Abstract
Despite numerous available resources of evidence, the results about the frequency of pregnancy-associated cancer (PAC) still show poor comparability due to dissimilarities in the study design and methodology, inclusion criteria, incoherent duration of follow-up and a heterogeneous reference population. We conducted a systematic review of population-based studies on PAC published up to December 2019, to provide updated research on this topic, highlighting strengths and limitations. Of the 24 papers included, 11 considered all types of tumors and 13 dealt with specific types of cancer. Differences in the procedures for estimating the frequency of PAC emerged even among population studies. However, we found consistent results for overall frequency of PAC— around 1/1000 pregnancies. Our review suggests that about 25% of PAC cases are diagnosed during pregnancy, confirming the hypothesis of an excess of diagnosis in the postpregnancy period. Sparse and inconsistent results were found regarding a potential increase in the frequency of PAC over calendar years. Alignments in the strategy to identify PAC are needed to overcome methodological weaknesses.
Highlights
Malignancies occurring in association with pregnancy pose major challenges for patients, their physicians and health care systems
We identified 770 articles dealing with pregnancy-associated cancer (PAC)
Hospitaldischarge records lack the identification of incident cancer cases, but can provide detailed information on the quality of care, on the adherence to diagnostic therapeutic pathways, covering all the follow-up period needed for identification of PAC
Summary
Malignancies occurring in association with pregnancy pose major challenges for patients, their physicians and health care systems. Pregnant patients diagnosed with cancer need a multidisciplinary approach with the involvement of different specialists. Both maternal and fetal health should be considered, and specialized management strategies should be implemented to ameliorate clinical results. Unmet needs in health care system organizations may become evident when incidence and prevalence of a specific condition is over- or under-evaluated. It is of utmost importance to quantify the burden of cancer in pregnancy. Pregnancy-associated cancer (PAC) complicates approximately 1/1000 pregnancies [1]. There is a considerable variation in incident and prevalent cancer types in different populations
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