Large Study Shows No Increase in Overall Cancer Risk in Children Born After Assisted Reproductive Technology Robert W. Rebar, MD Reviewing Williams CL et al., N Engl J Med 2013 Nov 7; 369:1819 Risk for certain rare neoplasms may be modestly increased, but this must be confirmed in future studies.

Children born after assisted reproductive technology (ART) are at slightly increased risk for prematurity, low birth weight, and congenital malformations, but information about long-term risks for rare but serious diseases is sparse. In a population-based study, investigators linked data on all children born after ART in Britain from 1992 through 2008 with national registry data on childhood tumors to determine incidence of cancer before age 15 in these children compared with those in the general population during the same period. The cohort consisted of 106,000 children born after nondonor ART (mean follow-up, 6.6 years). A total of 108 cancers were identified in this group compared with 109.7 expected cancers (standardized incidence ratio [SIR], 0.98; 95% confidence interval, 0.81–1.19). Risks for leukemia, neuroblastoma, retinoblastoma, central nervous system tumors, renal tumors, and germ cell tumors were not increased. Excess risks for hepatoblastoma (SIR, 3.64; 95% CI, 1.34–7.93) and rhabdomyosarcoma (SIR, 2.62; 95% CI 1.26–4.82) were observed, and were not associated with imprinting disorders. Hepatoblastoma was associated with low birth weight.