Gestational trophoblastic neoplasia risk factors
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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][7]
- Parous women also have an increased risk of choriocarcinoma (RR above unity). But this association is significant only for more than five births (RR= 5.2).[8]
Unknown risk factors
- Vitamin A deficiency
- Socio-economic status
References
- ↑ 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.
- ↑ La Vecchia C, Franceschi S, Parazzini F, Fasoli M, Decarli A, Gallus G, Tognoni G (March 1985). "Risk factors for gestational trophoblastic disease in Italy". Am. J. Epidemiol. 121 (3): 457–64. PMID 2990199.
- ↑ Ha MC, Cordier S, Bard D, Le TB, Hoang AH, Hoang TQ, Le CD, Abenhaim L, Nguyen TN (1996). "Agent orange and the risk of gestational trophoblastic disease in Vietnam". Arch. Environ. Health. 51 (5): 368–74. doi:10.1080/00039896.1996.9934424. PMID 8896386.