Reproduction and marriage among male survivors of cancer in childhood, adolescence and young adulthood: a national cohort study

Abstract

Background:Increased survival after cancer in young age has made long-term follow-up studies of high external validity important. In this national cohort study, we explored the impact of cancer in young age on reproduction and marital status in male survivors.Methods:Hazard ratios (HRs) and relative risks (RRs) of reproductive and marital outcomes were studied for male survivors of cancer in young age (<25 years) and cancer-free male comparisons, born during 1965–1985, by linking compulsory national registries in Norway.Results:Male cancer survivors (n=2687) had reduced paternity (HR: 0.72, 95% confidence interval (CI): 0.68–0.76). This was most apparent in survivors of testicular cancer, brain tumours, lymphoma, leukemia and bone tumours, and when diagnosed with cancer before 15 years of age. Male cancer survivors were more likely to avail of assisted reproduction (RR: 3.32, 95% CI: 2.68–4.11). There was no increased risk of perinatal death, congenital malformations, being small for gestational age, of low birth weight or preterm birth in their first offspring. Male cancer survivors were less likely to marry (HR: 0.93, 95% CI: 0.86–1.00), in particular brain tumour survivors.Conclusions:In this national cohort study, we demonstrated reduced paternity and increased use of assisted reproduction among male cancer survivors, but no adverse outcome for their first offspring at birth.

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

“…[77][78][79][80] The impact of cancer treatment on fertility is related to the age of the patient at the time of diagnosis and treatment and depends on the type, duration, and dose intensity of treatment. Alkylating agent-based chemotherapy, high-dose cranial RT that can impair hypothalamic pituitary function, and targeted RT to the uterus, ovaries, or testes are primary risk factors for gonadal dysfunction and decreased fertility in both females and males.…”

Psychosexual development and satisfaction with timing of developmental milestones among adult survivors of childhood cancer

“…Due to variability in previous findings, there may be other factors relevant for psychosexual development among childhood cancer survivors, such as type of diagnosis or treatment. One study indicated that brain tumor survivors and those treated with highly neurotoxic modalities were less likely to have had their sexual debut, 7 while other studies found lower attainment of adult psychosexual milestones among brain tumor survivors, such as getting married . Moreover, psychosexual development seems to differ by sex in the general population.…”

“…One study indicated that brain tumor survivors and those treated with highly neurotoxic modalities were less likely to have had their sexual debut, 7 while other studies found lower attainment of adult psychosexual milestones among brain tumor survivors, such as getting married. 3,[12][13][14][15] Moreover, psychosexual development seems to differ by sex in the general population. In early adolescence, boys tend to be more likely to engage in sexual activities (ie, 18% vs 13% of girls), but by age 19 rates of sexual debut are nearly equivalent at 69% of boys and 68% of girls.…”

Psychosexual development and satisfaction in long‐term survivors of childhood cancer: Neurotoxic treatment intensity as a risk indicator

“…18 Survivors also were less likely to achieve milestones of psychosexual development, such as being less sexually experienced, [19][20][21][22] older at the time of sexual debut, 19,20,23 less likely to have children, 20,[24][25][26] or reporting problems in sexual functioning. [27][28][29][30][31][32][33] Several studies also found survivors were less likely to marry than siblings/peers, 20,23,[34][35][36][37][38][39] with survivors of brain tumors 20,[34][35][36][37][38] or those treated with radiation 36,39 least likely to marry. Nevertheless, marriage rates comparable to those of controls also have been reported.…”