Male cancer survivors less likely to have children

Male survivors of childhood cancer diagnosed before age 25 years appeared less likely to have children and more likely to require assisted reproduction than men who did not have cancer, according to results of a national cohort study.

The number of survivors of childhood, adolescent and young adult cancers has increased steadily over time, as has concern about the potential for severe late effects after treatment. Reproductive outcomes among female survivors have been well explored; however, data about male survivors are limited, researchers wrote.

Maria Winther Gunne s , a PhD candidate in the department of global public health and primary care at University of Bergen in Norway, and colleagues used three national databases — the Cancer Registry of Norway, the Medical Birth Registry of Norway and the Central Population Registry — to collect data on men born from 1965 to 1985.

Researchers examined reproductive outcomes among 2,687 men diagnosed with cancer before age 25 years. The analysis also included 607,668 cancer-free males for comparison.

Thirty percent of the cancer survivors had been diagnosed prior to age 14 years, whereas 26% had been diagnosed between ages 15 and 19 years, and 43% had been diagnosed between ages 20 and 24 years. The most common cancer diagnoses were gonadal and germ cell tumors (27%), central nervous system tumors (18%), lymphoma (15%) and leukemia (13%).

The male cancer survivors appeared significantly less likely than cancer-free men to have children (HR = 0.72, 95% CI, 0.68-0.76). The trend appeared most apparent in survivors of testicular cancer, central nervous system tumors, lymphoma, leukemia, malignant bone tumors, sympathetic nervous system tumors and retinoblastoma.

When researchers stratified by age, they observed the greatest reduction in paternity among men diagnosed with cancer prior to age 15 years (HR = 0.59, 95% CI, 0.52-0.66).

Male cancer survivors appeared more than three times as likely as cancer-free men to rely on assisted reproductive technology for their first offspring (RR = 3.32, 95% CI, 2.69-4.1).

Use of these technologies was highest among survivors of testicular cancer, central nervous system tumors, lymphoma, leukemia, malignant bone tumors, sympathetic nervous system tumors and thyroid cancer, as well as among survivors who had been diagnosed with cancer after age 14 years.

“These [findings] are important for male cancer survivors, seeing as we can identify groups at risk of having reproduction problems,” Gunnes said in a press release.

The researchers did not observe an increased risk for perinatal death, congenital malformations, small size for gestational age, low birth weight or preterm birth among the first offspring of male cancer survivors.

“It is important to be able to assure young, male cancer survivors that their illness and treatment will not have a negative impact on their own children,” Gunnes said.

Researchers also found that male cancer survivors were slightly less likely to get married than cancer-free men (HR = 0.93, 95% CI, 0.86-1).

Gunnes and colleagues acknowledged study limitations, including a lack of detailed information about individual cancer treatments, assisted reproductive technology and cohabitation rates among survivors.

“Although a large proportion of male survivors of cancer in young age will be able to establish a family and father children, there is still room for improvement, especially with regards to decreasing the toxicity burden of current treatment regimens, as well as improving fertility preservation methods and access to these for young male cancer patients,” Gunnes and colleagues wrote. – by Kristie L. Kahl

Disclosure: The researchers report no relevant financial disclosures.