Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Cancer therapy and risk of congenital malformations in children fathered by men treated for testicular germ-cell cancer: A nationwide register study

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Community-based football in men with prostate cancer: 1-year follow-up on a pragmatic, multicentre randomised controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Early occupational intervention for people with low back pain in physically demanding jobs: A randomized clinical trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Airway obstruction and bronchial reactivity from age 1 month until 13 years in children with asthma: A prospective birth cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Lymphopenia and risk of infection and infection-related death in 98,344 individuals from a prospective Danish population-based study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Prognostic factors for relapse in patients with clinical stage I testicular cancer: protocol for a Danish nationwide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prognostic factors for relapse in patients with clinical stage I testicular cancer: protocol for a Danish nationwide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Quality of Life in Long-Term Testicular Cancer Survivors With Compensated Leydig Cell Dysfunction

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Yahia Al-Jebari
  • Ingrid Glimelius
  • Carina Berglund Nord
  • Gabriella Cohn-Cedermark
  • Olof Ståhl
  • Torgrim Tandstad
  • Allan Jensen
  • Hege Sagstuen Haugnes
  • Gedske Daugaard
  • Lars Rylander
  • Aleksander Giwercman
View graph of relations

BACKGROUND: Because of the potential mutagenic effects of chemo- and radiotherapy, there is concern regarding increased risk of congenital malformations (CMs) among children of fathers with cancer. Previous register studies indicate increased CM risk among children conceived after paternal cancer but lack data on oncological treatment. Increased CM risk was recently reported in children born before paternal cancer. This study aims to investigate whether anti-neoplastic treatment for testicular germ-cell cancer (TGCC) implies additional CM risk.

METHODS AND FINDINGS: In this nationwide register study, all singletons born in Sweden 1994-2014 (n = 2,027,997) were included. Paternal TGCC diagnoses (n = 2,380), anti-neoplastic treatment, and offspring CMs were gathered from the Swedish Norwegian Testicular Cancer Group (SWENOTECA) and the Swedish Medical Birth Register. Children were grouped based on +/- paternal TGCC; treatment regimen: surveillance (n = 1,340), chemotherapy (n = 2,533), or radiotherapy (n = 360); and according to time of conception: pre- (n = 2,770) or post-treatment (n = 1,437). Odds ratios (ORs) for CMs were calculated using logistic regression with adjustment for parental ages, maternal body mass index (BMI), and maternal smoking. Children conceived before a specific treatment acted as reference for children conceived after the same treatment. Among children fathered by men with TGCC (n = 4,207), 184 had a CM. The risk of malformations was higher among children of fathers with TGCC compared with children fathered by men without TGCC (OR 1.28, 95% confidence interval [CI] 1.19-1.38, p = 0.001, 4.4% versus 3.5%). However, no additional risk increase was associated with oncological treatment when comparing post-treatment-to pretreatment-conceived children (chemotherapy, OR = 0.82, 95% CI 0.54-1.25, p = 0.37, 4.1% versus 4.6%; radiotherapy, OR = 1.01, 95% CI 0.25-4.12, p = 0.98, 3.2% versus 3.0%). Study limitations include lack of data on use of cryopreserved or donor sperm and on seminoma patients for the period 1995-2000-both tending to decrease the difference between the groups with TGCC and without TGCC. Furthermore, the power of analyses on chemotherapy intensity and radiotherapy was limited.

CONCLUSIONS: No additional increased risk of CMs was observed in children of men with TGCC treated with radio- or chemotherapy. However, paternal TGCC per se was associated with modestly increased risk for offspring malformations. Clinically, this information can reassure concerned patients.

Original languageEnglish
JournalPLOS Medicine
Volume16
Issue number6
Pages (from-to)e1002816
ISSN1549-1277
DOIs
Publication statusPublished - Jun 2019

ID: 57752075