Is there evidence of a therapy-related increase in germ cell mutation among childhood cancer survivors?
Few studies have examined human population data for evidence of an association between environmental mutagens and genetic disease. Our objective was to determine whether study of pregnancies and offspring of childhood cancer survivors would show evidence that therapy potentially mutagenic to germ cells is associated with increased risk of miscarriage, serious congenital abnormalities, or altered sex ratio. We analyzed information from patients’ general practitioners for 2286 survivors of childhood cancer (1049 females and 1237 males) who were exposed or not exposed to direct irradiation of the abdomen or gonads or treatment with an alkylating agent. In addition, external control data based on the general population were used for some of the comparisons relating to congenital abnormalities and sex ratio. Data on reproductive history were complete for 1037 female survivors, who had 944 completed pregnancies, and 1078 male survivors, who produced 537 offspring. For the female survivors gi
