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Introduction: There are concerns about the possible ill effects that cancer treatment may have on children born to cancer survivors, based on the theory that radiation and many cancer drugs may produce transgenerational germ cell mutations leading to an increased risk of death in the next generation. However, only scant information is available. Materials and methods: This study includes 2,513 offspring of 1,329 survivors of childhood cancer identified from the population-based Danish Cancer Registry between 1943 and 1996. Their offspring were followed up for death in the Death Certificate Files. Standardized mortality ratios (SMRs) were calculated by use of mortality rates in the Danish population. Results: We observed a slightly non-significant excess mortality among children of survivors compared to the general population (SMR = 1.2; 95% CI, 0.9-1.7). This excess was due to a higher mortality from diabetes and infections among female offspring, based, however, on relatively few observed cases. Radiotherapy had no significant influence on the mortality of the children of survivors. Especially, no dose-related effects were observed. Discussion: In general, our study does not support the concern that there may be an increased mortality among the offspring of childhood cancer survivors. However, a larger data set is needed to evaluate the hypothesis further.

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