Few commonly available factors are known which independently of treatment are associated with post- diagnosis paternity in Testicular Cancer Survivors (TCSs). In TCSs and age-matched controls we assessed the associations between first-time post TC paternity and respectively the level of pre-diagnosis paternity and diagnostic age.
Using data from the Medical Birth Registry of Norway paternity was assessed during 30 post-diagnosis years in 1062 tumour-free TCSs, (treatment:1980-1994) and 10620 age-matched controls. Analyses comprised post-orchiectomy treatment type (loco-regional versus systemic), diagnostic age (<30 versus ≥30 years), number of pre-diagnosis children (0, 1 versus ≥2) and calender year of TC diagnosis (≤1987 versus ≥1988).
Kaplan-Meier estimates, log-rank tests, Cox regression analyses; significance level: p < 0.05 RESULTS: 30 years after the TC diagnosis 45% of the TCSs had fathered ≥ 1 post-TC child (controls: 55%; p < 0.001), Post-TC paternity increased during treatment de-escalation, Compared to pre-TC paternity of one child, pre-diagnosis childlessness (HR: 0.58;[55-0.62]) or fatherhood of ≥ 2 pre-TC children (HR: 0.34;[0.32-0.37]), as well as diagnostic age of ≥ 30 years (HR: 0.40; [0.38-0.43]) reduced post-TC fatherhood. 23% of the TCSs remained finally childless. (Controls: 17%; p < 0.001). Immortal time bias represents a limitation of this study.
TCSs can be informed about the generally favourable probability of post-TC fatherhood at least once.The probability of post-TC paternity is, however,slightly lower in TCSs than in controls, even after de-escalated treatment. During post-TC paternity counselling age at diagnosis and the number of pre-diagnosis children should be considered together with treatment type and intensity.
Cancer epidemiology. 2026 Apr 24 [Epub ahead of print]
Sophie Dorothea Fosså, Tor Åge Myklebust, Marianne Brydøy, Helene Francisca Stigter Negaard, Olbjørn Harald Klepp, Alv A Dahl, Kristine Marie Stangenes, Camilla Rørslett Kleveland, Eline Bragedatter Seljeflot, H S Haugnes
Department of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: ., Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway; Department of Registration, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway., Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway., Department of Oncology, Oslo University Hospital, Oslo, Norway., Department of Oncology, St.Olavs Hospital ( retired)Trondheim University Hospital Trondheim, Norway., Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway. Electronic address: ., Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway., Department of Oncology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT, The Arctic University, Tromsø, Norway.