Utilisation of healthcare in children born to lymphoma survivors in Sweden

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BACKGROUND AND PURPOSE: Advances in lymphoma treatment lead to a growing population of lymphoma survivors in childbearing ages who might be concerned about the impact of their disease on their children's health. In this study, we aim to explore healthcare utilisation patterns that were associated with parental history of lymphoma. PATIENTS/MATERIAL AND METHODS: Children born to lymphoma survivors (diagnosed over the period 2000-2018) were identified by linking the Swedish Cancer Register to 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. Information on in- and outpatient diagnoses and drug dispensations up to age five were obtained for all children. RESULTS: We identified a total of 1,424 children born to lymphoma survivors and 7,120 matched children born to lymphoma-free parents. Children born to lymphoma survivors had a 8% higher healthcare utilisation rate (rate ratio: 1.08, 95% confidence intervals: 1.06-1.10) than other children. The panorama of diseases requiring healthcare utilisation was diverse and only one disease (International Classification of Diseases-10: H66, otitis media, unspecified) and one drug cluster (Anatomical Therapeutic Chemical: J07BC20, combination vaccine against hepatitis A and hepatitis B) was associated with a systematic difference (p < 0.05) when applying tree-based scan statistics. INTERPRETATION: Children born to lymphoma survivors had slightly increased healthcare utilisation during early childhood. However, no strong or consistent disease- or drug-specific clusters explained this increase. Findings therefore suggest that the elevated healthcare use may reflect heightened health-seeking behaviour among cancer survivors, rather than underlying morbidity in their children. These results provide reassurance for lymphoma survivors considering parenthood.

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