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Published on: March 6, 2018
Hypogonadism risk in men treated for childhood cancer
Patrik Romerius1, Olof Ståhl, Christian Moëll
1Departments of Pediatrics, Lund University Hospital, Lund SE-221 85, Sweden.
Context:
Pediatric cancer treatment may imply an increased risk of hypogonadism, leading to metabolic disorders and osteoporosis. Such complications are potentially preventable.
Objective:
The aim of this study was to assess diagnosis- and treatment-dependent risk of hypogonadism in male childhood cancer survivors (CCS).
Design:
Male CCS who were treated during the period 1970-2002 and who in 2004 were 18-45 yr of age were eligible.
Setting:
The study was conducted in a university hospital clinic.
Patients:
A consecutive group of CCS treated at Lund University Hospital was selected for the study, of whom 151 (38%) agreed to participate. Furthermore, 141 healthy fertile men served as controls.
Interventions:
We measured serum levels of free and total testosterone, SHBG, and LH.
Main Outcome Measures:
Odds ratios (OR) for biochemical hypogonadism, defined as total testosterone less than 10 nmol/liter and/or LH above 10 IU/liter, were calculated and related to type of cancer, treatment received, as well as testicular volume.
Results:
Hypogonadism was more commonly detected in CCS than in controls (OR, 6.7; 95% CI, 2.7, 17). The increased presence of hypogonadism was noted in the following treatment groups: brain surgery, chemotherapy (with and without radiotherapy), and testicular irradiation. Low total testicular volume (
Conclusion:
Adult male survivors of childhood cancer are at risk of hypogonadism, which should be acknowledged in the long-term follow-up of these men.
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