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Cancer therapy and ...
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Al-Jebari, YahiaLund University,Lunds universitet,Reproduktionsmedicin, Malmö,Forskargrupper vid Lunds universitet,Reproductive medicine, Malmö,Lund University Research Groups
(author)
Cancer therapy and risk of congenital malformations in children fathered by men treated for testicular germ-cell cancer : A nationwide register study
- Article/chapterEnglish2019
Publisher, publication year, extent ...
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2019-06-04
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PUBLIC LIBRARY SCIENCE,2019
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-390647
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-390647URI
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https://doi.org/10.1371/journal.pmed.1002816DOI
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https://lup.lub.lu.se/record/ff6e5991-81f2-452b-853d-dfdfe9cba170URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:141274814URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Glimelius, Ingrid,1975-Uppsala University,Karolinska Institutet,Uppsala universitet,Experimentell och klinisk onkologi,Karolinska Inst, Div Clin Epidemiol, Dept Med, Stockholm, Sweden(Swepub:uu)inggl846
(author)
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Nord, Carina BerglundKarolinska Institutet
(author)
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Cohn-Cedermark, GabriellaKarolinska Institutet
(author)
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Ståhl, OlofSkane Univ Hosp, Dept Oncol, Lund, Sweden,Skåne University Hospital(Swepub:lu)kir-ost
(author)
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Tandstad, TorgrimNorwegian Univ Sci & Technol, Dept Clin & Mol Med, Fac Med & Hlth Sci, Trondheim, Norway;St Olavs Univ Hosp, Canc Clin, Trondheim, Norway,Norwegian University of Science and Technology,St. Olav’s University Hospital
(author)
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Jensen, AllanDanish Canc Soc Res Ctr, Virus Lifestyle & Genes, Copenhagen, Denmark,Danish Cancer Society
(author)
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Haugnes, Hege SagstuenUniv Hosp North Norway, Dept Oncol, Tromso, Norway;UiT Arctic Univ Norway, Inst Clin Med, Tromso, Norway,University Hospital of North Norway,UiT The Arctic University of Norway, Tromsø
(author)
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Daugaard, GedskeRigshosp, Dept Oncol, Copenhagen Univ Hosp, Copenhagen, Denmark,Copenhagen University Hospital
(author)
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Rylander, LarsLund University,Lunds universitet,Avdelningen för arbets- och miljömedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Occupational and Environmental Medicine, Lund University,Department of Laboratory Medicine,Faculty of Medicine(Swepub:lu)ymed-lry
(author)
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Giwercman, AleksanderLund University,Lunds universitet,Reproduktionsmedicin, Malmö,Forskargrupper vid Lunds universitet,Reproductive medicine, Malmö,Lund University Research Groups(Swepub:lu)kir-agi
(author)
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Reproduktionsmedicin, MalmöForskargrupper vid Lunds universitet
(creator_code:org_t)
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In:PLoS Medicine: PUBLIC LIBRARY SCIENCE16:61549-12771549-1676
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