Perceptions of risk of infertility among male survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Cancer. 2018 Jun 1;124(11):2447-2455. doi: 10.1002/cncr.31343. Epub 2018 Apr 17.


Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: childhood cancer; health knowledge; infertility; survivors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Adult Survivors of Child Adverse Events / psychology*
  • Cancer Survivors / psychology*
  • Cancer Survivors / statistics & numerical data
  • Child
  • Child, Preschool
  • Cohort Studies
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infertility / etiology
  • Infertility / psychology*
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / mortality
  • Neoplasms / therapy*
  • Patient Education as Topic
  • Perception
  • Risk Factors
  • Surveys and Questionnaires / statistics & numerical data
  • Testis / drug effects
  • Testis / radiation effects
  • Young Adult