Perception of infertility risk vs. objective fertility status in males exposed to alkylating agents but not radiation therapy: a report from the St. Jude Lifetime (SJLIFE) cohort study.
Megan E Ware, Raymond K We, William H Kutteh, Rachel T Webster, Angela Delaney, Christine Yu, Kyla Shelton, DeoKumar Srivastava, Siddhant Taneja, Yadav Sapkota, Zhaoming Wang, Melissa M Hudson, John Lucas, Gregory T Armstrong, Kirsten K Ness, Daniel M Green
{"title":"Perception of infertility risk vs. objective fertility status in males exposed to alkylating agents but not radiation therapy: a report from the St. Jude Lifetime (SJLIFE) cohort study.","authors":"Megan E Ware, Raymond K We, William H Kutteh, Rachel T Webster, Angela Delaney, Christine Yu, Kyla Shelton, DeoKumar Srivastava, Siddhant Taneja, Yadav Sapkota, Zhaoming Wang, Melissa M Hudson, John Lucas, Gregory T Armstrong, Kirsten K Ness, Daniel M Green","doi":"10.1007/s11764-025-01793-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to characterize associations between male childhood cancer survivors' perception of infertility risk and objective fertility status and to identify factors contributing to risk perception.</p><p><strong>Methods: </strong>Participants were from SJLIFE, exposed to alkylating agents but not radiation, and completed a Men's Health Questionnaire (MHQ) and semen analysis. Samples were obtained following the 2010 World Health Organization Guidelines, and classified as azoospermic (0 sperm), oligospermic (> 0 and < 15 million sperm/ml), or normospermic (≥ 15 million sperm/ml). Participants were classified as at minimally or high/significantly increased risk for infertility according to the Pediatric Initiative Network (PIN) criteria. Perception of infertility risk was assessed via self-report where survivors indicated the following: (1) more risk than peers without cancer history, (2) less risk, or (3) equal risk, as well as factors contextualizing perceived risk. Chi-squared tests or Fishers' exact tests assessed differences in variables of interest.</p><p><strong>Results: </strong>Among 238 participants (age 27 ± 6 years, 85% NH White, 47% survivors of leukemia), 58% perceived increased infertility risk than peers without cancer history, 29% equal risk, and 13% less risk. A larger proportion of survivors with azoospermia perceived higher risk than other groups (74%) (p = 0.01). No differences were observed in risk perception by PIN criteria. No differences were observed by sperm concentration category or PIN criteria in factors contextualizing perceived risk.</p><p><strong>Conclusions: </strong>Male survivors not exposed to radiation in the SJLIFE cohort are generally aware of their infertility risk.</p><p><strong>Implications for cancer survivors: </strong>Male survivors should seek continued follow-up care regarding fertility and information on risk from reputable sources.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Survivorship","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11764-025-01793-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aimed to characterize associations between male childhood cancer survivors' perception of infertility risk and objective fertility status and to identify factors contributing to risk perception.
Methods: Participants were from SJLIFE, exposed to alkylating agents but not radiation, and completed a Men's Health Questionnaire (MHQ) and semen analysis. Samples were obtained following the 2010 World Health Organization Guidelines, and classified as azoospermic (0 sperm), oligospermic (> 0 and < 15 million sperm/ml), or normospermic (≥ 15 million sperm/ml). Participants were classified as at minimally or high/significantly increased risk for infertility according to the Pediatric Initiative Network (PIN) criteria. Perception of infertility risk was assessed via self-report where survivors indicated the following: (1) more risk than peers without cancer history, (2) less risk, or (3) equal risk, as well as factors contextualizing perceived risk. Chi-squared tests or Fishers' exact tests assessed differences in variables of interest.
Results: Among 238 participants (age 27 ± 6 years, 85% NH White, 47% survivors of leukemia), 58% perceived increased infertility risk than peers without cancer history, 29% equal risk, and 13% less risk. A larger proportion of survivors with azoospermia perceived higher risk than other groups (74%) (p = 0.01). No differences were observed in risk perception by PIN criteria. No differences were observed by sperm concentration category or PIN criteria in factors contextualizing perceived risk.
Conclusions: Male survivors not exposed to radiation in the SJLIFE cohort are generally aware of their infertility risk.
Implications for cancer survivors: Male survivors should seek continued follow-up care regarding fertility and information on risk from reputable sources.
期刊介绍:
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.