Abstract：
BACKGROUND: Patients with familial adenomatous polyposis (FAP) experience psychological and social challenges concerning future events such as marriage and childbirth alongside the medical risks of colorectal cancer (CRC) and FAP-related disease. We retrospectively investigated the rate of marriage and childbirth postoperatively in Japanese patients with FAP.
METHODS: We included 161 patients who had colorectal surgery and reported marital status from a national survey of 35 Japanese institutions. Participants were classified according to marital status: married before colectomy (80 patients), married after colectomy (13 patients), and unmarried (68 patients).
RESULTS: The marriage rate for all 161 patients (57.8%, standardized ratio 0.95, 95% confidence interval [CI] 0.76-1.14) was comparable to that in the general Japanese population (57.1%). The marriage rate among the 81 patients who were unmarried before colectomy was low (16.0%); however, the standardized marital ratio (0.75, 95% CI 0.34-1.15) was not significantly lower than that of the general population. In multivariable logistic regression, younger age (born after 1980, odds ratio [OR] 0.12, p < 0.001) and genetic testing (OR 4.06, p = 0.001) were associated with postoperative marriage. Seventy-one percent of patients with FAP who married after colectomy became pregnant and achieved delivery.
CONCLUSIONS: The marriage rate of patients with FAP was comparable to that of the general population whereas the rate after colectomy was low among patients with FAP. However, in patients with FAP, colorectal surgery itself may not lead to negative consequences in terms of fecundity.
METHODS: We included 161 patients who had colorectal surgery and reported marital status from a national survey of 35 Japanese institutions. Participants were classified according to marital status: married before colectomy (80 patients), married after colectomy (13 patients), and unmarried (68 patients).
RESULTS: The marriage rate for all 161 patients (57.8%, standardized ratio 0.95, 95% confidence interval [CI] 0.76-1.14) was comparable to that in the general Japanese population (57.1%). The marriage rate among the 81 patients who were unmarried before colectomy was low (16.0%); however, the standardized marital ratio (0.75, 95% CI 0.34-1.15) was not significantly lower than that of the general population. In multivariable logistic regression, younger age (born after 1980, odds ratio [OR] 0.12, p < 0.001) and genetic testing (OR 4.06, p = 0.001) were associated with postoperative marriage. Seventy-one percent of patients with FAP who married after colectomy became pregnant and achieved delivery.
CONCLUSIONS: The marriage rate of patients with FAP was comparable to that of the general population whereas the rate after colectomy was low among patients with FAP. However, in patients with FAP, colorectal surgery itself may not lead to negative consequences in terms of fecundity.
摘要：
背景：家族性腺瘤性息肉病（FAP）患者在婚姻和分娩等未来事件方面面临心理和社会挑战，同时存在结直肠癌（CRC）和FAP相关疾病的医疗风险。我们回顾性调查了日本FAP患者术后的结婚率和分娩率。
方法：我们纳入了161名接受结直肠手术的患者，并在对35个日本机构的全国性调查中报告了婚姻状况。参与者根据婚姻状况进行分类：结肠切除术前已婚（80例），结肠切除术后结婚（13例），未婚（68例）。
结果：所有161名患者的结婚率（57.8％，标准化比率0.95,95%置信区间[CI]0.76-1.14)与普通日本人群(57.1%)的比率相当.结肠切除术前未婚的81例患者结婚率较低(16.0%);标准化婚姻比(0.75,95%CI0.34-1.15)并未显著低于普通人群.在多变量逻辑回归中，年龄较小（1980年以后出生，比值比[OR]0.12，p<0.001）和基因检测（OR4.06，p=0.001）与术后婚姻有关。结肠切除术后结婚的FAP患者中有71％怀孕并分娩。
结论：FAP患者的婚姻率与普通人群相当，而FAP患者的结肠切除术后婚姻率较低。然而,在FAP患者中，结直肠手术本身可能不会导致繁殖力方面的负面影响。
方法：我们纳入了161名接受结直肠手术的患者，并在对35个日本机构的全国性调查中报告了婚姻状况。参与者根据婚姻状况进行分类：结肠切除术前已婚（80例），结肠切除术后结婚（13例），未婚（68例）。
结果：所有161名患者的结婚率（57.8％，标准化比率0.95,95%置信区间[CI]0.76-1.14)与普通日本人群(57.1%)的比率相当.结肠切除术前未婚的81例患者结婚率较低(16.0%);标准化婚姻比(0.75,95%CI0.34-1.15)并未显著低于普通人群.在多变量逻辑回归中，年龄较小（1980年以后出生，比值比[OR]0.12，p<0.001）和基因检测（OR4.06，p=0.001）与术后婚姻有关。结肠切除术后结婚的FAP患者中有71％怀孕并分娩。
结论：FAP患者的婚姻率与普通人群相当，而FAP患者的结肠切除术后婚姻率较低。然而,在FAP患者中，结直肠手术本身可能不会导致繁殖力方面的负面影响。
