{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:11:25Z","timestamp":1789150285226,"version":"build-2803163510"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["115-2314-B-006 -085"],"award-info":[{"award-number":["115-2314-B-006 -085"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As cancer survival improves, increasing numbers of women diagnosed during their reproductive years face potential fertility impairment. However, population-based evidence on post-cancer childbearing remains limited in Asian settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide cohort study in Taiwan by linking the Cancer Registry, Birth Reporting Registry, and Death Registry. A total of 72,929 females diagnosed with cancer at age\u2009\u2264\u200939 years were followed to identify subsequent livebirths. The cumulative incidence of first post-diagnosis livebirth was estimated using competing-risk methods. Predictors were evaluated using cause-specific Cox models. Standardized birth ratios (SBRs) were calculated by comparing observed births with expected births in the general population, standardized by age and calendar year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 9.8% of female cancer survivors had at least one livebirth after diagnosis. The 5-, 10-, and 15-year cumulative incidences were 6.4%, 10.7%, and 13.9%, respectively. Compared with the general population, survivors had approximately half the expected number of births (SBR\u2009=\u20090.50; 95% CI, 0.49\u20130.51). Substantial heterogeneity was observed across cancer types: childbirth was most preserved among survivors of thyroid and skin cancers, whereas those with cervical, uterine, breast, leukemia, and central nervous system cancers had markedly reduced childbirth. Older age at diagnosis and receipt of chemotherapy were strongly associated with lower likelihood of childbirth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large, nationwide study, female cancer survivors in Taiwan experienced substantially reduced childbirth rates, with pronounced variation by cancer type, age at diagnosis, and treatment. These findings provide robust population-level evidence from an Asian context and highlight the need for early fertility counseling and improved access to oncofertility care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358466","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:49:06Z","timestamp":1789148946000},"page":"e0358466","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rates of childbirth in female cancer survivors: A population-based study in Taiwan"],"prefix":"10.1371","volume":"21","author":[{"given":"Ya-Ling","family":"Hsieh","sequence":"first","affiliation":[{"name":"Chi Mei Medical Center","place":["Tainan, Taiwan"],"department":["Nursing Department"]},{"name":"College of Medicine, National Cheng Kung University","place":["Tainan, Taiwan"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Jung","family":"Chiang","sequence":"additional","affiliation":[{"name":"College of Medicine, National Cheng Kung University","place":["Tainan, Taiwan"],"department":["Department of Public Health"]},{"name":"Kaohsiung Veterans General Hospital Tainan Branch","place":["Tainan, Taiwan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-3665","authenticated-orcid":true,"given":"Tsung","family":"Yu","sequence":"additional","affiliation":[{"name":"College of Medicine, National Cheng Kung University","place":["Tainan, Taiwan"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"pone.0358466.ref001","doi-asserted-by":"crossref","unstructured":"Health Promotion Administration M of H and W. 2022 cancer statistics: incidence and mortality. 2022. https:\/\/www.hpa.gov.tw\/Pages\/List.aspx?nodeid=269","DOI":"10.4324\/9781003281900-16"},{"key":"pone.0358466.ref002","unstructured":"Taiwan Cancer Registry. Cancer survival analysis (five-year relative survival rates). 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