Gestational trophoblastic neoplasia risk factors: Difference between revisions
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*A case-control study by La Vecchia et al revealed increased risk of gestational trophoblastic disease in general in women with husbands older than 40 (RR= 1.6 [95% CI 0·9 – 6·0] for age 41 - 45 years and RR= 4.9 [95% CI 2·2 – 11·1] for age > 45 years).<ref name="pmid6088880">{{cite journal |vauthors=La Vecchia C, Parazzini F, Decarli A, Franceschi S, Fasoli M, Favalli G, Negri E, Pampallona S |title=Age of parents and risk of gestational trophoblastic disease |journal=J. Natl. Cancer Inst. |volume=73 |issue=3 |pages=639–42 |date=September 1984 |pmid=6088880 |doi= |url=}}</ref> | *A case-control study by La Vecchia et al revealed increased risk of gestational trophoblastic disease in general in women with husbands older than 40 (RR= 1.6 [95% CI 0·9 – 6·0] for age 41 - 45 years and RR= 4.9 [95% CI 2·2 – 11·1] for age > 45 years).<ref name="pmid6088880">{{cite journal |vauthors=La Vecchia C, Parazzini F, Decarli A, Franceschi S, Fasoli M, Favalli G, Negri E, Pampallona S |title=Age of parents and risk of gestational trophoblastic disease |journal=J. Natl. Cancer Inst. |volume=73 |issue=3 |pages=639–42 |date=September 1984 |pmid=6088880 |doi= |url=}}</ref> | ||
* | *Paternal age > 45 years can also independently be associated with an increased risk of complete hydatidiform mole (CHM), a potential prerequisite of choriocarcinoma (RR= 2.9).<ref name="ParazziniVecchia1986">{{cite journal|last1=Parazzini|first1=F.|last2=Vecchia|first2=C. La|last3=Pampallona|first3=S.|title=Parental age and risk of complete and partial hydatidiform mole|journal=BJOG: An International Journal of Obstetrics and Gynaecology|volume=93|issue=4|year=1986|pages=582–585|issn=1470-0328|doi=10.1111/j.1471-0528.1986.tb07957.x}}</ref> | ||
===History of Gestational Trophoblastic Disease=== | |||
*Previous history of hydatidiform mole is associated with a 1000 – 2000 times increased risk of choriocarcinoma.<ref name="pmid6705308">{{cite journal |vauthors=Buckley JD |title=The epidemiology of molar pregnancy and choriocarcinoma |journal=Clin Obstet Gynecol |volume=27 |issue=1 |pages=153–9 |date=March 1984 |pmid=6705308 |doi= |url=}}</ref> | |||
*The risk of choriocarcinoma after a complete hydatidiform mole (CHM) is about 2500 times higher than after a live birth.<ref name="pmid6705308">{{cite journal |vauthors=Buckley JD |title=The epidemiology of molar pregnancy and choriocarcinoma |journal=Clin Obstet Gynecol |volume=27 |issue=1 |pages=153–9 |date=March 1984 |pmid=6705308 |doi= |url=}}</ref> | |||
===Reproductive Factors=== | |||
*Studies on gestational trophoblastic disease in general have shown a relative risk of 0·6 - 1·0 for parous women compared with nulliparous women.<ref name="BrintonWu1989">{{cite journal|last1=Brinton|first1=Louise A.|last2=Wu|first2=Bao-Zhen|last3=Wang|first3=Wen|last4=Ershow|first4=Abby G.|last5=Song|first5=Hong-Zhao|last6=Li|first6=Jun-Yao|last7=Bracken|first7=Michael B.|last8=Blot|first8=William J.|title=Gestational trophoblastic disease: A case-control study from the People's Republic of China|journal=American Journal of Obstetrics and Gynecology|volume=161|issue=1|year=1989|pages=121–127|issn=00029378|doi=10.1016/0002-9378(89)90248-2}}</ref><ref name="ParazziniLaVecchia1985">{{cite journal|last1=Parazzini|first1=Fabio|last2=LaVecchia|first2=Carlo|last3=Pampallona|first3=Sandro|last4=Franceschi|first4=Silvia|title=Reproductive patterns and the risk of gestational trophoblastic disease|journal=American Journal of Obstetrics and Gynecology|volume=152|issue=7|year=1985|pages=866–870|issn=00029378|doi=10.1016/S0002-9378(85)80079-X}}</ref> | |||
Revision as of 22:48, 22 February 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
Overview
Common risk factors in the development of choriocarcinoma are child-bearing age, previous hydatidiform mole, and family history of gestational trophoblastic disease.[1]
Risk factors
Parental Age
Maternal
- The risk of choriocarcinoma increases progressively in women older than 25 years (relative risk 1·4).[2]
- The risk increases more rapidly in women older than 39 years (relative risk 10·8).[2]
- The risk is higher for women younger than 20 compared with women aged 20 – 24 years (relative risk 1·5).[2]
Paternal
- A case-control study by La Vecchia et al revealed increased risk of gestational trophoblastic disease in general in women with husbands older than 40 (RR= 1.6 [95% CI 0·9 – 6·0] for age 41 - 45 years and RR= 4.9 [95% CI 2·2 – 11·1] for age > 45 years).[3]
- Paternal age > 45 years can also independently be associated with an increased risk of complete hydatidiform mole (CHM), a potential prerequisite of choriocarcinoma (RR= 2.9).[4]
History of Gestational Trophoblastic Disease
- Previous history of hydatidiform mole is associated with a 1000 – 2000 times increased risk of choriocarcinoma.[2]
- The risk of choriocarcinoma after a complete hydatidiform mole (CHM) is about 2500 times higher than after a live birth.[2]
Reproductive Factors
- Studies on gestational trophoblastic disease in general have shown a relative risk of 0·6 - 1·0 for parous women compared with nulliparous women.[5][6]
Known risk factors
There is convincing evidence that the following factors increase your risk for gestational trophoblastic disease(GTD).[1]
Child-bearing age
Gestational trophoblastic disease (GTD) occurs in women of child-bearing age. The risk is higher in women who become pregnant over the age of 40 and those who becomepregnant under the age of 20.
Previous hydatidiform mole
Women who have a hydatidiform mole, or molar pregnancy, are at a higher risk of having another one or having another type of gestational trophoblastic disease (GTD). A woman’s risk increases with a history of more than one hydatidiform mole.
Family history of gestational trophoblastic disease (GTD)
Although it is rare, there is a type of gestational trophoblastic disease (GTD) that occurs in families. Therefore, a family history of gestational trophoblastic disease (GTD) may increase your risk.
Possible risk factors
The following factors have been linked with gestational trophoblastic disease (GTD), but there is not enough evidence to show they are known risk factors. Further study is needed to clarify the role of these factors for gestational trophoblastic disease (GTD).[1]
Oral contraceptives
Several studies have shown a possible link between using oral contraceptives and an increased risk of gestational trophoblastic disease (GTD). But recent studies suggest that there is no association or that the association is weak.
Reproductive factors
Some reproductive factors may increase the risk of gestational trophoblastic disease (GTD). These factors include infertility, a history of miscarriage, not having children, having had many children (5 or more), menarche after 12 years of age, and a light menstrual flow.
Blood types
Some studies have suggested that women with certain blood types are at increased risk of developing gestational trophoblastic disease (GTD). These are women with type A or AB blood, or women with blood type A who have male partners with blood type O.
Unknown risk factors
- Vitamin A deficiency
- Socio-economic status
References
- ↑ 1.0 1.1 1.2 Risk factors for gestational trophoblastic disease. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/gestational-trophoblastic-disease/risks/?region=ns. Accessed on October 7, 2015
- ↑ 2.0 2.1 2.2 2.3 2.4 Buckley JD (March 1984). "The epidemiology of molar pregnancy and choriocarcinoma". Clin Obstet Gynecol. 27 (1): 153–9. PMID 6705308.
- ↑ La Vecchia C, Parazzini F, Decarli A, Franceschi S, Fasoli M, Favalli G, Negri E, Pampallona S (September 1984). "Age of parents and risk of gestational trophoblastic disease". J. Natl. Cancer Inst. 73 (3): 639–42. PMID 6088880.
- ↑ Parazzini, F.; Vecchia, C. La; Pampallona, S. (1986). "Parental age and risk of complete and partial hydatidiform mole". BJOG: An International Journal of Obstetrics and Gynaecology. 93 (4): 582–585. doi:10.1111/j.1471-0528.1986.tb07957.x. ISSN 1470-0328.
- ↑ Brinton, Louise A.; Wu, Bao-Zhen; Wang, Wen; Ershow, Abby G.; Song, Hong-Zhao; Li, Jun-Yao; Bracken, Michael B.; Blot, William J. (1989). "Gestational trophoblastic disease: A case-control study from the People's Republic of China". American Journal of Obstetrics and Gynecology. 161 (1): 121–127. doi:10.1016/0002-9378(89)90248-2. ISSN 0002-9378.
- ↑ Parazzini, Fabio; LaVecchia, Carlo; Pampallona, Sandro; Franceschi, Silvia (1985). "Reproductive patterns and the risk of gestational trophoblastic disease". American Journal of Obstetrics and Gynecology. 152 (7): 866–870. doi:10.1016/S0002-9378(85)80079-X. ISSN 0002-9378.