title: Reproduction and marriage among male survivors of cancer in childhood, adolescence and young adulthood: a national cohort study.
abstract: BACKGROUND
  Increased survival after cancer in young age has made long-term follow-up studies of high external validity important. In this national cohort study, we explored the impact of cancer in young age on reproduction and marital status in male survivors.
  
  
  METHODS
  Hazard ratios (HRs) and relative risks (RRs) of reproductive and marital outcomes were studied for male survivors of cancer in young age (<25 years) and cancer-free male comparisons, born during 1965-1985, by linking compulsory national registries in Norway.
  
  
  RESULTS
  Male cancer survivors (n=2687) had reduced paternity (HR: 0.72, 95% confidence interval (CI): 0.68-0.76). This was most apparent in survivors of testicular cancer, brain tumours, lymphoma, leukemia and bone tumours, and when diagnosed with cancer before 15 years of age. Male cancer survivors were more likely to avail of assisted reproduction (RR: 3.32, 95% CI: 2.68-4.11). There was no increased risk of perinatal death, congenital malformations, being small for gestational age, of low birth weight or preterm birth in their first offspring. Male cancer survivors were less likely to marry (HR: 0.93, 95% CI: 0.86-1.00), in particular brain tumour survivors.
  
  
  CONCLUSIONS
  In this national cohort study, we demonstrated reduced paternity and increased use of assisted reproduction among male cancer survivors, but no adverse outcome for their first offspring at birth.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, Bergen 5018, Norway.|Department of Pediatrics, Haukeland University Hospital, Bergen 5021, Norway.
authors.forename: M W
authors.initials: MW
authors.lastname: Gunnes
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, Bergen 5018, Norway.|Norwegian Institute of Public Health, Bergen 5018, Norway.
authors.forename: R T
authors.initials: RT
authors.lastname: Lie
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, Bergen 5018, Norway.|Cancer Registry of Norway, Oslo 0304, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Bjørge
authors.affiliation: Norwegian Institute of Public Health, Bergen 5018, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Ghaderi
authors.affiliation: Department of Pediatric Medicine, Oslo University Hospital, Oslo 0424, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Ruud
authors.affiliation: Department of Research, Statistics Norway, Oslo 0033, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Syse
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, Bergen 5018, Norway.|Department of Pediatrics, Haukeland University Hospital, Bergen 5021, Norway.|Norwegian Institute of Public Health, Bergen 5018, Norway.
authors.forename: D
authors.initials: D
authors.lastname: Moster
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001859:Bone Neoplasms; D001932:Brain Neoplasms; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D006801:Humans; D007938:Leukemia; D008223:Lymphoma; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data*; D009369:Neoplasms; D009664:Norway; D016016:Proportional Hazards Models; D012042:Registries; D043762:Reproductive Behavior / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D017741:Survivors / Q000706:statistics & numerical data*; D013736:Testicular Neoplasms; D055815:Young Adult