Cancer
Utilization of Healthcare in Children Born to Lymphoma Survivors in Sweden Joshua P Entrop* Joshua P Entrop Viktor Wintzell Caroline E Dietrich Anna Marklund Ingrid Glimelius Tarec C El-Galaly Karin E Smedby Sandra Eloranta
Background Advances in lymphoma treatment lead to a rising population of young lymphoma survivors in childbearing ages who might be concerned about the impact of their disease on their children’s health. Yet, no study has explored the effect of lymphoma on disease risks in children born to lymphoma survivors. Hence, our study aims to investigate the impact of lymphoma and its treatments on birth outcomes and health of children born to lymphoma survivors.
Methods We analyzed data on in- and outpatient diagnoses up to age five from Swedish national health registers using tree-based scan statistics to identify disease clusters prompting the utilization of healthcare comparing children born to lymphoma survivors (diagnosed 2000-2015) and children born lymphoma-free parents. Children born to lymphoma survivors were identified using the Swedish Lymphoma and national population registers. Each child born to a lymphoma survivor was matched on maternal age at childbirth to five children born to lymphoma-free parents.
Results We identified a total of 1 040 children born to lymphoma survivors and 5 200 children born to matched comparators, of whom 792 and 3 834 had at least one in- or outpatient diagnosis before age five, respectively. Children born to lymphoma survivors had a 13% higher rate of healthcare utilization (Rate Ratio: 1.13, 95% CI: 1.05-1.22) than children born to lymphoma-free parents. However, the panorama of diseases requiring healthcare utilization was broad and we could not identify any specific disease cluster with significantly elevated risk (P<0.05) using tree-based scan statistics.
Conclusion Children born to lymphoma survivors have an overall increased healthcare utilization up to age five, distributed across a broad range of diseases. This increase might be due to an increased health seeking behavior of their parents. An ongoing extension of this study involves investigating excess drug utilization to also capture diseases treated in primary care.
