Nonsurgical premature menopause (NSPM) in the Childhood Cancer Survivor Study (CCSS): Prevalence, risk factors, and reproductive outcomes.

Abstract

10504Background: Female survivors of childhood cancers are at increased risk for NSPM, cessation of menses prior to age 40 not secondary to resection of reproductive organs. Our aims were to assess prevalence of and risk factors for NSPM and to examine the implications of NSPM on reproductive outcomes. Methods: Participants included 2930 female survivors diagnosed between 1970 and 1986 and enrolled in the original CCSS cohort (median age at diagnosis 6 years, range 0-20; median age at follow-up 34 years; range 18-59) who were older than age 18 at last follow-up without prior acute ovarian failure. They were compared to 1399 siblings (median age 38 years, range 19-63). Among survivors, multivariable logistic regression identified risk factors for NSPM. Pregnancy and live birth rates were compared between survivors with and without NSPM. Results: 110 survivors developed NSPM [median age 32, range 16-40, prevalence of 9.1 % at age 40 (95% CI 4.9-17.2), relative risk 10.5 (95% CI 4.2-26.3) compared to sibling...