Tang Siau-Wei, Liu Jenny, Juay Lester, Czene Kamila, Miao Hui, Salim Agus, Verkooijen Helena M, Hartman Mikael
Department of Surgery, Yong Loo Lin School of Medicine, 1E Kent Ridge Road, National University Health System, Singapore, 119228, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Singapore, 117597, Singapore.
BMC Cancer. 2016 Mar 8;16:196. doi: 10.1186/s12885-016-2236-y.
With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring.
From the Swedish Multi-generation Register and Cancer Register, we identified 84,752 men ≤70 years with a history of cancer, for which we calculated relative birth rates as compared to the background population(Standardized Birth Ratios, SBRs). We also identified 126,696 offspring of men who had cancer, and compared their risks of death to the background population(Standardized Mortality Ratio, SMRs). Independent factors associated with reduced birth rates and mortality rates were estimated with Poisson modelling.
Men with a history of cancer were 23 % less likely to father a child compared to the background population(SBR 0.77, 95 % Confidence Interval[CI] 0.75-0.79). Nulliparous men were significantly more likely to father a child after diagnosis (SBR 0.81, 95 % CI 0.79-0.83) compared to parous men (SBR 0.68, 95 % CI 0.66-0.74). Cancer site(prostate), onset of cancer during childhood or adolescence, parity status at diagnosis(parous), current age(>40 years) and a recent diagnosis were significant and independent predictors of a reduced probability of fathering a child after diagnosis. Of the 126,696 children born to men who have had a diagnosis of cancer, 2604(2.06 %) died during follow up. The overall mortality rate was similar to the background population(SMR of 1.00, 95 %CI 0.96-1.04) and was not affected by the timing of their birth in relation to father's cancer diagnosis.
Male cancer survivors are less likely to father a child compared to the background population. This is influenced by cancer site, age of onset and parity status at diagnosis. However, their offspring are not at an increased risk of death.
随着癌症治疗水平的提高，越来越多处于生育年龄的男性成为癌症幸存者。本研究评估了男性癌症幸存者的出生率趋势及其后代的死亡率。
我们从瑞典多代登记册和癌症登记册中，识别出84752名年龄≤70岁且有癌症病史的男性，计算他们相对于背景人群的相对出生率（标准化出生率，SBR）。我们还识别出126696名患癌男性的后代，并将他们的死亡风险与背景人群进行比较（标准化死亡率，SMR）。采用泊松模型估计与出生率和死亡率降低相关的独立因素。
与背景人群相比，有癌症病史的男性生育子女的可能性低23%（SBR 0.77，95%置信区间[CI] 0.75 - 0.79）。与已育男性（SBR 0.68，95% CI 0.66 - 0.74）相比，未育男性在诊断后生育子女的可能性显著更高（SBR 0.81，95% CI 0.79 - 0.83）。癌症部位（前列腺）、童年或青少年期患癌、诊断时的生育状况（已育）、当前年龄（>40岁）以及近期诊断是诊断后生育子女可能性降低的显著且独立的预测因素。在126696名患癌男性所生子女中，2604名（2.06%）在随访期间死亡。总体死亡率与背景人群相似（SMR为1.00，95% CI 0.96 - 1.
