Murphy Caitlin C, Wang Jennifer S, Betts Andrea C, Lupo Philip J, Shay L Aubree, Allicock Marlyn A, Kirk Caroline L, Pruitt Sandi L
Department of Health Promotion & Behavioral Sciences, UTHealth Houston School of Public Health, Houston, TX 77030, United States.
Department of Epidemiology, UTHealth Houston School of Public Health, Houston, TX 77030, United States.
J Natl Cancer Inst. 2025 May 1;117(5):1008-1017. doi: 10.1093/jnci/djae347.
Few studies have examined childbirth and adverse perinatal outcomes among male adolescents and young adults with cancer (AYAs, diagnosed at age 15-39 years). We conducted a population-based assessment of these outcomes in a large, diverse sample.
Male AYAs diagnosed between January 1, 1995, and December 31, 2015, were identified using the Texas Cancer Registry and linked to live birth certificates and the Texas Birth Defects Registry through December 31, 2016. Cumulative incidence of live birth after diagnosis was estimated. Log binomial regression models were used to estimate prevalence of preterm birth (<37 weeks), low birth weight (<2500 g), small for gestational age (<10th percentile), and any birth defect among liveborn offspring of male AYAs compared with age-, race-, and ethnicity-matched men without cancer.
We identified 42 896 male AYAs, among whom germ cell cancers (20.0%) were the most common. There were 9686 live births to 6833 male AYAs after diagnosis. Cumulative incidence of live birth was 18.0% (95% confidence interval [CI] = 17.6% to 18.4%) at 10 years after diagnosis. Ten-year cumulative incidence differed by cancer type (P < .01) and was highest for thyroid (27.6%, 95% CI = 25.4% to 29.9%) but lowest for gastrointestinal (9.6%, 95% CI = 8.1% to 10.6%) cancer. Prevalence of preterm birth (8.9% vs 8.0%, P = .02) and low birth weight (6.0% vs 5.3%, P = .02) was higher for liveborn offspring of male AYAs compared with men without cancer. There was no difference in prevalence of birth defects (4.9% vs 4.8%, P = .64).
Our findings underscore the continued importance of reproductive counseling for AYAs.
很少有研究调查患癌男性青少年和青年成人（青少年及青年成人癌症患者，15 - 39岁确诊）的分娩情况及不良围产期结局。我们在一个大型多样的样本中对这些结局进行了基于人群的评估。
利用德克萨斯癌症登记处识别出1995年1月1日至2015年12月31日期间确诊的男性青少年及青年成人癌症患者，并将其与出生证明及德克萨斯出生缺陷登记处进行关联，随访至2016年12月31日。估计诊断后活产的累积发病率。使用对数二项回归模型估计男性青少年及青年成人癌症患者的活产后代中早产（<37周）、低出生体重（<2500克）、小于胎龄儿（<第10百分位数）及任何出生缺陷的患病率，并与年龄、种族和族裔匹配的无癌男性进行比较。
我们识别出42896名男性青少年及青年成人癌症患者，其中生殖细胞癌（20.0%）最为常见。诊断后，6833名男性青少年及青年成人癌症患者中有9686例活产。诊断后10年活产的累积发病率为18.0%（95%置信区间[CI]=17.6%至18.4%）。10年累积发病率因癌症类型而异（P<0.01），甲状腺癌最高（27.6%，95%CI = 25.4%至29.9%），胃肠道癌最低（9.6%，95%CI = 8.1%至10.6%）。与无癌男性相比，男性青少年及青年成人癌症患者的活产后代中早产（8.9%对8.0%，P = 0.02）和低出生体重（6.0%对5.3%，P = 0.02）的患病率更高。出生缺陷的患病率无差异（4.9%对4.8%，P = 0.64）。
我们的研究结果强调了为青少年及青年成人癌症患者提供生殖咨询的持续重要性。
