Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia.
Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Cancer. 2018 Jun 1;124(11):2447-2455. doi: 10.1002/cncr.31343. Epub 2018 Apr 17.
The objective of the current study was to characterize and identify factors associated with perceptions of risk of infertility among adult male survivors of childhood cancer.
A total of 1233 adult male survivors from the Childhood Cancer Survivor Study who were without a history of disease recurrence or subsequent malignancy reported their perceptions of their risk of infertility compared with men never diagnosed with cancer. Survivors were a median age of 37.8 years (range, 22.0-58.7 years) and were 28.4 years from their diagnosis (range, 21.4-39.2 years). Multivariable logistic regression evaluated factors associated with perceptions of risk.
Overall, 35.9% of the survivors (443 of 1233 survivors) reported perceptions of their risk of infertility that were discordant with their actual risk based on previous cancer treatment exposures. Discordant perceptions were equally common among men exposed to gonadotoxic therapies (36.3%; 311 of 857 men) and those with no history of gonadotoxic exposure (35.1%; 132 of 376 men). Survivors who fathered children (odds ratio [OR], 4.14; 95% confidence interval [95% CI], 2.74-6.24), had no survivor-focused health care (OR, 3.07; 95% CI, 1.57-5.99), were nonwhite (OR, 2.28; 95% CI, 1.10-4.75), and were of lower income were more likely to report no increased risk of infertility after gonadotoxic treatment. Perceptions of increased risk of infertility among men with no history of gonadotoxic treatment were predicted by never having fathered a child (OR, 1.88; 95% CI, 1.17-3.03), recent participation in survivor-focused health care (OR, 2.11; 95% CI, 1.01-4.42), and higher educational achievement.
Many male survivors of childhood cancer are unaware of how their cancer treatments could impact their reproductive health, underscoring the need for all patients to receive education regarding their risk of infertility throughout the continuum of cancer care. Cancer 2018;124:2447-55. © 2018 American Cancer Society.
本研究旨在描述并确定成年男性癌症幸存者对其不孕风险的认知特点，及其相关影响因素。
本研究纳入了来自癌症幸存者研究的 1233 名成年男性幸存者，他们均无疾病复发或继发恶性肿瘤病史，报告了他们对自己不孕风险的认知，将其与从未被诊断为癌症的男性进行比较。幸存者的中位年龄为 37.8 岁（范围，22.0-58.7 岁），诊断后时间为 28.4 年（范围，21.4-39.2 年）。多变量逻辑回归评估了与认知风险相关的因素。
总体而言，35.9%（443/1233 名幸存者）的幸存者报告称，他们对不孕风险的认知与其基于既往癌症治疗暴露的实际风险不符。在接受性腺毒性治疗的男性（36.3%；311/857 名男性）和无性腺毒性暴露史的男性（35.1%；132/376 名男性）中，这种认知差异同样常见。生育过子女的幸存者（比值比[OR]，4.14；95%置信区间[95%CI]，2.74-6.24）、未接受过以幸存者为中心的医疗保健（OR，3.07；95%CI，1.57-5.99）、非白人（OR，2.28；95%CI，1.10-4.75）和收入较低的幸存者，更有可能报告在接受性腺毒性治疗后不孕风险没有增加。在无性腺毒性治疗史的男性中，报告不孕风险增加的认知与从未生育过子女（OR，1.88；95%CI，1.17-3.03）、最近接受以幸存者为中心的医疗保健（OR，2.11；95%CI，1.01-4.42）和较高的教育程度有关。
许多儿童癌症幸存者男性不知道他们的癌症治疗可能会影响他们的生殖健康，这突显了所有患者在癌症治疗过程中都需要接受有关不孕风险的教育。癌症 2018；124:2447-55。©2018 美国癌症协会。
