究和行动促进癌症后生育公平势在必行。
